Association between Growth Hormone and Insulin-like Growth Factor-1 (IGF-1) Levels, Liver Function and Short-Term Survival of Paediatric Liver Recipients

The growth hormone/insulin-like growth factor-1 (IGF-1) system is an important humoral mediator of liver function with an inherent potential for assessing liver condition and survival prognosis following liver transplantation (LT).

Aim. Analysis of associations between growth hormone and IGF-1 levels in blood and markers of liver function and post-LT survival in children.

Materials and methods. We examined 143 children with end-stage liver disease (ESLD) aged 3 to 73 (median 8) months after related LT. The growth hormone and IGF-1 concentrations in plasma were evaluated in ELISA assays.

Results. In children with ESLD, concentrations of growth hormone and IGF-1 were significantly higher and lower, respectively, compared to healthy children of the same age (p <0.01). Compared to the level of growth hormone, the level of IGF-1 was related to the diagnosis (r = 0.30, p = 0.004). IGF-1 shows lower concentrations in biliary atresia and other cholestatic liver diseases compared to non-cholestatic aetiologies (4.7 (0.0—23.4) and 42.3 (9.0—55.0) ng/mL, respectively, p = 0.03). The growth hormone level directly correlated with the severity of liver fibrosis (r = 0.47, p = 0.02). It was higher in fibrosis grade 4 (F4) than in F1—F3 (4.7 (2.1—7.2) and 2.1 (1.2—3.3) ng/mL, respectively, p = 0.02). Hormone levels normalised after LT. Unlike IGF-1, the level of growth hormone correlated one month after LT with the 6-months survival rate of recipients (r = 0.36, p = 0.01) being significantly lower in survivors compared to patients who did not survive this period (1.3 (0.5—1.9) and 2.9 (1.6—12.4) ng/mL, respectively, p = 0.02).

Conclusion. Blood levels of growth hormone and IGF-1 were shown to differ significantly between ESLD and healthy children, correlating with fibrosis severity and disease aetiology. The level of growth hormone in the blood of LT recipients associates with a short-term survival rate.

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