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Nguyen KH, Yao XH, Erickson AG, Mishra S, Nyomba BLG. Glucose intolerance in aging male IGFBP-3 transgenic mice: differential effects of human IGFBP-3 and its mutant IGFBP-3 devoid of IGF binding ability. Endocrinology 2015; 156:462-74. [PMID: 25490144 DOI: 10.1210/en.2014-1271] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
We have reported a reduction of insulin secretion and glucose intolerance in young mice overexpressing human IGFBP-3 (phosphoglycerate kinase [PGK]BP3) or its mutant Gly56/Gly80/Gly81-IGFBP-3 (PGKmutBP3) under the PGK promoter. Here, we investigated changes in glucose and lipid homeostasis with age in PGKBP3 and PGKmutBP3 mice compared with wild-type mice. Body weight, glucose tolerance, insulin tolerance, visceral fat, interscapular brown adipose tissue (BAT), serum lipids, and pancreas histology were examined at age 3, 6, and 12 months. Murine IGFBP-3 was similar in all mouse genotypes and decreased with age in parallel with total IGF-1. Visceral fat and BAT masses increased in PGKmutBP3 mice, but not in PGKBP3 mice. Glucose tolerance was impaired in both PGKBP3 and PGKmutBP3 mice. However, PGKBP3 mice had increased expression of uncoupling protein-1 in BAT and reduced adiposity, and continued to have smaller pancreatic β-cell mass and reduced insulin secretion through age 12 months. In contrast, PGKmutBP3 mice developed insulin resistance with age in association with pancreatic β-cell hyperplasia, impaired expression of uncoupling protein-1 in BAT, and increased adiposity. In addition, both PGKBP3 and PGKmutBP3 mice had elevated glycerol in the circulation, but only PGKBP3 mice had elevated free fatty acids and only PGKmutBP3 mice had elevated triglycerides. Estimated free IGF-1 did not increase with age in transgenic mice, as it did in wild-type mice. Thus, overexpression of human IGFBP-3 or its mutant devoid of IGF binding ability leads to glucose intolerance with, however, different effects on insulin secretion, insulin sensitivity, and lipid homeostasis in aging mice.
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Affiliation(s)
- K Hoa Nguyen
- Department of Internal Medicine, University of Manitoba, Winnipeg, Canada R3E3P4
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102
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Tsilidis KK, Allen NE, Appleby PN, Rohrmann S, Nöthlings U, Arriola L, Gunter MJ, Chajes V, Rinaldi S, Romieu I, Murphy N, Riboli E, Tzoulaki I, Kaaks R, Lukanova A, Boeing H, Pischon T, Dahm CC, Overvad K, Quirós JR, Fonseca-Nunes A, Molina-Montes E, Gavrila Chervase D, Ardanaz E, Khaw KT, Wareham NJ, Roswall N, Tjønneland A, Lagiou P, Trichopoulos D, Trichopoulou A, Palli D, Pala V, Tumino R, Vineis P, Bueno-de-Mesquita HB, Malm J, Orho-Melander M, Johansson M, Stattin P, Travis RC, Key TJ. Diabetes mellitus and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition. Int J Cancer 2015; 136:372-81. [PMID: 24862312 DOI: 10.1002/ijc.28989] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 03/17/2014] [Indexed: 01/23/2023]
Abstract
The current epidemiologic evidence suggests that men with type 2 diabetes mellitus may be at lower risk of developing prostate cancer, but little is known about its association with stage and grade of the disease. The association between self-reported diabetes mellitus at recruitment and risk of prostate cancer was examined in the European Prospective Investigation into Cancer and Nutrition (EPIC). Among 139,131 eligible men, 4,531 were diagnosed with prostate cancer over an average follow-up of 12 years. Multivariable hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards models stratified by EPIC-participating center and age at recruitment, and adjusted for education, smoking status, body mass index, waist circumference, and physical activity. In a subset of men without prostate cancer, the cross-sectional association between circulating concentrations of androgens and insulin-like growth factor proteins with diabetes status was also investigated using linear regression models. Compared to men with no diabetes, men with diabetes had a 26% lower risk of prostate cancer (HR, 0.74; 95% CI, 0.63-0.86). There was no evidence that the association differed by stage (p-heterogeneity, 0.19) or grade (p-heterogeneity, 0.48) of the disease, although the numbers were small in some disease subgroups. In a subset of 626 men with hormone measurements, circulating concentrations of androstenedione, total testosterone and insulin-like growth factor binding protein-three were lower in men with diabetes compared to men without diabetes. This large European study has confirmed an inverse association between self-reported diabetes mellitus and subsequent risk of prostate cancer.
