The pathogenesis of extrapancreatic tumor hypoglycemia has been related to the secretion of big insulin-like growth factor (IGF) II by the tumor. In 25 of 28 patients with this type of hypoglycemia we found 1.5-8-fold elevated serum levels of immunoreactive big (15-25 kD), but decreased levels of normal IGF II. After removal of the tumor, big IGF II disappeared and normal IGF II increased. Tumors contained elevated levels of IGF II, 65-80% in the big form. The insulin-like bioactivity of big IGF II and its affinity towards IGF-binding proteins (IGFBP)-2 and -3 are similar to those of normal IGF II, but two-to threefold higher on a molar basis. Big IGF II is mainly bound to the 50-kD IGFBP complex. The latter contains -10 times more of this peptide than in normal serum and displays three-to fourfold increased insulin-like bioactivity. The formation of the 150-kD IGFBP complex with "25I-recombinant human IGFBP-3 is impaired in tumor serum. This results in sequestration of IGFBP-3 and predominant association of big IGF II with IGFBP-2 and -3 in the 50-kD complex. Increased bioavailability of big IGF II in this complex due to unrestricted capillary passage and enhanced insulin bioactivity of this big IGF II pool provide a continuous increased insulin-like potential available to insulin and type 1 IGF receptors of insulin-sensitive tissues and thus may lead to sustained hypoglycemia. (J.

Osteoblast-like cells prepared from calvaria of newborn rats produce insulin-like growth factor (IGF) I and several insulin-like growth factor binding proteins (IGFBPs) in vitro. Among the IGFBPs found in conditioned cell culture medium, IGFBP-3 is the most abundant. Intact IGFBP-3, as assessed by 125I-labeled IGF-II ligand blot analysis, is more abundant in culture media of cells exposed to growth hormone (GH) or to parathyroid hormone (PTH), both at 5 x 10(-9) mol/l, for 24 h. At the same time, concentrations of IGF-I are increased in media of cells exposed to PTH but not to GH, compared with hormone-free control cultures. IGFBP-3 mRNA is increased in osteoblasts exposed to PTH or to GH but not in response to 5 x 10(-9) mol/l IGF-I. PTH exerts a rapid (within 2 h) stimulatory effect on IGF-I and IGFBP-3 production, both at the message and peptide levels, whereas GH increases only IGFBP-3, both at the message and peptide levels (after 24 h). We conclude that IGF-I does not mediate increased IGFBP-3 production by rat osteoblasts in response to GH and PTH.

Insulin-like growth factor-I (IGF-I) mRNA levels in rat white adipose tissue (WAT) are in the same range as those in liver, the major source of serum IGF-I, and are far above the levels in other tissues. IGF-I mRNA and IGF-I peptide levels in WAT decrease drastically after hypophysectomy and are restored to near normal by GH treatment in vivo. IGF-I gene expression in WAT from hypophysectomized rats is also stimulated by GH in vitro; half-maximal stimulation of IGF-I mRNA occurs between 0.25-0.5 nM GH, and maximal stimulation (3.5- to 5.5-fold) at 15 nM after 2 h. However, maximally stimulated IGF-I mRNA levels in vitro lie far below those measured in vivo in normal or GH-treated hypophysectomized rats. T3 does not enhance the GH effect in vitro. Rat WAT expresses the messages for IGF-binding protein (IGFBP)-2, -3, -4, -5, and -6. IGFBP-2, -3, -5, and -6 mRNAs are all regulated by GH. IGF-I mRNA and IGFBP-5 mRNA are localized in both adipocytes and stromal-vascular cells, whereas IGFBP-2 and -3 expression is restricted to stromal-vascular tissue. As physiological concentrations of IGF-I are able to induce adipocyte differentiation in vitro, we suggest that locally produced IGF-I and IGFBPs play a crucial role in the in vivo differentiation of adipose cells from stromal-vascular cells.

Insulin-like growth factor-I (IGF-I) mRNA levels in rat white adipose tissue (WAT) are in the same range as those in liver, the major source of serum IGF-I, and are far above the levels in other tissues. IGF-I mRNA and IGF-I peptide levels in WAT decrease drastically after hypophysectomy and are restored to near normal by GH treatment in vivo. IGF-I gene expression in WAT from hypophysectomized rats is also stimulated by GH in vitro; half-maximal stimulation of IGF-I mRNA occurs between 0.25-0.5 nM GH, and maximal stimulation (3.5- to 5.5-fold) at 15 nM after 2 h. However, maximally stimulated IGF-I mRNA levels in vitro lie far below those measured in vivo in normal or GH-treated hypophysectomized rats. T3 does not enhance the GH effect in vitro. Rat WAT expresses the messages for IGF-binding protein (IGFBP)-2, -3, -4, -5, and -6. IGFBP-2, -3, -5, and -6 mRNAs are all regulated by GH. IGF-I mRNA and IGFBP-5 mRNA are localized in both adipocytes and stromal-vascular cells, whereas IGFBP-2 and -3 expression is restricted to stromal-vascular tissue. As physiological concentrations of IGF-I are able to induce adipocyte differentiation in vitro, we suggest that locally produced IGF-I and IGFBPs play a crucial role in the in vivo differentiation of adipose cells from stromal-vascular cells.

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