Insulin-like Growth Factor-1 Levels Reflect Muscle and Bone Health and Determine Complications and Mortality in Decompensated Cirrhosis

Authors

• Parminder Kaur
• Nipun Verma
• Aishani Wadhawan
• Pratibha Garg
• Samonee Ralmilay
• Naveen Kalra
• Abhiman Baloji
• Pinaki Dutta
• Gaurav Sharma
• Sahaj Rathi
• Arka De
• Madhumita Premkumar
• Sunil Taneja
• Ajay Duseja
• Virendra Singh

Language

English

Publication Date

1-1-2025

Journal

Journal of Clinical and Experimental Hepatology

DOI

10.1016/j.jceh.2024.102402

PMID

39296665

PMCID

PMC11405804

PubMedCentral® Posted Date

8-12-2024

PubMedCentral® Full Text Version

Post-print

Abstract

Background: The growth hormone-insulin-like growth factor (GH-IGF-1) axis and its impairment with sarcopenia, frailty, bone health, complications, and prognosis are not well characterized in cirrhosis.

Methods: We investigated the adult decompensated cirrhosis out-patients at a tertiary care institute between 2021 and 2023 for serum GH and IGF-1 levels, and associated them with sarcopenia (CT-SMI in cm2/m2), liver frailty index (LFI), osteodystrophy (DEXA), clinical decompensations (overall, ascites, encephalopathy, infection, and bleed), and survival up to 180 days.

Results: One-hundred-seventy-two patients, 95% males, aged 46.5 years (median). logIGF-1 levels were negatively associated with sarcopenia, osteodystrophy, LFI, CTP, and MELD-Na score (P < 0.05 each). Patients with low IGF-1 levels had a higher incidence of complications (overall, ascites and encephalopathy) than those with intermediate, and high IGF-1 levels (P < 0.05 each). Both logIGF-1 (AUC: 0.686) and MELD (AUC: 0.690) could predict 180-day mortality (P < 0.05, each). Adding logIGF-1 with MELDNa further improved discriminative accuracy of MELDNa (AUC: 0.729) P < 0.001. The increase in IGF-1 on follow-up was associated with better survival and fewer complications.

Conclusion: Reduced IGF-1 levels reflect sarcopenia, frailty, and osteodystrophy in cirrhosis. Low IGF-1 are associated with severity, development of decompensations, and mortality.

Keywords

decompensated cirrhosis, sarcopenia, frailty, osteodystrophy, insulin-like growth factor 1

Published Open-Access

yes

Recommended Citation

Kaur, Parminder; Verma, Nipun; Wadhawan, Aishani; et al., "Insulin-like Growth Factor-1 Levels Reflect Muscle and Bone Health and Determine Complications and Mortality in Decompensated Cirrhosis" (2025). Faculty, Staff and Students Publications. 8291.
https://digitalcommons.library.tmc.edu/baylor_docs/8291