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Affiliation(s)
- Konstantinos K Tsilidis
- Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom; Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
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Abstract
We propose that dietary carbohydrate restriction, particularly ketogenic diets, may provide benefit as a therapeutic or preventive strategy in cancer, alone or as an adjunct to pharmacology. The argument derives from several points of evidence: There is a close association between cancer and both diabetes and obesity. Extensive evidence shows that low carbohydrate diets are the most effective dietary treatment of Type 2 diabetes and dietary adjunct in Type 1. Such diets also target all the markers of metabolic syndrome. Finally, de facto reduction in carbohydrate likely contributes to total dietary restriction, which is effective in the prevention and treatment of cancer. The idea is consistent with recent interest in treating cancer with drugs that target diabetes. To move forward, we must understand obesity and diabetes as response to a hyperglycemic state rather than simply a cause of downstream effects.
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Affiliation(s)
- Eugene J Fine
- a 1 Department of Nuclear Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
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104
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Lewitt MS, Dent MS, Hall K. The Insulin-Like Growth Factor System in Obesity, Insulin Resistance and Type 2 Diabetes Mellitus. J Clin Med 2014; 3:1561-74. [PMID: 26237614 PMCID: PMC4470198 DOI: 10.3390/jcm3041561] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 11/21/2014] [Accepted: 12/05/2014] [Indexed: 12/11/2022] Open
Abstract
The insulin-like growth factor (IGF) system, acting in concert with other hormone axes, is important in normal metabolism. In obesity, the hyperinsulinaemia that accompanies peripheral insulin resistance leads to reduced growth hormone (GH) secretion, while total IGF-I levels are relatively unchanged due to increased hepatic GH sensitivity. IGF-binding protein (IGFBP)-1 levels are suppressed in relation to the increase in insulin levels in obesity and low levels predict the development of type 2 diabetes several years later. Visceral adiposity and hepatic steatosis, along with a chronic inflammation, contribute to the IGF system phenotype in individuals with metabolic syndrome and type 2 diabetes mellitus, including changes in the normal inverse relationship between IGFBP-1 and insulin, with IGFBP-1 concentrations that are inappropriately normal or elevated. The IGF system is implicated in the vascular and other complications of these disorders and is therefore a potential therapeutic target.
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Affiliation(s)
- Moira S Lewitt
- School of Health Nursing & Midwifery, the University of the West of Scotland, Paisley PA1 2BE, UK.
| | - Mairi S Dent
- School of Health Nursing & Midwifery, the University of the West of Scotland, Paisley PA1 2BE, UK.
| | - Kerstin Hall
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm SE171 76, Sweden.
