IGF-1 as an early marker for low bone mass or osteoporosis in premenopausal and postmenopausal women

Abstract

To find out which of the following parameters-serum levels of insulin-like growth factor 1 (IGF-1), osteoprotegerin (OPG), leptin, osteocalcin (OC), and urinary excretion of N-terminal telopeptide of type I collagen (NTx), can be used as an early marker for osteopenia/osteoporosis in women diagnosed by dual-energy X-ray absorptiometry (DXA), 282 premenopausal and 222 postmenopausal women aged 20-75 years were investigated by the measurement of bone mineral densities (BMDs) at lumbar spine (LS) and femoral neck (FN) by DXA, together with serum concentrations of IGF-1, OPG, leptin, OC, and urinary NTx. The characteristics of the earliest marker(s) were tested with the receiver operating characteristic (ROC) analysis. The area under the curve (AUC), sensitivity, and specificity parameters were determined. It was revealed that serum levels of IGF-1 and leptin changed the earliest, with both markers significantly decreasing (P < 0.0001) or increasing (P = 0.020), respectively, at age 30. However, in ROC analysis, IGF-1 was the only early parameter that had the capacity to differentiate the low bone mass/osteoporosis women from the normal ones (P < 0.0001). If the serum level of IGF-1 at 1.5 SD below its peak was adopted as a cutoff point, it could identify women with low bone mass/osteoporosis with a sensitivity of 73% and specificity of 67%. In the premenopausal women subgroup analysis, the low bone mass women (30/282, 10.6%) were older (38.2 +/- 1.7 vs. 34.5 +/- 0.5 years; P = 0.026), with lower serum levels of IGF-1 (215.1 +/- 22.4 vs. 278.8 +/- 9.4 ng/ml; P = 0.02) and less lean mass (33.1 +/- 0.6 vs. 34.8 +/- 0.2 kg; P = 0.010) than the normal ones. After controlling for age, the serum level of IGF-1 had a weak, but still significant, positive correlation with lean mass (r = 0.17, P < 0.001). In conclusion, measurement of serum IGF-1 in young women may help in the early identification of those at risk for developing low bone mass and osteoporosis.

An Association Between Abnormal Bone Turnover, Systemic Inflammation, and Osteoporosis in Patients With Chronic Pancreatitis: A Case-Matched Study

“…Although the data do not support IGF-1 as a unique driver of osteoporosis in CP (levels were not diff erent compared with controls), hsCRP levels were highest in the lowest tertile of IGF-1, indicating that IGF-1 levels may be associated with a systemic infl ammatory state. Nevertheless, although IGF-1 has been suggested as an early serum marker for osteoporosis ( 25 ), data from the current study did not support an association between IGF-1 and BMD. Analysis of variance statistically signifi cant at P =0.047.…”

Circulating Insulin-Like Growth Factor-1 Level and Ovarian Cancer Risk

“…In addition, owing to the lack of usable information, further subgroup analysis by types of ovarian cancer was not performed. Secondly, the circulating IGF-1 level changes obviously after menopause [41,42]. In addition, IGF-1 levels also decreases significantly with age [43].…”

Low-dose estrogen combined oral contraceptives may negatively influence physiological bone mineral density acquisition during adolescence

“…However, in this study the bioavailable estrogen was not measured. Also, we did not measure serum IGF1 which may be helpful for the early identification of young women at risk for developing low bone mass and osteoporosis (39).…”