The trajectory of IGF-1 across age and duration of type 1 diabetes

Diabetes Metab Res Rev. 2014 Nov;30(8):777-83. doi: 10.1002/dmrr.2554.

Abstract

Background: Individuals with type 1 diabetes may have low IGF-1, related to insulinopenia and insulin resistance. There are few longitudinal studies of IGF-1 levels to establish its pattern in type 1 diabetes with duration and age, and to examine whether IGF-1 tracks within individuals over time. We examine age and duration trends, and the relationship of IGF-1 to gender, glycaemic control, insulin level and other factors.

Methods: Participants in the Wisconsin Diabetes Registry Study, an incident cohort study of type 1 diabetes diagnosed May 1987-April 1992, were followed for up to 18 years with IGF-1 samples up to age 45 for women and age 37 for men.

Results: IGF-1 is lower with type 1 diabetes than in normative samples. Although, the pattern across age resembles that in normative samples with a peak in adolescence and slow decline after age 20, the adolescent peak is delayed for women with type 1 diabetes. There was low to moderate tracking of IGF-1 within an individual. Higher insulin dose was associated with higher IGF-1 as was puberty, and female gender. Adjusted for these factors, IGF-1 declined rapidly across early diabetes duration. Lower HbA1c was most strongly related to higher IGF-1 at Tanner stages 1 and 2.

Conclusions: IGF-1 is low in type 1 diabetes, with a delayed adolescent peak in women and is especially influenced by glycaemic control in early and pre-adolescence. High variability within an individual is likely a challenge in investigating associations between IGF-1 and long-term outcomes, and may explain contradictory findings.

Keywords: IGF-1; predictors; tracking; trajectory; type 1 diabetes; variance.

Publication types

  • Research Support, American Recovery and Reinvestment Act
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aging*
  • Child
  • Cohort Studies
  • Diabetes Complications / epidemiology
  • Diabetes Complications / prevention & control*
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / metabolism
  • Diabetes Mellitus, Type 1 / physiopathology
  • Disease Progression
  • Down-Regulation
  • Female
  • Humans
  • Hypoglycemic Agents / blood
  • Hypoglycemic Agents / therapeutic use
  • Insulin / blood
  • Insulin / therapeutic use*
  • Insulin Resistance*
  • Insulin-Like Growth Factor I / analysis*
  • Longitudinal Studies
  • Male
  • Prospective Studies
  • Registries
  • Risk Factors
  • Sex Characteristics
  • Up-Regulation / drug effects*
  • Wisconsin / epidemiology
  • Young Adult

Substances

  • Hypoglycemic Agents
  • IGF1 protein, human
  • Insulin
  • Insulin-Like Growth Factor I