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Almgren M, Atkinson RL, Hilding A, He J, Brismar K, Schalling M, Ostenson CG, Lavebratt C. Human adenovirus-36 is uncommon in type 2 diabetes and is associated with increased insulin sensitivity in adults in Sweden. Ann Med 2014; 46:539-46. [PMID: 25045929 DOI: 10.3109/07853890.2014.935469] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Human adenovirus-36 (Adv36) increases adiposity, but also upregulates distal insulin signaling in vitro in human adipose and muscle tissue and in vivo in the rodent independently of adiposity. Accordingly, healthy adults and children with antibodies against Adv36 had increased insulin sensitivity and reduced hepatic lipid accumulation. We hypothesized that Adv36 infection would be less frequent in individuals with type 2 diabetes or impaired glycemic control. METHODS Presence of antibodies against Adv36 was analyzed for association to type 2 diabetes or impaired glycemic control in a two-wave population-based sample of well-characterized adults (n = 1734). Indices of impaired glycemic control included oral glucose tolerance, and circulating fasting levels of glucose, insulin, and insulin-like growth factor binding protein-1 (IGFBP-1). RESULTS Adv36 seropositivity was more common in those with normal glucose tolerance (NGT) than in those with diabetes (females: OR 17.2, 95% CI 4.0-74.3; males: OR 3.5, 95% CI 1.8-6.7). Also, females with NGT had higher frequency of Adv36 seropositivity than females with prediabetes (impaired glucose tolerance and/or impaired fasting glucose; OR 1.8, 95% CI 1.1-3.1). Within the female prediabetes group Adv36 seropositivity was associated with higher insulin sensitivity reflected by reduced HOMA-IR and increased IGFBP-1. CONCLUSION Adv36 infection is associated with lower occurrence of type 2 diabetes and better insulin sensitivity in adults, particularly among females.
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Affiliation(s)
- Malin Almgren
- Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm , Sweden
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106
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MicroRNA regulation of cancer metabolism: role in tumour suppression. Mitochondrion 2014; 19 Pt A:29-38. [DOI: 10.1016/j.mito.2014.06.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Revised: 06/16/2014] [Accepted: 06/17/2014] [Indexed: 12/18/2022]
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Beasley JM, Wedick NM, Rajpathak SN, Xue X, Holmes MD, Gunter MJ, Wylie-Rosett J, Rohan TE, Pollak M, Kaplan RC, Hu FB, Sun Q, Strickler HD. Circulating IGF-axis protein levels and their relation with levels of plasma adipocytokines and macronutrient consumption in women. Growth Horm IGF Res 2014; 24:142-9. [PMID: 24888819 PMCID: PMC4190839 DOI: 10.1016/j.ghir.2014.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 04/28/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Circulating free insulin-like growth factor (IGF)-I and its binding proteins, most notably, IGFBP-1 and IGFBP-2, have been prospectively associated with incident type 2 diabetes in women. However, little is known regarding the factors that may influence these IGF-axis protein levels. The aim is to study the relation of IGF-axis protein levels with adipcytokines, macronutrient consumption, and other factors related to diabetes. DESIGN Fasting plasma from 558 controls enrolled in a nested case-control study within the Nurses' Health Study of incident type 2 diabetes in women was tested for: IGF-axis proteins (free and total IGF-I, IGFBP-1, IGFBP-2, IGFBP-3), adipocytokines (leptin, adiponectin, resistin), soluble leptin receptor (sOB-R), inflammatory factors (IL-18 and C-reactive protein (CRP)), insulin, and glycated hemoglobin (HbA1C). RESULTS In multivariate models, each 1% increase in sOB-R (mean 34.9ng/mL, standard deviation (SD) ±11.3) was associated with -0.20% total IGF-I (P=0.0003) and -0.42% free IGF-I (P=0.002), as well as 0.73% higher IGFBP-1 (P<0.0001) and 0.27% IGFBP-2 (P=0.003). For example, a one SD change from the mean sOB-R level was associated with 11% lower free IGF-I. Insulin levels (mean 6.8μU/mL±5.3) were inversely and adiponectin (mean 18.3μg/mL±7.4) positively associated with IGFBP-1 and IGFBP-2 (all P<0.01). Consumption of dairy protein, monounsaturated fats, and saturated fats, was also correlated with IGF-axis protein levels (all P<0.05). CONCLUSIONS Several molecular factors and macronutrients were independently associated with plasma IGF-axis protein levels. Which of these, if any, reflect biologic relationships that can be intervened upon to influence IGF-axis protein concentrations warrants further investigation.
