肥胖受试者中游离胰岛素样生长因子的循环水平：2型糖尿病的影响。
Circulating levels of free insulin-like growth factors in obese subjects: the impact of type 2 diabetes.
作者信息
Frystyk J, Skjaerbaek C, Vestbo E, Fisker S, Orskov H
机构信息
Institute of Experimental Clinical Research, Medical Research Laboratories and Medical Department M, Aarhus University Hospital, Aarhus, Denmark.
出版信息
Diabetes Metab Res Rev. 1999 Sep-Oct;15(5):314-22. doi: 10.1002/(sici)1520-7560(199909/10)15:5<314::aid-dmrr56>3.0.co;2-e.
BACKGROUND
Obese subjects show major abnormalities in the growth hormone (GH)/insulin-like growth factor (IGF) system. Furthermore, they are prone to develop Type 2 diabetes, but the impact of diabetes plus obesity on the GH/IGF system remains unknown.
METHODS
We compared overnight fasting serum levels of free and total (extractable) IGF-I and -II, IGF-binding protein (IGFBP) -1, -2 and -3, and the high affinity GH-binding protein (GHBP) in matched groups of lean subjects (n=26) and obese subjects without (n=24) and with (n=29) Type 2 diabetes. Two groups (n=7) of healthy and Type 1 diabetic subjects were also studied.
RESULTS
Non-diabetic obese subjects had increased free IGF-I and -II, total IGF-II, IGFBP-3 and GHBP, reduced IGFBP-1 and -2 (p<0.05), but normal total IGF-I, when compared to lean subjects. In obese Type 2 diabetics free IGF-I was insignificantly reduced by 9% (p=0.3), when compared to non-diabetic obese subjects. However, the concentration was not significantly elevated when compared to that of lean controls (p=0.13). Also IGFBP-1 and total IGF-I were normal in obese Type 2 diabetics, whereas free and total IGF-II and IGFBP-3 remained elevated to a similar extent as in simple obesity (p<0.05). In contrast, GHBP was further increased and IGFBP-2 further reduced in obese Type 2 diabetics (p<0.05). In Type 1 diabetics total IGF-I and -II, and IGFBP-3 were normal. In contrast, free IGF-I and -II and GHBP were markedly reduced, whereas IGFBP-1 and -2 were increased (p<0.05).
CONCLUSIONS
Simple obesity was associated with marked changes in the GH/IGF system. Many of these abnormalities were unaffected by the concomitant presence of Type 2 diabetes (total IGF-I, free and total IGF-II and IGFBP-3). However, some changes became accentuated (GHBP and IGFBP-2), while others (free IGF-I and IGFBP-1) were no longer present. Notably, the impact of Type 1 diabetes on the GH/IGF system was clearly different from that of Type 2 diabetes.
背景
肥胖受试者的生长激素（GH）/胰岛素样生长因子（IGF）系统存在重大异常。此外，他们易患2型糖尿病，但糖尿病合并肥胖对GH/IGF系统的影响仍不清楚。
方法
我们比较了瘦受试者（n = 26）、无2型糖尿病的肥胖受试者（n = 24）和有2型糖尿病的肥胖受试者（n = 29）匹配组中空腹过夜血清游离和总（可提取）IGF-I和 -II、IGF结合蛋白（IGFBP）-1、-2和 -3以及高亲和力GH结合蛋白（GHBP）的水平。还研究了两组（n = 7）健康和1型糖尿病受试者。
结果
与瘦受试者相比，非糖尿病肥胖受试者的游离IGF-I和 -II、总IGF-II、IGFBP-3和GHBP升高，IGFBP-1和 -2降低（p<0.05），但总IGF-I正常。与非糖尿病肥胖受试者相比，肥胖2型糖尿病患者的游离IGF-I无明显降低，仅降低了9%（p = 0.3）。然而，与瘦对照组相比，其浓度没有显著升高（p = 0.13）。肥胖2型糖尿病患者的IGFBP-1和总IGF-I也正常，而游离和总IGF-II以及IGFBP-3仍与单纯肥胖患者一样升高到相似程度（p<0.05）。相比之下，肥胖2型糖尿病患者的GHBP进一步升高，IGFBP-2进一步降低（p<0.05）。1型糖尿病患者的总IGF-I和 -II以及IGFBP-3正常。相比之下，游离IGF-I和 -II以及GHBP明显降低，而IGFBP-1和 -2升高（p<0.05）。
结论
单纯肥胖与GH/IGF系统的显著变化有关。许多这些异常不受2型糖尿病并存的影响（总IGF-I、游离和总IGF-II以及IGFBP-3）。然而，一些变化变得更加明显（GHBP和IGFBP-2），而其他变化（游离IGF-I和IGFBP-1）不再存在。值得注意的是，1型糖尿病对GH/IGF系统的影响与2型糖尿病明显不同。
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