Estimation of insulin-like growth factor-1 as a biomarker in nonalcoholic fatty liver disease in patients with metabolic syndrome

BackgroundNonalcoholic fatty liver disease (NAFLD) is becoming the most common chronic liver pathology especially in developed countries, ranging from simple liver steatosis to nonalcoholic steatohepatitis. Patients with NAFLD having metabolic syndrome have abnormal liver enzymes that positively correlate with the number of metabolic syndrome components. Abdominal ultrasonography is frequently used in epidemiological studies to detect NAFLD. Insulin-like growth factor (IGF-1) is the critical hormone in the pathophysiology of metabolic syndrome and is associated with cardiovascular disease, diabetes mellitus, and abnormal lipid metabolism.Participants and methodsA total of 70 patients, 50 patients having NAFLD by ultrasonography and 20 individuals as control, matched for age, sex, BMI, and waist circumference were clinically assessed. Abdominal ultrasonography was done, and laboratory investigations included estimation of IGF-1, homeostasis model assessment insulin resistance (HOMA IR), blood glucose, alanine aminotransferase (ALT), and lipid profile.ResultsIGF-1 is highly significantly lower in the patient group than in the control group (P < 0.01). Moreover, there was a highly significant correlation between the low concentration of IGF-1 and BMI, waist circumference, fasting blood glucose, homeostasis model assessment insulin resistance, ALT, and serum cholesterol in the patient group (P < 0.01) and insignificant correlation with serum triglyceride and serum insulin (P > 0.05).ConclusionIGF-1 is lower in patients with NAFLD, especially those with elevated ALT, and is associated with increased number of metabolic syndrome components. Improving lifestyle, by decreasing body weight and controlling blood sugar using insulin sensitizers like pioglitazone, GLP-1 inhibitors like liraglutide, and SLGT2 inhibitors, and improving lipid profile are associated with good prognosis of NAFLD.