Circulating insulin-like growth factor I concentrations in clinically severe obese patients with and without NIDDM in response to weight loss.
Earlier studies have demonstrated decreased levels of circulating Insulin-Like Growth Factor-I (IGF-I) in patients with NIDDM and IDDM (Yde 1969; Rieu and Binoux 1985), with a return to normal in those diabetics who achieve improved metabolic control (Rieu and Binoux 1985; Ameil, Sherwin, Hintz, Gertner, Press and Tamborlane 1984) following insulin therapy. One method of improving metabolic control in clinically severe obese NIDDM patients is the gastric bypass procedure (GBP). This study revealed a significant decrease in serum IGF-I concentrations in clinically severe obese patients with NIDDM (obese NIDDM) (105 ng/dl +/- 11; n = 29) as compared with clinically severe obese patients with normal glucose tolerances (obese control) (143 +/- 11; n = 21) and lean controls (177 +/- 14; n = 19) (p < 0.001). Following a GBP, IGF-I levels increased in the NIDDM group (142 ng/dl +/- 13.0; n = 20) to the extent that no significant difference was seen between postoperative NIDDM, obese controls, and lean controls. Postoperative IGF-I levels in the obese controls (151 +/- 14; n = 9) revealed no difference from preoperative levels. Postoperative obese NIDDM and obese control had a 28% and 29% decrease, respectively, in weight, with no difference between the groups in respect to Body Mass Indices. The NIDDM postoperative group revealed reductions in levels of HbA1C, insulin, and glucose concurrent with elevations in IGF-I when compared with controls. We conclude that improvement in glucose control led to the increase in IGF-I levels.
Poulos
J E
JE
Department of Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania.
Leggett-Frazier
N
N
Khazanie
P
P
Long
S
S
Sportsman
R
R
MacDonald
K
K
Caro
J F
JF
D000328:Adult; D000704:Analysis of Variance; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D015390:Gastric Bypass; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D016014:Linear Models; D009765:Obesity; D009767:Obesity, Morbid / Q000601:surgery; D015431:Weight Loss / Q000502:physiology*
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; D007334:Insulin-Like Growth Factor I