2型糖尿病患者体内的晚期糖基化终末产物（AGEs）、胰岛素样生长因子-1（IGF-1）和胰岛素样生长因子结合蛋白-3（IGFBP-3）

Advanced glycosylation end products (AGEs), insulin-like growth factor-1 (IGF-1) and IGF-binding protein-3 (IGFBP-3) in patients with type 2 diabetes mellitus.

作者信息

Garay-Sevilla M E, Nava L E, Malacara J M, Wróbel K, Wróbel K, Pérez U

机构信息

Instituto de Investigaciones Médicas, Universidad de Guanajuato, 20 de Enero 929, 37320 León Gto, Mexico.

出版信息

Diabetes Metab Res Rev. 2000 Mar-Apr;16(2):106-13. doi: 10.1002/(sici)1520-7560(200003/04)16:2<106::aid-dmrr88>3.0.co;2-h.

DOI:10.1002/(sici)1520-7560(200003/04)16:2<106::aid-dmrr88>3.0.co;2-h

PMID:10751750

Abstract

BACKGROUND

Advanced glycosylation end product (AGE) formation is a major mechanism for the development of complications in diabetes, and the possible roles of insulin-like growth factor 1 (IGF-1) and IGF binding protein 3 (IGFBP-3) are not clearly established.

METHODS

We examined the associations of AGEs, free IGF-I and IGFBP-3 in Type 2 diabetes mellitus (DM) patients under diverse conditions. In a cross-sectional design we studied 110 subjects (67 women and 43 men): non-diabetic controls in group 1, (n = 15) and diabetes patients as follows: group 2, without complications (n = 25); group 3, with chronic complications (n = 25); group 4, with acute or chronic infections (n = 24); group 5, hospitalized for reasons unrelated to diabetes (n = 9); group 6, with end-stage renal disease (ESRD) (n = 12). AGEs were determined by a spectrofluorometric method (HPLC). Insulin and IGFBP-3 were measured by RIA and free IGF-1 with an IRMA method.

RESULTS

AGEs were 13-fold higher in patients with ESRD (p<0.001), and lower in healthy individuals. Free IGF-1 was lower in the patients with complications (p = 0.017), with infections (p = 0.006) and hospitalized (p = 0.04). IGFBP-3 was higher in hospitalized patients (p=0.017). AGEs were associated with free IGF-1 (r = 0.41, p = 0.04) in the group with complications, and with HbA(1c) (r = -0.90, p = 0.002) in hospitalized patients. In the total group, free IGF-1 (r = -0.25, p = 0.008), and IGFBP-3 (r = -0.22, p = 0.021) were associated with HbA(1c).

CONCLUSION

We concluded that AGEs were markedly increased in diabetic patients with ESRD, IGF-1 was decreased in patients with infections and hospitalized, and was negatively associated with HbA(1c). IGFBP-3 was increased in hospitalized patients, with higher levels in patients with long bone fractures. A complex interaction of humoral factors may participate in the acceleration of complications of diabetes.

摘要

背景

晚期糖基化终末产物（AGE）的形成是糖尿病并发症发生发展的主要机制，胰岛素样生长因子1（IGF-1）和IGF结合蛋白3（IGFBP-3）的潜在作用尚未明确。

方法

我们在多种情况下研究了2型糖尿病（DM）患者中AGEs、游离IGF-I和IGFBP-3之间的关联。采用横断面设计，我们研究了110名受试者（67名女性和43名男性）：第1组为非糖尿病对照组（n = 15），糖尿病患者如下：第2组，无并发症（n = 25）；第3组，有慢性并发症（n = 25）；第4组，有急性或慢性感染（n = 24）；第5组，因与糖尿病无关的原因住院（n = 9）；第6组，患有终末期肾病（ESRD）（n = 12）。采用荧光分光光度法（HPLC）测定AGEs。采用放射免疫分析法（RIA）测定胰岛素和IGFBP-3，采用免疫放射分析法（IRMA）测定游离IGF-1。

结果

ESRD患者的AGEs水平高13倍（p<0.001），健康个体的AGEs水平较低。有并发症的患者（p = 0.017）、有感染的患者（p = 0.006）和住院患者（p = 0.04）的游离IGF-1水平较低。住院患者的IGFBP-3水平较高（p = 0.017）。在有并发症的组中，AGEs与游离IGF-1相关（r = 0.41，p = 0.04），在住院患者中，AGEs与糖化血红蛋白（HbA1c）相关（r = -0.90，p = 0.002）。在整个研究组中，游离IGF-1（r = -0.25，p = 0.008）和IGFBP-3（r = -0.22，p = 0.021）与HbA1c相关。