GH-resistance in different stages of chronic liver disease

Background/Aims: In liver cirrhosis, there is a state of acquired GHresistance,with low levels of IGF-1, IGFBP-3, and acid labile subunit(ALS) despite high serum GH levels. We aimed to characterize theGWIGF-1 axis in non-cirrhotic liver disease, and to evaluate indices ofGH-resistance.Methods: We studied 30 patients with HCV-related chronic liver disease(CLD) -14 with chronic hepatitis (CH) and 16 with cirrhosis (CIR) -,and 8 controls (CON). Basal GH, IGF-1, IGFBP-3, and ALS levels weredetermined to verify the GH: IGF-1, GH: IGFBP-3, and GH: ALS ratios.Results: See Table. IGF-1, IGFBP-3, and ALS were significantly lowerin CIR respect to CH and CON. IGF-1 and ALS were also reduced inCH respect to CON, despite similar IGFBP-3 levels. Conversely, GH wasgreatly increased in CIR compared to CH and CON. In CH, mean GHlevels were about 1.5 times superior to CON, but the difference was notsignificant due to the strong variability of values in CH patients. GH: IGF-1, GH: IGFBP-3, and GH: ALS ratios were significantly higher in CIR thanin CH and CON. The values of such ratios clearly tended to be higher alsoin CH than in CON, although without statistical significance.Conclusions: Our results show that GH/IGF-1 axis is impaired also innon-cirrhotic liver disease. GH: IGF-1, GH: IGFBP-3, and GH: ALS ratiosrepresent easy and reliable indices to determine the degree of GH-resistancein different stages of CLD.