Diabetic retinopathy is associated with decreased serum levels of free IGF-I and changes of IGF-binding proteins

Berit Feldmann, Peter M. Jehle, Subburaman Mohan, Gabriele E. Lang, Gerhard K. Lang, Joachim Brueckel, Bernhard O. Boehm

Research output: Contribution to journalArticlepeer-review

Abstract

In patients with diabetic retinopathy, elevated serum levels of total circulating insulin-like growth factor-I (IGF-I) have been implicated as an important mediator of the disease. There is no study, however, measuring free IGF-I levels in patients with diabetic retinopathy which mediate the biological effects of IGF-I and are modulated by a complex system of six specific IGF binding proteins (IGFBPs) and several IGFBP proteases. To address the role of free IGF-I, we performed a cross-sectional study in 159 diabetes patients, among them 99 individuals with retinopathy (RP+; diabetes type 1/type 2: 41/58) and 60 without retinopathy (RP-; diabetes type 1/type 2: 22/38) and 110 age-matched healthy control subjects. Serum levels of both free and total IGF-I and IGFB-1 to -6 were determined by specific immunoassays. Free IGF-I levels were significantly lower in RP+ patients (1.1 ± 0.1 ng/ml) than in RP, patients (3.22 ± 0.3 ng/ml, P<0.005). In contrast, RP+ patients showed higher serum levels of total IGF-I (139.7 ± 5.8 ng/ml) than RP- patients (116.3 ± 8 ng/ml, P<0.05 vs RP+), which is consistent with previous reports. Type 1 diabetic patients with retinopathy showed significantly higher levels of IGFBP-1 but lower levels of IGFBP-2, -3 and -6 than type 1 patients without retinopathy. Type 2 patients with retinopathy showed lower levels of IGFBP-3 and -6, IGFBP-4 and -5 levels were not different between subgroups. Linear regression analysis revealed that free IGF-I levels correlated positively with IGFBP-3 and negatively with IGFBP-1. Furthermore, free IGF-I levels correlated negatively with HbA1c values, indicating that poor glycaemic control may contribute to a decreased IGF-I bioavailability. In summary, type 1 as well as type 2 diabetics with retinopathy showed markedly decreased levels of free IGF-I which correlated with complex alterations in IGFBPs and glycaemic control. (C) 2000 Harcourt Publishers Ltd.

Original languageEnglish
Pages (from-to)53-59
Number of pages7
JournalGrowth Hormone and IGF Research
Volume10
Issue number1
DOIs
StatePublished - Feb 2000

ASJC Scopus Subject Areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Keywords

  • Diabetic retinopathy
  • Insulin-like growth factor binding protein-1 to -6
  • Insulin-like growth factor-I (IGF-I)
  • Retinal regeneration

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