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Low Insulin-like Growth Factor-II Levels Predict Weight Gain in Normal Weight Subjects with Type 2 Diabetes - 18/08/11

Doi : 10.1016/j.amjmed.2005.08.001 
Adrian H. Heald, DM a, , Lars Kärvestedt, MD b, c, Simon G. Anderson, PhD a, Julie McLaughlin, BSc a, Anne Knowles, BSc d, Louise Wong, BSc a, Valdemar Grill, MD c, J. Kennedy Cruickshank, MD d, Anne White, PhD e, J. Martin Gibson, MD a, Kerstin Brismar, MD c
a Department of Diabetes and Endocrinology, Salford Royal Hospitals University Trust, Salford, United Kingdom 
b Department of Molecular Medicine, Karolinska Institutet, Stockholm, Sweden 
c Diabetes Center Karolinska, Karolinska Institutet, Stockholm, Sweden 
d Diabetes Centre, Manchester Royal Infirmary, Manchester, United Kingdom 
e Endocrine Sciences, University of Manchester Medical School, Manchester, United Kingdom 

Requests for reprints should be addressed to Adrian H. Heald, DM, Department of Diabetes and Endocrinology, University of Manchester, Salford Royal Hospitals University Trust, Hope Hospital, Stott Lane, Salford, Greater Manchester, M68HD, UK

Abstract

Purpose

Insulin-like growth factor (IGF)-I and IGF-II are important in the regulation of metabolism and growth. We previously reported in normoglycemic individuals of normal weight that low circulating IGF-II predicts future weight gain. We subsequently investigated whether such relationships persisted in circumstances of type 2 diabetes.

Methods

In 224 subjects with type 2 diabetes we assessed the association between baseline IGF-II levels and risk of weight gain (>2.0 kg) at the 5-year follow-up.

Results

At follow-up, 90 participants (40.2%) gained more than 2.0 kg in body weight. For subjects (body mass index <26) at baseline, mean IGF-II levels were significantly lower in those who gained more than 2 kg in weight than in subjects of stable weight, 454 ng/mL (95% confidence interval 349-559) versus 620 ng/mL (534-705) (F=7.4, P=.01). For this subgroup low circulating IGF-II at baseline strongly correlated with weight gain (Spearman rho=−0.52, P <.001). With increasing weight, the relationship no longer prevailed. Logistic regression showed that for body mass index less than 26, individuals at baseline for each 100 ng/mL increase in baseline IGF-II there was a 47% decreased risk of gaining 2.0 kg or more in weight. Adjustment for treatment group did not materially alter this relationship. There was no difference in baseline IGF-II by treatment group. There was no difference between the group with weight gain and the group with stable weight in those who additionally received insulin or sulfonylurea treatment in the 5 years between the baseline visit and the follow-up.

Conclusions

In subjects of normal weight with type 2 diabetes, baseline IGF-II concentration is inversely related to future weight gain, independent of treatment effect, strengthening the putative role for IGF-II in regulating fat mass. We propose that IGF-II measurement has potential utility in this group for targeting such individuals for early intervention.

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Keywords : IGF-II, Type 2 diabetes, Weight gain


Esquema


 The NHS North-West Research and Development Directorate funded the work of AH in this project, and Salford Royal Hospitals NHS Trust funded technical support. Support was also given by the Swedish Diabetes Foundation and the S. Persson Family Foundation.


© 2006  Elsevier Inc. Reservados todos los derechos.
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Vol 119 - N° 2

P. 167.e9-167.e15 - février 2006 Regresar al número
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