Document Detail


The IGF system after insertion of a transjugular intrahepatic porto-systemic shunt in patients with liver cirrhosis.
MedLine Citation:
PMID:  19336524     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Insertion of a transjugular intrahepatic porto-systemic shunt (TIPS) into patients with liver cirrhosis usually induces a gain in body cell mass. Changes in the IGF system in favor of anabolism may be involved. We, therefore measured blood concentrations of the components of the IGF system in cirrhosis patients before and after elective TIPS. DESIGN AND METHODS: The study comprised 17 patients and 11 healthy controls. Patients were examined before and 1, 4, 12, and 52 weeks after TIPS. Biochemical analyses of the IGF system were compared with changes in body composition (bioimpedance analysis), glucose and insulin, and metabolic liver function (galactose elimination capacity). RESULTS: After TIPS, body cell mass rose by 3.2 kg (95% confidence interval (CI): 1.0-5.5) at 52 weeks, in correlation with baseline liver function (r(2)=0.22; P=0.03). Peripheral blood concentrations of total IGF1 and 2, bioactive IGF1, and the IGF-binding proteins (IGFBP-1, -2, and -3) remained unchanged throughout the study period. There was no change in fasting glucose, whereas fasting insulin rose by 40% (CI: 11-77%) and glucagon by 58% (CI: 11-132%) from baseline to 52 weeks after TIPS. CONCLUSION: Our data confirm that TIPS was associated with an increase in body cell mass in patients with liver cirrhosis, but without any change in the circulating IGF system. Thus, the results do not support the notion that effects on the circulating IGF system are involved in the anabolic effects of TIPS insertion.
Authors:
Peter Holland-Fischer; Hendrik Vilstrup; Jan Frystyk; Dennis Tønner Nielsen; Allan Flyvbjerg; Henning Grønbaek
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-03-31
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  160     ISSN:  1479-683X     ISO Abbreviation:  Eur. J. Endocrinol.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-12     Completed Date:  2009-06-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  957-63     Citation Subset:  IM    
Affiliation:
Department of Medicine V (Hepatology and Gastroenterology), Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus C, Denmark. phf@svf.au.dk
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Glucose / analysis
Body Composition
Dietary Proteins / metabolism
Energy Intake
Female
Humans
Insulin-Like Growth Factor Binding Proteins / blood*
Liver / metabolism
Liver Cirrhosis / blood,  metabolism*,  surgery*
Male
Middle Aged
Portasystemic Shunt, Transjugular Intrahepatic / adverse effects*
Somatomedins / metabolism*
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Dietary Proteins; 0/Insulin-Like Growth Factor Binding Proteins; 0/Somatomedins

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