Wang Q, Dills D G, Klein R, Klein B E, Moss S E
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison.
Diabetes. 1995 Feb;44(2):161-4. doi: 10.2337/diab.44.2.161.
We evaluated the relationship of insulin-like growth factor (IGF)-I to incidence and progression of diabetic retinopathy over a 6-year interval in a large population-based study of diabetes in southern Wisconsin. Participants included people with younger-onset diabetes (n = 66 adolescents, n = 661 adults > or = 18 years of age) and older-onset diabetes (n = 285 for those using insulin, n = 248 for those not using insulin). Fundus photographs were graded in a masked fashion using standardized protocols to determine the severity of retinopathy in each eye. Serum IGF-I levels were measured during 1984-1986 using a double-antibody radioimmunoassay. Mean IGF-I was highest in adolescents (499.1 micrograms/l), lower in younger-onset adult (280.1 micrograms/l), and lowest in the older-onset group (205.7 and 221.2 micrograms/l for older-onset group using insulin and not using insulin, respectively). The incidence of retinopathy was not significantly higher in people with higher IGF-I levels in any group. The odds of developing diabetic retinopathy in 6 years for each 10 micrograms/l increase in IGF-I after controlling for age, glycosylated hemoglobin, and duration of diabetes at baseline was 1.21 (95% confidence interval [CI] 0.95-1.54) for adolescents; 1.00 (95% CI 0.93-1.08) for younger-onset adults; 0.93 (95% CI 0.85-1.02) for the older-onset group using insulin; and 0.99 (95% CI 0.95-1.04) for the older-onset group not using insulin. In summary, IGF-I was not associated with 6-year incidence or progression of diabetic retinopathy in any of the groups.
在威斯康星州南部一项基于人群的大型糖尿病研究中，我们评估了胰岛素样生长因子（IGF）-I与糖尿病视网膜病变6年期间发病率及病情进展之间的关系。参与者包括发病年龄较小的糖尿病患者（66名青少年，661名年龄≥18岁的成年人）以及发病年龄较大的糖尿病患者（285名使用胰岛素者，248名未使用胰岛素者）。使用标准化方案以盲法对眼底照片进行分级，以确定每只眼睛视网膜病变的严重程度。1984 - 1986年期间使用双抗体放射免疫分析法测量血清IGF-I水平。青少年的平均IGF-I水平最高（499.1微克/升），发病年龄较小的成年人较低（280.1微克/升），发病年龄较大的组最低（使用胰岛素的发病年龄较大组为205.7微克/升，未使用胰岛素的发病年龄较大组为221.2微克/升）。在任何组中，IGF-I水平较高的人群视网膜病变的发病率均未显著升高。在控制了年龄、糖化血红蛋白和基线糖尿病病程后，IGF-I每升高10微克/升，青少年6年内发生糖尿病视网膜病变的几率为1.21（95%置信区间[CI] 0.95 - 1.54）；发病年龄较小的成年人是1.00（95% CI 0.93 - 1.08）；使用胰岛素的发病年龄较大组是0.93（95% CI 0.85 - 1.02）；未使用胰岛素的发病年龄较大组是0.99（95% CI 0.95 - 1.04）。总之，在任何组中，IGF-I均与糖尿病视网膜病变的6年发病率或病情进展无关。
