Serum Vascular Endothelial Growth Factor and Insulin-Like Growth Factor-1 in Liver Cirrhosis: Relation to Disease Severity and Development of Portal Hypertension

Document Type : Original Article

Authors

1 Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University

2 Biochemistry Department, Faculty of Medicine, Assiut University

3 Biochemistry Department, Faculty of Medicine, Sohag university

Abstract

Aims:To assess the level of Vascular Endothelial Growth factor (VEGF) and Insulin-like Growth Factor -1(IGF-1) in serum of patients with liver cirrhosis and correlate
them to Child-Pugh classes and to correlate Vascular Endothelial Growth factor to
Color Doppler indices of portal and splenic veins.Patients and Methods: fifty-five
patients with liver cirrhosis and ten healthy controls were chosen. They underwent a
thorough history, physical examination, abdominal ultrasonography and Color
Doppler examination of portal vein and portal pressure. The serum levels of VEGF
and IGF-1 were measured using commercial ELISA kits.Results: The median (and
interquartile range) of serum VEGF was significantly lower in patients than controls
(120ng/L [110-330] and 341ng/L [258-990] respectively, p value < 0.001), also there
was a significant decrease in IGF-1 in patients than controls (34ng/ml [23-48.3] and
147.2ng/ml[125.8-220.2] respectively, p value < 0.000). There was a significant
difference in median serum VEGF and IGF-1 levels among the different Child-Pugh
classes (class A: 110ng/L [109-120], class B: 120.5ng/L [120-462], and class C
126.5ng/L [110-286], p value < 0.005 for VEGF and class A: 48.3ng/ml [42.8-49.4],
class B: 23ng/ml [20.8-34], and class C 36.6ng/ml [32.3-49.7], p value < 0.000 for
IGF-1). A significant positive correlation was noted between serum VEGF and
maximum portal vein velocity and maximum splenic vein velocity (Spearman's r =
0.780, r = 0.693 respectively, p value < 0.000). A significant negative correlation was
noted between serum VEGF and the hepatic artery resistance index and splenic hilar
diameter (Spearman's r = -0.462, r = - 0.695 respectively, p value < 0.000).
Significant positive correlation was found between IGF-1 serum levels and serum
albumin (Spearman's r = 0.310, p value = 0.012). No correlation was found between
VEGF serum levels and serum albumin.Conclusion: Circulating VEGF level in
patients with liver cirrhosis could not serve as an indicator of the progression of liver
cirrhosis but rather it may reflect developmentof complication in the form of portal
hypertension. Also, liver cirrhosis is associated with changes in serum IGF-1 that is
related to the degree of liver dysfunction.

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