Korean J Intern Med.  2007 Sep;22(3):186-191. 10.3904/kjim.2007.22.3.186.

IGF-1 is an Independent Risk Factor for Anemia in Diabetic Pre-dialysis Patients

• Kim DH
• Kim TY
• Kim SM
• Yoo SJ
• Oh DJ
• Yu SH

• KMID: 1785625
• DOI: http://doi.org/10.3904/kjim.2007.22.3.186

Abstract

BACKGROUND: We investigated whether the presence of diabetes mellitus (DM) was related to the degree of the anemia in predialytic patients with renal failure and what was the most relevant factor for anemia in patients with chronic kidney disease (CKD) from DM (DM-CKD). METHODS: Seventy seven patients (47 predialytic patients with long-term type 2 DM (DM-CKD) and 30 predialytic patients whose disease was due to other causes (non DM-CKD)) were enrolled in this study. The blood hemoglobin (Hb) and hematocrit, and the creatinine, ferritin, vitamin B12, folate, iron, LDH, albumin, hs-CRP, intact-PTH, erythropoietin, leptin and Insulin-like growth factor I (IGF-1) levels were measured using standard methods. The estimated GFR was calculated using the abbreviated MDRD equation. RESULTS: The two groups did not significantly differ as to age, gender, the serum creatinine level and the inflammatory status. The Hb level was significantly lower in the DM-CKD patients than that in the non DM-CKD patients (8.5+/-1.7 g/dL vs 9.6+/-1.6 g/dL, respectively, p=0.01). The Hb level was significantly lower in the DM-CKD patients who were being treated with ACE inhibitors (the DM-ACE patients) than that in the non DM-CKD patients who were being treated with ACE inhibitors (the non DM-ACE patients) (8.5+/-1.5 g/dL vs 10.8+/-1.6 g/dL, respectively, p=0.001). Multiple regression analysis indicated that serum IGF-1 concentration was independently associated with the Hb level (beta=0.425, p=0.02) in the DM-CKD patients. CONCLUSIONS: The Hb concentration was significantly lower in the DM-CKD patients than that in the non DM-CKD patients. It was independently associated with the serum IGF-1 concentration in the DM-CKD patients.

Keyword

Diabetes mellitus; Kidney failure; Anemia; Insulin-like growth factor I; ACE inhibitor

MeSH Terms

Adult
Aged
Aged, 80 and over
Anemia/blood/diagnosis/*etiology
Case-Control Studies
Diabetes Mellitus, Type 1/blood/*complications
Female
Glomerular Filtration Rate
Hemoglobins/analysis
Humans
Insulin-Like Growth Factor I/*analysis
Male
Middle Aged
Renal Insufficiency, Chronic/blood/*complications
Risk Factors