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Affiliation(s)
- Jeannette M Beasley
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States.
| | - Nicole M Wedick
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Swapnil N Rajpathak
- US Outcomes Research, US Medical Affairs, Merck & Co., North Wales, PA, United States
| | - Xiaonan Xue
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Michelle D Holmes
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Marc J Gunter
- Department of Epidemiology Biostatistics, School of Public Health, Imperial College, London, UK
| | - Judith Wylie-Rosett
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Michael Pollak
- Department of Medicine and Oncology, Cancer Prevention Research Unit, Lady Davis Research Institute of Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Frank B Hu
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Qi Sun
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States
| | - Howard D Strickler
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
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108
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Thankamony A, Capalbo D, Marcovecchio ML, Sleigh A, Jørgensen SW, Hill NR, Mooslehner K, Yeo GSH, Bluck L, Juul A, Vaag A, Dunger DB. Low circulating levels of IGF-1 in healthy adults are associated with reduced β-cell function, increased intramyocellular lipid, and enhanced fat utilization during fasting. J Clin Endocrinol Metab 2014; 99:2198-207. [PMID: 24617714 PMCID: PMC4413372 DOI: 10.1210/jc.2013-4542] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Low serum IGF-1 levels have been linked to increased risk for development of type 2 diabetes. However, the physiological role of IGF-1 in glucose metabolism is not well characterized. OBJECTIVE Our objective was to explore glucose and lipid metabolism associated with variations in serum IGF-1 levels. DESIGN, SETTING AND PARTICIPANTS IGF-1 levels were measured in healthy, nonobese male volunteers aged 18 to 50 years from a biobank (n = 275) to select 24 subjects (age 34.8 ± 8.9 years), 12 each in the lowest (low-IGF) and highest (high-IGF) quartiles of age-specific IGF-1 SD scores. Evaluations were undertaken after a 24-hour fast and included glucose and glycerol turnover rates using tracers, iv glucose tolerance test to estimate peripheral insulin sensitivity (IS) and acute insulin and C-peptide responses (indices of insulin secretion), magnetic resonance spectroscopy to measure intramyocellular lipids (IMCLs), calorimetry, and gene expression studies in a muscle biopsy. MAIN OUTCOME MEASURES Acute insulin and C-peptide responses, IS, and glucose and glycerol rate of appearance (Ra) were evaluated. RESULTS Fasting insulin and C-peptide levels and glucose Ra were reduced (all P < .05) in low-IGF compared with high-IGF subjects, indicating increased hepatic IS. Acute insulin and C-peptide responses were lower (both P < .05), but similar peripheral IS resulted in reduced insulin secretion adjusted for IS in low-IGF subjects (P = 0.044). Low-IGF subjects had higher overnight levels of free fatty acids (P = .028) and β-hydroxybutyrate (P = .014), increased accumulation of IMCLs in tibialis anterior muscle (P = .008), and a tendency for elevated fat oxidation rates (P = .058); however, glycerol Ra values were similar. Gene expression of the fatty acid metabolism pathway (P = .0014) was upregulated, whereas the GLUT1 gene was downregulated (P = .005) in the skeletal muscle in low-IGF subjects. CONCLUSIONS These data suggest that serum IGF-1 levels could be an important marker of β-cell function and glucose as well as lipid metabolic responses during fasting.
