Paolisso G, Ammendola S, Del Buono A, Gambardella A, Riondino M, Tagliamonte M R, Rizzo M R, Carella C, Varricchio M
Department of Geriatric Medicine and Metabolic Diseases, II University of Naples, Italy.
J Clin Endocrinol Metab. 1997 Jul;82(7):2204-9. doi: 10.1210/jcem.82.7.4087.
It has been demonstrated that healthy centenarians have more favorable anthropometric characteristics and insulin-mediated glucose uptake than aged subjects. The plasma insulin-like-growth factor I (IGF-I) concentration may account for such differences. Three groups of subjects were studied: 1) adults (< 50 yr; n = 30), 2) aged subjects (75-99 yr; n = 30), 3) centenarians (> 100 yr; n = 19). In all subjects, fasting plasma IGF-I, IGF-binding protein-3 (IGFBP-3), leptin, and lipid concentrations were determined; body composition was assessed by bioimpedance analysis; and insulin-mediated glucose up-take was evaluated by euglycemic hyperinsulinemic glucose clamp. IGF-I declined with advancing age, but no differences between aged subjects and centenarians were found. IGFBP-3 showed a trend similar to IGF-I, but lower values were present in centenarians than in aged subjects. Nevertheless, centenarians had a plasma IGF-I/IGFBP-3 molar ratio greater than that in aged subjects. Centenarians had also a whole body glucose disposal (WBGD) greater than that in aged subjects, but similar to that in adults. Mini Mental State Examination (27 +/- 2.1 vs. 18.3 +/- 3.1; P < 0.02) and Instrumental Activities Daily Living (26 +/- 2.6 vs. 8.4 +/- 4.1; P < 0.001) scores were significantly different in aged subjects and centenarians, respectively. In centenarians, the plasma IGF-I/IGFBP-3 molar ratio correlated with the body mass index (r = -0.55; P < 0.009); the amount of body fat (r = -0.62; P < 0.003); fat-free mass (r = 0.56; P < 0.008); fasting plasma leptin (r = -0.63; P < 0.004), triglycerides (r = -0.58; P < 0.01), free fatty acid (r = -0.64; P < 0.005), and low density lipoprotein cholesterol (r = -0.59; P < 0.009) concentrations; Mini Mental State Examination (r = 0.53; P < 0.0.03); and WBGD (r = 0.64; P < 0.005). All correlations were independent of daily fat and carbohydrate intake and WBGD (P < 0.05 for all). No significant correlations between the plasma IGF-I/IGFBP-3 molar ratio and plasma total (r = 0.31; P = NS) and high density lipoprotein cholesterol (r = 0.34; P = NS) concentrations were present. The correlation between the plasma IGF-I/IGFBP-3 molar ratio and WBGD persisted after adjustment for body fat, fasting plasma insulin concentration, daily carbohydrate and fat intake, and daily physical activity (r = 0.55; P < 0.009), but not after further adjustment for plasma free fatty acid concentration (r = 0.30; P = 0.17). In conclusion, healthy centenarians have plasma IGF-I/IGFBP-3 molar ratio greater than aged subjects. A more elevated plasma IGF-I/IGFBP-3 molar ratio might improve insulin action and plasma lipid concentration in centenarians.
业已证明，健康的百岁老人比老年受试者具有更有利的人体测量学特征和胰岛素介导的葡萄糖摄取。血浆胰岛素样生长因子I（IGF-I）浓度可能解释了这些差异。研究了三组受试者：1）成年人（<50岁；n = 30），2）老年受试者（75 - 99岁；n = 30），3）百岁老人（>100岁；n = 19）。在所有受试者中，测定了空腹血浆IGF-I、IGF结合蛋白-3（IGFBP-3）、瘦素和脂质浓度；通过生物电阻抗分析评估身体成分；通过正常血糖高胰岛素葡萄糖钳夹评估胰岛素介导的葡萄糖摄取。IGF-I随着年龄的增长而下降，但老年受试者和百岁老人之间未发现差异。IGFBP-3呈现出与IGF-I相似的趋势，但百岁老人中的值低于老年受试者。然而，百岁老人的血浆IGF-I/IGFBP-3摩尔比高于老年受试者。百岁老人的全身葡萄糖处置（WBGD）也高于老年受试者，但与成年人相似。简易精神状态检查表得分（27±2.1对18.3±3.1；P<0.02）和日常生活活动工具性量表得分（26±2.6对8.4±4.1；P<0.001）在老年受试者和百岁老人中分别有显著差异。在百岁老人中，血浆IGF-I/IGFBP-3摩尔比与体重指数相关（r = -0.55；P<0.009）；体脂量（r = -0.62；P<0.003）；去脂体重（r = 0.56；P<0.008）；空腹血浆瘦素（r = -0.63；P<0.004）、甘油三酯（r = -0.58；P<0.01）、游离脂肪酸（r = -0.64；P<0.005）和低密度脂蛋白胆固醇（r = -0.59；P<0.009）浓度；简易精神状态检查表（r = 0.53；P<0.0.03）；以及WBGD（r = 0.64；P<0.005）。所有相关性均独立于每日脂肪和碳水化合物摄入量以及WBGD（所有P<0.05）。血浆IGF-I/IGFBP-3摩尔比与血浆总胆固醇（r = 0.31；P = 无显著性差异）和高密度脂蛋白胆固醇（r = 0.34；P = 无显著性差异）浓度之间无显著相关性。在调整了体脂、空腹血浆胰岛素浓度、每日碳水化合物和脂肪摄入量以及每日身体活动后，血浆IGF-I/IGFBP-3摩尔比与WBGD之间的相关性仍然存在（r = 0.55；P<0.009），但在进一步调整血浆游离脂肪酸浓度后不再存在（r = 0.30；P = 0.17）。总之，健康的百岁老人的血浆IGF-I/IGFBP-3摩尔比高于老年受试者。更高的血浆IGF-I/IGFBP-3摩尔比可能改善百岁老人的胰岛素作用和血浆脂质浓度。
