INSULIN-LIKE-GROWTH-FACTOR BINDING PROTEIN-3 - A NOVEL BIOMARKER FOR THE ASSESSMENT OF THE SYNTHETIC CAPACITY OF HEPATOCYTES IN LIVER-CIRRHOSIS

The liver is the major source of circulating insulin-like growth facto r binding protein-3 (IGFBP-3). Because the hepatic tissue is deranged in cirrhotic patients, we measured serum IGFBP-3 concentrations by two -site immunoradiometric assay in sera from 37 cirrhotic patients with different stages of hepatic dysfunction. These were compared with IGFB P-3 levels from 11 healthy controls. Serum IGFBP-3 levels in patients with chronic liver disease were significantly lower than those of the control group (P < 0.0005). The mean percent decrease in cases of earl y liver cirrhosis, cirrhosis without, and cirrhosis with ascites were 44%, 59%, and 82% respectively, indicating that serum IGFBP-3 levels d ecrease as the severity of hepatic dysfunction increases. Moreover, th e decrease was more pronounced in cases with hyperbilirubinemia, eleva ted serum transaminases, hypoalbuminemia, and prolonged prothrombin ti me. There was a significant positive correlation between serum IGFBP-3 and serum albumin, as well as a significant negative correlation betw een serum IGFBP-3 and prothrombin time. Those results indicate the clo se correlation of IGFBP-3 levels to worsening of hepatic functions. Th e determination of serum IGFBP-3 level is a clinically useful marker f or the assessment of the synthetic capacity of hepatocytes in cirrhoti c patients and an early predictor of impending hepatic dysfunction as well.