title: Decreased serum levels of insulin-like growth factors and IGF binding protein 3 in osteoporosis.
abstract: OBJECTIVE
  The aim of the study was to investigate endogenous growth hormone (GH) secretion in patients with osteoporosis and in patients with degenerative bone diseases or no spinal disease by measuring serum insulin-like growth factors 1 and 2 (IGFs) and their major binding protein 3 (BP-3) as an indirect parameter of GH secretion.
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  All patients were seen as out-patients of the Endocrinology Department of the University of Heidelberg where all bone parameters were measured. IGFs and BP-3 serum levels were measured at the Children's Hospital of the University of Tübingen.
  
  
  METHODS
  A total number of 310 patients were studied. The group with primary osteoporosis and vertebral fractures (OPO) consisted of 141 patients (98 females, 43 males). Spinal degenerative bone disease or osteoarthritis (DEG) was present in 108 patients (91 females, 17 males). Sixty-one control patients (56 females, 5 males) had no spinal disease on X-ray, but presented with lower back pain.
  
  
  METHODS
  Serum levels of IGFs, BP-3, PTH and 25-vitamin D3 were measured by radioimmunoassay. Bone mineral density (BMD) was determined using absorptiometry; anthropometric parameters and menopausal status were recorded.
  
  
  RESULTS
  There was no difference in age and years after menopause between OPO and DEG, but control individuals were younger. Mean IGFs and BP-3 serum levels in patients with OPO were lower (P < 0.001) than those in patients with DEG or in controls. Patients with DEG had significantly higher BP-3 levels than controls (P < 0.001). There was a significant (P < 0.05) negative correlation of BP-3 with age in females with OPO, but not in controls or in DEG patients. The IGFs did not decrease with age in any of the three groups. Binding protein 3 was positively correlated (P < 0.05) with BMD in postmenopausal women with OPO but not in controls or DEG patients.
  
  
  CONCLUSIONS
  We conclude that systemic IGFs and IGF binding protein 3 are decreased in patients with osteoporosis. Further studies are needed to investigate whether this is as a result of diminished secretion of endogenous GH and whether this reflects the local circumstances of IGFs and IGF binding proteins in bone.
authors.affiliation: Department of Internal Medicine I, Endocrinology and Metabolism, University of Heidelberg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Wüster
authors.forename: W F
authors.initials: WF
authors.lastname: Blum
authors.forename: S
authors.initials: S
authors.lastname: Schlemilch
authors.forename: M B
authors.initials: MB
authors.lastname: Ranke
authors.forename: R
authors.initials: R
authors.lastname: Ziegler
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D015519:Bone Density; D002352:Carrier Proteins / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D018969:Insulin-Like Growth Factor Binding Proteins; D017116:Low Back Pain / Q000097:blood; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000097:blood; D010024:Osteoporosis / Q000097:blood*; D015663:Osteoporosis, Postmenopausal / Q000097:blood; D011863:Radioimmunoassay; D012044:Regression Analysis; D013002:Somatomedins / Q000378:metabolism*
chemical_list: D002352:Carrier Proteins; D018969:Insulin-Like Growth Factor Binding Proteins; D013002:Somatomedins