Advanced glycosylation end products (AGEs), insulin-like growth factor-1 (IGF-1) and IGF-binding protein-3 (IGFBP-3) in patients with Type 2 diabetesmellitus
Me. Garay-sevilla et al., Advanced glycosylation end products (AGEs), insulin-like growth factor-1 (IGF-1) and IGF-binding protein-3 (IGFBP-3) in patients with Type 2 diabetesmellitus, DIABET M R, 16(2), 2000, pp. 106-113
Background Advanced glycosylation end product (AGE) formation is a major me
chanism for the development of complications in diabetes, and the possible
roles of insulin-like growth factor 1 (IGF-1) and IGF binding protein 3 (IG
FBP-3) are not clearly established.
Methods We examined the associations of AGEs, free IGF-1 and IGFBP-3 in Typ
e 2 diabetes mellitus (DM) patients under diverse conditions. In a cross-se
ctional design we studied 110 subjects (67 women and 43 men): nondiabetic c
ontrols in group 1, (n = 15) and diabetes patients as follows: group 2, wit
hout complications (n = 25); group 3, with chronic complications (n = 25);
group 4, with acute or chronic infections (n = 24); group 5, hospitalized f
or reasons unrelated to diabetes (n = 9); group 6, with end-stage renal dis
ease (ESRD) (n = 12). AGEs were determined by a spectrofluorometric method
(HPLC). Insulin and IGFBP-3 were measured by RIA and free IGF-1 with an IRM
A method.
Results AGEs were 13-fold higher in patients with ESRD (p < 0.001), and low
er in healthy individuals. Free IGF-1 was lower in the patients with compli
cations (p = 0.017), with infections (p = 0.006) and hospitalized (p = 0.04
). IGFBP-3 was higher in hospitalized patients (p = 0.017). AGEs were assoc
iated with free IGF-1 (r = 0.41, p = 0.04) in the group with complications,
and with HbA(1c) (r = - 0.90, p = 0.002) in hospitalized patients. In the
total group, free IGF-1 (r = -0.25, p = 0.008), and IGFBP-3 (r = -0.22, p =
0.021) were associated with HbA(1c).
Conclusion We concluded that AGEs were markedly increased in diabetic patie
nts with ESRD, IGF-1 was decreased in patients with infections and hospital
ized, and was negatively associated with HbA(1c). IGFBP-3 was increased in
hospitalized patients, with higher levels in patients with long bone fractu
res. A complex interaction of humoral factors may participate in the accele
ration of complications of diabetes. Copyright (C) 2000 John Wiley & Sons,
Ltd.