The impact of insulin resistance and glycaemic control on insulin-like growth factor-1 in patients with type 2 diabetes: a cross-sectional study.

Clinical Diabetes and Endocrinology Pub Date : 2024-11-23 DOI:10.1186/s40842-024-00202-8

Hasanain MohammedHuthaifa AbdlWhab, Araz Al-Saffar, Osama Abbas Mahdi, Rafid Badri Alameri

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Abstract

Background: Type 2 diabetes mellitus (T2DM) is a multifaceted metabolic disorder. Over the past decade, the potential role of Growth Hormone (GH) and Insulin-like Growth Factor-1 (IGF-1) in the pathogenesis and progression of T2DM has garnered scientific interest. These hormones, while interrelated, exert differential effects on glucose homeostasis; GH elevates blood glucose levels, whereas IGF-1 sustains insulin secretion and augments insulin sensitivity.

Objective: The study aimed to investigate the impact of insulin resistance and glycaemic control on IGF-1 levels and to assess other risk factors influencing IGF-1 in T2DM.

Methods: A cross-sectional study was conducted at the National Diabetes Centre, Baghdad, Iraq, from May 2020 to May 2021. Sixty patients with T2DM were evaluated for fasting plasma glucose (FPG), GH, IGF-1, HbA1c, HOMA-IR, HOMA-B, and anthropometric measures following a comprehensive history and physical examination, focusing on any variables that could influence their metabolic profile. Patients with Type 1 diabetes mellitus, thyroid disease, pituitary disease, chronic kidney disease, hepatic disease, and pregnancy were excluded from the study.

Results: Patients with poorly controlled diabetes (HbA1c > 8) exhibited significantly elevated IGF-1 levels compared to those with HbA1c < 8 (166 vs. 134, P = 0.016). The mean IGF-1 was significantly lower in patients with insulin resistance (IR) compared to those without IR (143 vs. 192, P = 0.001), with a significant negative correlation with Body Mass Index (BMI) and a significant positive correlation with HbA1c and Quantitative Insulin Sensitivity Index (QUICKI). Elevated IGF-1 levels were observed with increasing age, duration of T2DM, higher HbA1c, higher QUICKI, and lower BMI. No significant difference was found in IGF-1 values with regards to HOMA-B, fasting insulin, and waist-hip ratio.

Conclusion: Patients with poorly controlled T2DM exhibit higher IGF-1 levels, while those with obesity and high insulin resistance demonstrate lower IGF-1 levels. Further prospective studies are warranted to evaluate the potential of using IGF-1 to reduce insulin resistance and improve metabolic and glycaemic measures in individuals with T2DM and obesity or insulin resistance.

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胰岛素抵抗和血糖控制对 2 型糖尿病患者胰岛素样生长因子-1 的影响：一项横断面研究。

背景：2 型糖尿病（T2DM）是一种多方面的代谢紊乱。在过去十年中，生长激素（GH）和胰岛素样生长因子-1（IGF-1）在 T2DM 的发病和发展过程中的潜在作用引起了科学界的关注。这两种激素虽然相互关联，但对血糖稳态的影响却各不相同；生长激素能升高血糖水平，而 IGF-1 则能维持胰岛素分泌并增强胰岛素敏感性：本研究旨在调查胰岛素抵抗和血糖控制对 IGF-1 水平的影响，并评估影响 T2DM 中 IGF-1 的其他风险因素：2020年5月至2021年5月在伊拉克巴格达国家糖尿病中心进行了一项横断面研究。对 60 名 T2DM 患者进行了空腹血浆葡萄糖 (FPG)、GH、IGF-1、HbA1c、HOMA-IR、HOMA-B 和人体测量指标的评估，并进行了全面的病史和体格检查，重点关注可能影响其代谢状况的任何变量。1型糖尿病患者、甲状腺疾病患者、垂体疾病患者、慢性肾病患者、肝病患者和妊娠患者被排除在研究之外：结果：控制不佳的糖尿病患者（HbA1c > 8）与 HbA1c 结论的患者相比，IGF-1 水平明显升高：控制不佳的 T2DM 患者 IGF-1 水平较高，而肥胖和高胰岛素抵抗患者 IGF-1 水平较低。有必要开展进一步的前瞻性研究，以评估使用 IGF-1 减少胰岛素抵抗、改善 T2DM 患者代谢和血糖指标的潜力。

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Clinical Diabetes and Endocrinology

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8 weeks

期刊介绍： Clinical Diabetes and Endocrinology is an open access journal publishing within the field of diabetes and endocrine disease. The journal aims to provide a widely available resource for people working within the field of diabetes and endocrinology, in order to improve the care of people affected by these conditions. The audience includes, but is not limited to, physicians, researchers, nurses, nutritionists, pharmacists, podiatrists, psychologists, epidemiologists, exercise physiologists and health care researchers. Research articles include patient-based research (clinical trials, clinical studies, and others), translational research (translation of basic science to clinical practice, translation of clinical practice to policy and others), as well as epidemiology and health care research. Clinical articles include case reports, case seminars, consensus statements, clinical practice guidelines and evidence-based medicine. Only articles considered to contribute new knowledge to the field will be considered for publication.