Relationship of Serum Total Insulin-Like Growth Factor Binding Protein-3 with Insulin-Like Growth Factor-I and Glucose Tolerance in Korean Children and Adolescents

Abstract

Insulin is important in glucose metabolism. However, insulin-like growth factor binding protein (IGFBP) also plays an important role in glucose homeostasis, although the IGF-independent role of IGFBP-3 in the glucose intolerance state is poorly understood. We investigated the relationship of serum IGF-I with total IGFBP-3 levels and glucose tolerance in Korean children and adolescents who underwent the oral glucose tolerance test (OGTT). A total of 187 children without known diabetes underwent OGTT, and data related to their clinical and laboratory parameters were collected. Serum IGF-I and total IGFBP-3 levels, fasting plasma glucose levels, lipid profiles, insulin levels, C-peptide levels, homeostasis model assessment of insulin resistance (HOMA-IR) index, and glycated hemoglobin (HbA1c) levels were measured. Serum IGF-I and total IGFBP-3 levels were significantly higher in individuals with impaired glucose tolerance and type 2 diabetes (DM) than in those with normal glucose tolerance (NGT) ( P < 0.05 ). Serum IGF-I and IGFBP-3 levels were correlated with age, HbA1c, C-peptide, insulin, and HOMA-IR in the NGT group. However, these relationships were altered in patients with glucose intolerance, especially in those with DM. In the DM group, serum IGF-I and total IGFBP-3 levels were positively correlated with fasting plasma glucose and HbA1c levels. In addition, total IGFBP-3 levels were positively correlated with total cholesterol and low-density lipoprotein cholesterol and IGF-I levels but not with age or body mass index. The IGF-I-IGFBP-3 axis, especially IGFBP-3, may be involved in the pathogenesis and metabolic control of glucose intolerance, specifically in diabetes patients. Moreover, IGFBP-3 might be a therapeutic marker.

Persistent level 1 hypoglycemia due to hypothyroidism and underlying Neurofibromatosis type 1

“…The association between IGF‐1, IGF‐binding protein level, and insulin resistance has been showed in several researches. 15 , 16 , 17 , 18 While both high and low IGF‐1 level may be associated with glucose intolerance and insulin resistance (U‐shaped effect), 15 , 18 there are positive correlation between IGFBP3 (IGF‐binding protein 3) and glucose intolerance/insulin resistance. 17 , 19 , 20 Our case has normal IGF‐1 level and low IGF‐binding protein 3.…”

“… 15 , 16 , 17 , 18 While both high and low IGF‐1 level may be associated with glucose intolerance and insulin resistance (U‐shaped effect), 15 , 18 there are positive correlation between IGFBP3 (IGF‐binding protein 3) and glucose intolerance/insulin resistance. 17 , 19 , 20 Our case has normal IGF‐1 level and low IGF‐binding protein 3. It may indicate that the patient is insulin sensitive.…”

Insulin Like Growth Factor Binding Protein 7 as a Novel Diagnostic Marker in Sera of Iraqi Patients with Acromegaly

“…IGF-I is a hormone that is generated mostly by the liver in response to growth hormone stimulation and has a structure similar to insulin. Because insulin and IGF-I receptors are related, they share a number of signaling pathways as well as cell and biological responses 18 . As a result, it's difficult to tell the difference between the functions of insulin and IGF-1 in the development of diabetes and the advancement of IR 19 .…”