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Affiliation(s)
- Ajay Thankamony
- Department of Paediatrics (A.T., D.C., M.L.M., K.M., D.B.D.) and Wolfson Brain Imaging Centre (A.S.), University of Cambridge, CB2 0QQ, Cambridge, United Kingdom; Medical Research Council (MRC) Metabolic Diseases Unit (G.S.H.Y.), University of Cambridge Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom; MRC Human Nutrition Research of Growth and Reproduction (L.B.); and National Institute for Health Research Cambridge Comprehensive Biomedical Research Centre (D.B.D.), Cambridge, CB1 9NL, United Kingdom; Department of Endocrinology (S.W.J., A.V.), Rigshospitalet and Copenhagen University, DK-2100 Denmark; Oxford Centre for Diabetes, Endocrinology, and Metabolism (N.R.H.), University of Oxford, Oxford, OX3 7LE, United Kingdom; and Department of Growth and Reproduction (A.J.), Rigshospitalet, Faculty of Health and Medical Sciences, DK-2100 Denmark
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First Trimester Aneuploidy Screening Markers in Women with Pre-Gestational Diabetes Mellitus. J Clin Med 2014; 3:480-90. [PMID: 26237386 PMCID: PMC4449679 DOI: 10.3390/jcm3020480] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 03/18/2014] [Accepted: 03/19/2014] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To investigate whether maternal serum pregnancy associated plasma protein-A (PAPP-A), total β human chorionic gonadotropin (hCG) levels and nuchal translucency (NT) measurements differ in women with pre-gestational diabetes mellitus (PGDM) compared to non-diabetic controls and to assess whether correction factors are needed for diabetic women in calculation of aneuploidy risks. STUDY DESIGN We performed a retrospective study of all women who underwent first trimester aneuploidy screening (11 + 0 to 13 + 6 weeks) from 2005 to 2011. The primary study outcome was the difference in PAPP-A, β-hCG and NT multiples of median between women with PGDM and non-diabetic women. RESULTS Of 6741 eligible patients, 103 patients with PGDM were using insulin and 4 patients were using oral hypoglycemic agents; the latter were excluded due to small number. There was 12% reduction of median PAPP-A (p = 0.001) and 18% reduction of median hCG (p = 0.006) in women with PGDM receiving insulin. There was no difference in NT. CONCLUSIONS In women with PGDM receiving insulin, PAPP-A and β-hCG levels are significantly lower compared to non-diabetic women. This suggests that when calculating risks for aneuploidy, correction factors should be considered to adjust PAPP-A and β-hCG concentrations to those seen in non-diabetic women.
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110
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Dong X, Chang G, Ji XF, Tao DB, Wang YX. The relationship between serum insulin-like growth factor I levels and ischemic stroke risk. PLoS One 2014; 9:e94845. [PMID: 24728374 PMCID: PMC3984250 DOI: 10.1371/journal.pone.0094845] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 03/20/2014] [Indexed: 12/17/2022] Open
Abstract
Objective The aim of the study was to assess the relationship between insulin-like growth factor I (IGF-I) serum levels and acute ischemic stroke (AIS) in a Chinese population. Methods All consecutive patients with first-ever AIS from August 1, 2011 to July 31, 2013 were recruited to participate in the study. The control group comprised 200 subjects matched for age, gender, and conventional vascular risk factors. IGF-I serum levels were determined by chemiluminescence immunoassay. The National Institutes of Health Stroke Scale (NIHSS) score was assessed on admission blinded to serum IGF-I levels. Results The median serum IGF-1 levels were significantly (P = 0.011) lower in AIS patients (129; IQR, 109–153 ng/mL) compared with control cases (140; IQR, 125–159 ng/mL). We found that an increased risk of AIS was associated with IGF-I levels ≤135 ng/mL (unadjusted OR: 4.17; 95% CI: 2.52–6.89; P = 0.000). This relationship was confirmed in the dose-response model. In multivariate analysis, there was still an increased risk of AIS associated with IGF-I levels ≤135 ng/mL (OR: 2.16; 95% CI:1.33–3.52; P = 0.002) after adjusting for possible confounders. Conclusion Lower IGF-I levels are significantly related to risk of stroke, independent from other traditional and emerging risk factors, suggesting that they may play a role in the pathogenesis of AIS. Thus, strokes were more likely to occur in patients with low serum IGF-I levels in the Chinese population; further, post-ischemic IGF-I therapy may be beneficial for stroke.
