Korean J Nephrol.  2005 May;24(3):375-383.

Relationship between Serum Insulin-like Growth Factor-1 Concentration and Insulin Resistance in End-stage Renal Disease Patients

• Lee SW
• Lee KH
• Park GH
• Lee SW
• Song JH
• Kim MJ

Abstract

BACKGROUND
Insulin resistance is a characteristic feature of uremia and recent studies suggested that it might be one of the causes of muscle wasting. Serum insulin-like growth factor 1 (IGF-1) has been known as one of marker of malnutrition in end-stage renal disease (ESRD) patients. However, there were few studies on the relationship between IGF-1 and insulin resistance. METHODS: We measured serum IGF-1, prealbumin, albumin, plasma insulin and glucose concentration and body composition by dual energy X-ray absorptiometry in 20 non-diabetic ESRD patients who admitted to start dialysis. Homeostasis model assessment method of insulin resistance (HOMA-IR) was used for insulin resistance. RESULTS: Patients with IGF-1 <200 ng/mL (n=6) had significantly lower body weight (BW), body mass index (BMI), prealbumin (29.8+/-7.0 vs. 39.7+/-9.3 mg/ dL, p=0.022), Fat mass, pFat (percent fat mass), pFat-limb and HOMA-IR (1.44+/-0.59 vs. 3.47+/-2.22, p=0.04) than those with >200 ng/mL (n=14). IGF-1 showed positive correlations with BMI (r=0.45), prealbumin (r=0.6), Fat-limb (r=0.51), and HOMA-IR (r=0.67). On WHO classification for weight status, IGF-1 seemed to be higher when weight status was increased from underweight (151.8+/-41.6 ng/mL) to overweight (371.8+/-109.8 ng/mL) and these trends were similar to those of HOMA-IR. On multivariate analysis, IGF-1 was independent variable for affecting HOMA-IR. CONCLUSION: Serum IGF-1 concentration seems to be associated with insulin resistance in ESRD patients and reflect body composition, especially fat mass.

Keyword

Insulin-like growth factor-1; Insulin resistance; Chronic renal failure; Body composition

MeSH Terms

Absorptiometry, Photon
Body Composition
Body Mass Index
Body Weight
Classification
Dialysis
Glucose
Homeostasis
Humans
Insulin Resistance*
Insulin*
Insulin-Like Growth Factor I
Kidney Failure, Chronic*
Malnutrition
Multivariate Analysis
Overweight
Plasma
Prealbumin
Thinness
Uremia
Glucose
Insulin
Insulin-Like Growth Factor I
Prealbumin