Decreased serum insulin-like growth factor (IGF-I) levels have been sh
own in malnutrition and liver diseases. To analyse which of them is th
e main cause of GH-IGF-I axis alterations, serum levels of growth horm
one (GH), growth-hormone releasing factor (GHRH), IGF-I and its bindin
g protein IGFBP-3 were measured in 85 hospitalized alcoholics (51 with
out cirrhosis, 15 with compensated cirrhosis and 19 with cirrhosis wit
h ascites) and in 25 healthy controls. Liver function tests and object
ive nutritional assessment were also performed. Serum IGF-I and IGFBP-
3 levels were lower in alcoholics, particularly in those with liver ci
rrhosis. Serum GH was raised in cirrhotics with ascites but GHRH level
s were not significantly altered. Although these patients were frequen
tly malnourished there was no relationship between data derived from G
H-IGF-I axis and nutritional parameters. However, there was a signific
ant positive correlation between serum GH concentrations and impaired
liver function and a significant negative correlation between serum IG
F-I and IGFBP-3 and impaired liver function. This suggests that, in th
is population, serum IGF-I and IGFBP-3 levels reflect liver dysfunctio
n rather than malnutrition.