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Affiliation(s)
- Xiang Dong
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, P.R. China
- * E-mail:
| | - Geng Chang
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, P.R. China
| | - Xiao-Fei Ji
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, P.R. China
| | - Ding-Bo Tao
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, P.R. China
| | - Ying-Xin Wang
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, P.R. China
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Shah N, Rice T, Tracy D, Rohan T, Bůžková P, Newman A, Kaplan RC. Sleep and insulin-like growth factors in the Cardiovascular Health Study. J Clin Sleep Med 2013; 9:1245-51. [PMID: 24340285 PMCID: PMC3836334 DOI: 10.5664/jcsm.3260] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
STUDY OBJECTIVES Sleep and sleep disordered breathing (obstructive sleep apnea [OSA]) are known to affect the growth hormone/insulin-like growth factor (GH/IGF) axis. There are few relevant population studies in this area, particularly in the elderly. We conducted this study to investigate the relationship between sleep (architecture and OSA) and circulating IGF-I (insulin-like growth factor-1), IGFBP-1 (insulin-like growth factor binding protein-1), and IGFBP-3 (insulin-like growth factor binding protein-3) levels in an elderly population. DESIGN SETTING Cross-sectional analysis of participants from the year 9 visit of the Cardiovascular Health Study (CHS) who were enrolled in the Sleep Heart Health Study (SHHS). PATIENTS OR PARTICIPANTS 1,233 elderly participants from the CHS and SHHS. MEASUREMENTS AND RESULTS The mean age of males (n = 526) and females (n = 697) was 77 years. The mean value of IGF-I (ng/mL) in males was 112.4 vs. 97.1 in females (p < 0.01). Mean IGFBP-1 and IGFBP-3 levels were higher in females than males (p < 0.01). As expected, slow wave sleep was better preserved in females compared to males (22% total sleep time vs. 9% total sleep time, p < 0.01). Furthermore, as expected, OSA (apneahypopnea index [AHI] ≥ 5/h) was more prevalent in males compared to females (60% vs. 46%, p < 0.01). Multivariable linear regression was used to determine the relationship between objective sleep parameters and circulating IGF-I, IGFBP-1, and IGFBP-3 levels, with adjustment for age, sex, race, BMI, diabetes, estrogen use, progestin use, and physical activity. We did not detect a significant association between slow wave sleep (SWS) (per 5 min) and IGF-I, IGFBP-1, and IGFBP-3 levels (ng/mL). We found no significant linear association between OSA (AHI ≥ 5/h) and IGF-I, IGFBP-1, and IGFBP-3 levels. Gender-stratification of the entire cohort did not alter these findings. Sensitivity analyses excluding diabetics revealed that moderate OSA (AHI ≥ 5 and < 15) is inversely associated with IGFBP-3 levels in women. Conclusions The relationship between SWS and GH/IGF system is not significant in the elderly. Furthermore, OSA does not appear to adversely influence the GH/IGF axis, as reported in younger individuals. Whether our study findings are due to diminished GH/IGF-I axis activity in elderly needs further investigation by replication in other large population based elderly cohorts.
