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Circulating IGF‐I and its protective role in the pathogenesis of diabetic angiopathy
Author(s) -
Joseph A M J L Janssen,
Steven W. J. Lamberts
Publication year - 2000
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1046/j.1365-2265.2000.00922.x
Subject(s) - medicine , angiopathy , endocrinology , pathogenesis , diabetes mellitus , diabetic angiopathy , type 2 diabetes , growth factor , insulin , receptor
Poor glycaemic control in type 1 diabetes is associated with elevated serum IGFBP‐1 levels and reduced rather than elevated serum IGF‐I levels. Increasing age is accompanied by a further decrease in serum IGF‐I levels as well as an increase in IGFBP‐l levels in adult diabetic type 1 and type 2 subjects. This is especially observed in diabetic type 1 subjects with manifest microvascular complications. IGFBP‐I has been proposed as one of the IGF‐I inhibitors in the serum of diabetics. Lowered IGF‐I and increased IGFBP‐1 levels in the blood may thus result in decreased IGF‐I bioavailability at the tissue level. We hypothesize that the premature and progressive decline in serum IGF‐I bioactivity during ageing in diabetics ultimately results in insufficient protective effects by IGF‐I in the kidneys, eyes and neurones, and thus the progression of diabetic microvascular complications. If this hypothesis is proven to be right, treatment of diabetic patients with IGF‐I (eventually complexed to IGFBPs) as an adjunct to insulin might prevent and not worsen the development of diabetic microvascular complications.