ABSTRACT
Low bone mass has been described in patients with chronic liver disease. Reduced osteoblastic function with diminished bone formation has been suggested as the main factor responsible for osteoporosis in liver cirrhosis. Insulin like growth fact or 1, [IGF-1] has been linked to idiopathic osteoporosis, so this study aimed to evaluate the role of IGF-1 in bone remodeling in non alcoholic liver cirrhosis and to detect the presence of low or high bone turnover in those patients. Subjects and Thirty male patients with chronic non-alcoholic, liver disease and 10 age matched healthy male subjects as a control group, were included in this study. The patients were classified according to Child-Poitgh into 3 groups, A, B and C. Both patients and control were subjected to assessment of their liver function, fasting and postprandial blood glucose, blood urea and serum creatinine, serum levels of parathormone, insulin like growth factor, [IGF-1], osteocalcin and urinary levels of deoxypyridoline [DPD], in addition to abdominal ultra-sonography and upper gastrointestinal endoscopy for patients only. Patients showed significantly lower serum levels of both IGF-1 and osteocalcin, [the marker of bone formation] than controls and significantly higher levels of urinary deoxypyridinoline [DPD] [the marker of bone resorption]. The mean value of IGF I was 33.44 +/- 34.41 ng/dL in patients and 256.69 +/- 96.67 in control [p value=0.01]. The mean value of osteocalcin was 2.70 +/- 1.79 ng/ml in patient whereas it was 6.59 +/- 2.13 ng/ml in control subjects [p value<0.0l]. Urinary DPD was 13.52 +/- 650 NM DPD/mm in patients whereas, it was 6.75 +/- 1.47 in control subjects [p value<0.0l]. Definite osteoprosis has been found in all the examined patients [100%] mostly in the lumbar spines by dual x-ray absorptiometty [DXA] scan. No correlation has been found between IGF-1 level and severity of liver cirrhosis