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Affiliation(s)
- Neomi Shah
- Albert Einstein College of Medicine, Bronx, NY
- Montefiore Medical Center, Bronx, NY
| | - Tom Rice
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | | | | | - Anne Newman
- University of Pittsburgh School of Medicine, Pittsburgh, PA
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Hjortebjerg R, Flyvbjerg A, Frystyk J. Insulin growth factor binding proteins as therapeutic targets in type 2 diabetes. Expert Opin Ther Targets 2013; 18:209-24. [PMID: 24261835 DOI: 10.1517/14728222.2014.858698] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION The signaling pathways of the insulin-like growth factors (IGFs) have been implicated in the aetiology of type 2 diabetes (T2D) and a number of therapeutic modalities aiming at the IGF-axis have been considered. Administration of IGF-I has been reported to improve insulin sensitivity in healthy subjects and patients with T2D. In recent years, the IGF binding proteins (IGFBPs) have also been associated with metabolic disorders, prompting the idea that IGFBPs play important roles in the pathogenesis of T2D. Thus, by virtue of their role in the regulation of IGF effects, the IGFBPs have emerged as potential biomarkers and therapeutic targets in metabolic syndromes and T2D. AREAS COVERED The article provides an overview on recent findings in clinical and experimental IGFBP-research and addresses the studies that have investigated the potentials of the IGFBPs as therapeutic targets in T2D. EXPERT OPINION There is plenty of therapeutic promise within the IGF system, but further understanding of the IGFs in T2D is necessary to avoid off-target effects. Strong evidence supports the use of IGFBPs as therapeutic targets in the treatment of T2D, and it is not difficult to foresee the use of IGFBPs as part of a combination therapy alongside other anti-diabetic drugs.
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Affiliation(s)
- Rikke Hjortebjerg
- Aarhus University, Department of Clinical Medicine, Medical Research Laboratory, Faculty of Health , DK-8000 Aarhus C , Denmark
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Abstract
The liver is known to be involved in the natural history of the ongoing epidemics of type 2 diabetes mellitus and cardiovascular disease. In particular, the liver has a role in increased glucose production and dysregulated lipoprotein metabolism, conditions that are often found in patients with nonalcoholic fatty liver disease. Additionally, several proteins that are exclusively or predominantly secreted from the liver are now known to directly affect glucose and lipid metabolism. In analogy to the functional proteins released from adipose tissue and skeletal muscle-adipokines and myokines-these liver-derived proteins are known as hepatokines. The first hepatokine that has been proven to have a major pathogenetic role in metabolic diseases is α2-HS-glycoprotein (fetuin-A). Production of this glycoprotein is increased in steatotic and inflamed liver, but not in expanded and dysregulated adipose tissue. Thus, research into this molecule and other hepatokines is expected to aid in differentiating between the contribution of liver and those of skeletal muscle and adipose tissue, to the pathogenesis of type 2 diabetes mellitus and cardiovascular disease.
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Affiliation(s)
- Norbert Stefan
- Department of Internal Medicine, Division of Endocrinology, Diabetology, Vascular Medicine, Nephrology and Clinical Chemistry, University Hospital of Tübingen, Otfried-Müller-Straße 10, 72076 Tübingen, Germany. norbert.stefan@ med.uni-tuebingen.de
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Effect of Ghrelin on Hepatic IGF-Binding Protein-1 Production. ISRN OBESITY 2013; 2013:751401. [PMID: 24555152 PMCID: PMC3901966 DOI: 10.1155/2013/751401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 01/01/2013] [Indexed: 11/18/2022]
Abstract
Ghrelin plays key roles in energy homeostasis by central and peripheral actions that include effects on insulin signalling pathways in liver. Insulin is an important inhibitor of production by hepatocytes of insulin-like growth factor-binding protein-1 (IGFBP-1) which has an endocrine role to inhibit IGF availability. The effects of ghrelin, insulin, an AMPK activator, and an AMPK inhibitor on IGFBP-1 secretion were studied in H4-II-E rat liver cells. Ghrelin (100 nM) blocked the inhibitory effect of a maximally effective concentration of insulin (10 ng/mL) on IGFBP-1 secretion during a 5 h incubation period (P < 0.001) in the absence and presence of an AMPK inhibitor. Ghrelin, alone, had no effect on IGFBP-1 production, but enhanced secretion independently of insulin under conditions of AMPK activation (P < 0.001). In conclusion, IGFBP-1 is identified as a novel target of ghrelin action in liver that may contribute to its metabolic effects in obesity.
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