ARC Epidemiology Unit, The University of Manchester, Manchester, UK.
J Rheumatol. 2009 Nov;36(11):2523-30. doi: 10.3899/jrheum.090113. Epub 2009 Oct 15.
To determine whether perturbations of insulin-like growth factor-1 (IGF-1) and IGF binding protein-3 (IGFBP-3) were associated with the presence of chronic widespread pain (CWP) in men.
The European Male Ageing Study (EMAS) is an 8-center population-based study of men aged 40-79 years recruited from population registers. A questionnaire asked about the presence and duration of musculoskeletal pain, from which subjects reporting CWP were identified. Subjects also had an interviewer-assisted questionnaire: levels of physical activity and mood were assessed, and height and weight were measured. IGF-1 and IGFBP-3 were assayed from a fasting blood sample. Logistic regression models were used to determine the association between IGF measures and CWP. Results were expressed as odds ratios or relative risk ratios.
A total of 3206 subjects provided full data. Of those, 1314 (39.0%) reported no pain in the past month and 278 (8.3%) reported pain that satisfied criteria for CWP. IGF-1 concentrations were similar among subjects who reported no pain and those with CWP: 131.5 mg/l and 128.4 mg/l, respectively. This was true also for IGFBP-3 (4.3 and 4.3 mg/l). Obesity was associated with low IGF-1 and a high IGFBP-3/IGF-1 ratio, indicating less bioavailable IGF-1, irrespective of pain status. This relationship persisted after adjustment for comorbidities, depression, smoking, alcohol consumption, and quality of life.
Overall CWP was not associated with perturbations in IGF-1 and IGFBP-3 concentrations. Hypofunctioning of the axis was noted among subjects who were obese and this was not specific to CWP. These data suggest that IGF-1 is unlikely to be etiologically important in relation to CWP, although the relationship with growth hormone remains to be elucidated.
确定胰岛素样生长因子-1(IGF-1)和 IGF 结合蛋白-3(IGFBP-3)的变化是否与男性慢性广泛性疼痛(CWP)的存在有关。
欧洲男性衰老研究(EMAS)是一项基于人群的 8 中心研究,招募了年龄在 40-79 岁的男性,来自人口登记处。调查问卷询问了肌肉骨骼疼痛的存在和持续时间,根据报告 CWP 的受试者确定。受试者还进行了访谈辅助的问卷调查:评估了身体活动水平和情绪,测量了身高和体重。从空腹血样中测定 IGF-1 和 IGFBP-3。使用逻辑回归模型确定 IGF 测量值与 CWP 之间的关联。结果表示为比值比或相对风险比。
共有 3206 名受试者提供了完整的数据。其中,1314 名(39.0%)报告过去一个月没有疼痛,278 名(8.3%)报告疼痛符合 CWP 标准。报告无疼痛和 CWP 的受试者的 IGF-1 浓度相似:分别为 131.5 毫克/升和 128.4 毫克/升。IGFBP-3 也是如此(4.3 和 4.3 毫克/升)。肥胖与 IGF-1 水平低和 IGFBP-3/IGF-1 比值高有关,表明 IGF-1 的生物利用度降低,无论疼痛状况如何。在调整了合并症、抑郁、吸烟、饮酒和生活质量后,这种关系仍然存在。
总体而言,CWP 与 IGF-1 和 IGFBP-3 浓度的变化无关。在肥胖的受试者中观察到该轴的功能低下,这与 CWP 无关。这些数据表明,IGF-1 不太可能与 CWP 有关,尽管与生长激素的关系仍有待阐明。