Benbassat C A, Maki K C, Unterman T G
Department of Medicine, Veterans Administration Chicago Health Care System: West Side Division, and University of Illinois College of Medicine, 60612, USA.
J Clin Endocrinol Metab. 1997 May;82(5):1484-91. doi: 10.1210/jcem.82.5.3930.
Reduced secretion of GH and production of insulin-like growth factor I (IGF-I) contribute to altered body composition in human aging. IGF-binding proteins (IGFBPs) are important modulators of IGF action, yet little is known regarding their role and regulation in aging. Accordingly, we measured levels of IGFBP-1, an important short term modulator of IGF bioavailability that is suppressed by insulin, and levels of IGFBP-3, the major circulating IGF carrier protein, and examined their relationships to insulin, glucose, IGF, and dehydroepiandrosterone sulfate levels and anthropometric measures in old (63-89 yr) and young (23-39 yr) men. Serum levels of IGFBP-1 were increased 3-fold in old vs. young men despite high insulin levels in elders. Nevertheless, IGFBP-1 and insulin levels correlated in old and young men (r = - 0.49; P < 0.002 and r = -0.42; P < 0.025), suggesting that insulin continues to play an important role in the regulation of IGFBP-1 in aging. Glucose levels also were significantly inversely related to IGFBP-1 in old and young men (r = 0.37; P = 0.02 and r = -0.49; P < 0.01), and this relationship was not accounted for by the effect of insulin. IGF-I levels were reduced by 33% in elders (P < 0.001) and correlated with IGFBP-1 levels among old (r = -0.40; P < 0.01), but not young, men, indicating that low GH secretion and/or IGF-I production may contribute to the elevation of IGFBP-1 levels in aging. IGFBP-3 levels were reduced among elders, but not to the same extent as IGF-I, resulting in a relative excess of IGFBP-3 in elders (IGFBP-3/IGF-I ratio, 20.1 +/- 0.9 vs. 15.4 +/- 1.0; P < 0.001). The IGFBP-3/IGF-I ratio correlated with IGF-I levels in young and old men (r = -0.79; P < 0.001 and r = -0.82; P < 0.001), indicating that diminished GH secretion also may contribute to a relative excess of IGFBP-3 among elders. Dehydroepiandrosterone sulfate levels were low in elders, but did not correlate with IGF, IGFBP, insulin, or glucose levels in either age group. Serum levels of IGFBP-1 (but not IGF-I or -II or IGFBP-3) correlated with body mass index and upper arm fat and muscle areas in elders. These relationships were accounted for by the effects of insulin, suggesting that regulation of IGFBP-1 by insulin may play a role in determining body composition in aging. We conclude that insulin remains an important determinant of IGFBP-1 levels in elders, that the fasting glucose level is also a significant determinant of IGFBP-1 in both old and young subjects, and that reduced secretion of GH may contribute to impaired anabolism in aging through multiple mechanisms, including reduced production of IGF-I and alterations in circulating levels of both IGFBP-1 and -3. These findings are consistent with the concept that alterations in IGFBP levels may contribute to changes in IGF bioavailability and body composition in aging.
生长激素(GH)分泌减少以及胰岛素样生长因子I(IGF-I)生成减少,促使人体衰老过程中身体成分发生改变。胰岛素样生长因子结合蛋白(IGFBPs)是IGF作用的重要调节因子,然而关于它们在衰老过程中的作用和调节机制却知之甚少。因此,我们测定了IGFBP-1(一种重要的IGF生物利用度短期调节因子,受胰岛素抑制)以及主要循环IGF载体蛋白IGFBP-3的水平,并研究了它们与老年(63 - 89岁)和年轻(23 - 39岁)男性的胰岛素、葡萄糖、IGF及硫酸脱氢表雄酮水平以及人体测量指标之间的关系。尽管老年人胰岛素水平较高,但老年男性血清IGFBP-1水平比年轻男性升高了3倍。然而,IGFBP-1与胰岛素水平在老年和年轻男性中均呈负相关(r = - 0.49;P < 0.002和r = -0.42;P < 0.025),这表明胰岛素在衰老过程中对IGFBP-1的调节仍发挥重要作用。在老年和年轻男性中,葡萄糖水平也与IGFBP-1显著负相关(r = 0.37;P = 0.02和r = -0.49;P < 0.01),且这种关系不受胰岛素影响。老年人的IGF-I水平降低了33%(P < 0.001),并且在老年男性中IGF-I水平与IGFBP-1水平相关(r = -0.40;P < 0.01),但在年轻男性中不相关,这表明低GH分泌和/或IGF-I生成减少可能导致衰老过程中IGFBP-1水平升高。老年人的IGFBP-3水平降低,但程度不如IGF-I,导致老年人中IGFBP-3相对过剩(IGFBP-3/IGF-I比值,20.1 ± 0.9 vs. 15.4 ± 1.0;P < 0.001)。IGFBP-3/IGF-I比值在年轻和老年男性中均与IGF-I水平相关(r = -0.79;P < 0.001和r = -0.82;P < 0.001),这表明GH分泌减少也可能导致老年人中IGFBP-3相对过剩。老年人硫酸脱氢表雄酮水平较低,但在两个年龄组中均与IGF、IGFBP、胰岛素或葡萄糖水平无关。在老年人中,血清IGFBP-1水平(而非IGF-I或-II或IGFBP-3)与体重指数以及上臂脂肪和肌肉面积相关。这些关系受胰岛素影响,提示胰岛素对IGFBP-1的调节可能在衰老过程中身体成分的决定中起作用。我们得出结论,胰岛素仍是老年人IGFBP-1水平的重要决定因素,空腹血糖水平也是老年和年轻受试者中IGFBP-1的重要决定因素,并且GH分泌减少可能通过多种机制导致衰老过程中合成代谢受损,包括IGF-I生成减少以及IGFBP-1和-3循环水平改变。这些发现与IGFBP水平改变可能导致衰老过程中IGF生物利用度和身体成分变化的概念一致。