Medizinische Klinik-Innenstadt, Ludwig-Maximilians University, Munich, Germany.
Eur J Endocrinol. 2011 Feb;164(2):223-9. doi: 10.1530/EJE-10-0963. Epub 2010 Nov 8.
IGF1 is associated with metabolic parameters and involved in glucose metabolism. Low-IGF1 has been implicated in the etiology of glucose intolerance and subjects with pathological causes of either low- or high-IGF1 are at risk of diabetes. We hypothesized that both low- and high-IGF1 levels increase the risk of diabetes and aimed to assess the role of IGF1 in the risk of developing diabetes in a large prospective study.
An analysis of two prospective cohort studies, the DETECT study and SHIP.
We measured IGF1 levels in 7777 nondiabetic subjects and assessed incident diabetes mellitus during follow-up.
There were 464 cases of incident diabetes during 32 229 person-years (time of follow-up in the DETECT study and SHIP: 4.5 and 5 years respectively). There was no heterogeneity between both studies (P > 0.4). The hazard ratios (HRs) of incident diabetes in subjects with IGF1 levels below the 10th or above the 90th age- and sex-specific percentile, compared to subjects with intermediate IGF1 levels, were 1.44 (95% confidence interval (CI) 1.07-1.94) and 1.55 (95% CI 1.06-2.06) respectively, after multiple adjustment. After further adjustment for metabolic parameters, the HR for low-IGF1 became insignificant. Analysis of IGF1 quintiles revealed a U-shaped association of IGF1 with risk of diabetes. Results remained similar after exclusion of patients with onset of new diabetes within 1 year or with borderline glucose or HbA1c levels at baseline.
Subjects with low- or high-IGF1 level are at increased risk of developing diabetes.
IGF1 与代谢参数相关，并参与葡萄糖代谢。低 IGF1 与葡萄糖耐量异常的病因有关，并且 IGF1 水平低或高的患者都有患糖尿病的风险。我们假设低 IGF1 和高 IGF1 水平都会增加患糖尿病的风险，并旨在通过一项大型前瞻性研究评估 IGF1 在糖尿病发病风险中的作用。
两项前瞻性队列研究（DETECT 研究和 SHIP）的分析。
我们测量了 7777 名非糖尿病受试者的 IGF1 水平，并在随访期间评估了新发糖尿病病例。
在 32229 人年（DETECT 研究和 SHIP 的随访时间分别为 4.5 年和 5 年）期间，有 464 例新发糖尿病病例。两项研究之间没有异质性（P > 0.4）。与 IGF1 水平处于中间范围的受试者相比，IGF1 水平低于第 10 百分位或高于第 90 百分位的受试者新发糖尿病的风险比（HRs）分别为 1.44（95%可信区间 [CI] 1.07-1.94）和 1.55（95% CI 1.06-2.06），经多重调整后。在进一步调整代谢参数后，低 IGF1 的 HR 变得不显著。IGF1 五分位分析显示 IGF1 与糖尿病风险呈 U 型关联。排除新发糖尿病发病后 1 年内的患者或基线时血糖或 HbA1c 水平临界的患者后，结果仍然相似。
低 IGF1 或高 IGF1 水平的受试者患糖尿病的风险增加。
