[Correlation between insulin-like growth factor-I [Igf-1] levels and severity of liver involvement in patients afflicted with liver cirrhosis]

Insulin-like growth factor [IGF-1] is a polypeptide that 90% of it is secreted by liver. Cirrhosis of liver is a condition accompanied with decreased level of IGF-1, and with progression of the disease the level of IGF-1 may be further decreased. In this study the relation between the degree of IGF-1 and severity of liver disease on the basis of Child-Pugh and Model for end stage liver disease[MELD] score is investigated. In this cross sectional study, 100 cirrhotic patients who were diagnosed on the basis of liver biopsy or clinical criteria, referring to the gastroenterology clinic of Imam Khomeini Hospital in Tehran, Iran during the years 2007-2008 were recruited. Laboratory investigations including IGF-1, CBC, liver Enzymes, Alkaline phosphates, serum Albumin, Creatinine, direct and total Bilirubin were carried out for all the patients. Similarly ultrasound for evaluation of ascites and endoscopy for varices were performed. 100 cirrhotic patients with male to female ratio of 63 to 37 and median age of 44.4 +/- 15 years were enrolled in the study. This study showed a mean IGF-1 level [ +/- standard deviation] equal to 92.95 +/- 91.51 ng/dl. Fourteen patients [14%] had IGF-1 within normal limits while 86 patients [86%] had abnormal IGF-1 level. In all patients the correlation coefficient between IGF-1 and MELD was -0.317 [p=0.001] and correlation coefficient between IGF-1 and Child-Pugh was equal to -0.478 [p<0.001]. The findings of this study showed that IGF-1 could be an index of severity of cirrhosis and can be used to determine the severity of the disease in patients, in particular, when liver biopsy is not possible

Insulin resistance and related factors in non-alcoholic fatty liver disease [NAFLD]: an analytic cross-sectional study

Non-alcoholic fatty liver disease [NAFLD] is characterized by fatty change of liver without inflammation. The aim of this study was to evaluate presence of clinical and metabolic components in non-diabetic patients with NAFLD and to assess the relationship between insulin resistance and these factors. In this study, a group of 50 sonographically confirmed patients with NAFLD was studied. Following an overnight fasting, blood samples were obtained to measure serum levels of Triglyceride, Cholesterol, Low Density Lipoprotein [LDL-C], High Density Lipoprotein [HDL-C], SGOT and SGPT, haemoglobin A1C, Fasting Blood Sugar [FBS] and peripheral blood insulin level. Based on homeostatic model assessment [HOMA] score, patients were divided into four quartiles. Other variables including BMI, waist and hip circumference were also measured. The mean age was 42 +/- 10.3 years [range, 22-65], 33 cases [66%] were men, and 17 cases [34%] were women. Mean insulin level was higher in females [female=15.3 +/- 6.7, males=12.9 +/- 5.7]. Variables including waist [P=0.38] and LDL-C [P =0.49] were significantly different among defined study groups. The higher the HOMA index, the lower the HDL-C level [P <0.05]. Patients with insulin resistance showed significant higher values of LDL and Waist circumference. Values of HDL were significantly lower in these patients. Body mass index, Weight, Triglyceride, Cholesterol, AST and ALT values showed no relation with insulin resistance