IGF-1 as an early marker for low bone mass or osteoporosis in premenopausal and postmenopausal women.
To find out which of the following parameters-serum levels of insulin-like growth factor 1 (IGF-1), osteoprotegerin (OPG), leptin, osteocalcin (OC), and urinary excretion of N-terminal telopeptide of type I collagen (NTx), can be used as an early marker for osteopenia/osteoporosis in women diagnosed by dual-energy X-ray absorptiometry (DXA), 282 premenopausal and 222 postmenopausal women aged 20-75 years were investigated by the measurement of bone mineral densities (BMDs) at lumbar spine (LS) and femoral neck (FN) by DXA, together with serum concentrations of IGF-1, OPG, leptin, OC, and urinary NTx. The characteristics of the earliest marker(s) were tested with the receiver operating characteristic (ROC) analysis. The area under the curve (AUC), sensitivity, and specificity parameters were determined. It was revealed that serum levels of IGF-1 and leptin changed the earliest, with both markers significantly decreasing (P < 0.0001) or increasing (P = 0.020), respectively, at age 30. However, in ROC analysis, IGF-1 was the only early parameter that had the capacity to differentiate the low bone mass/osteoporosis women from the normal ones (P < 0.0001). If the serum level of IGF-1 at 1.5 SD below its peak was adopted as a cutoff point, it could identify women with low bone mass/osteoporosis with a sensitivity of 73% and specificity of 67%. In the premenopausal women subgroup analysis, the low bone mass women (30/282, 10.6%) were older (38.2 +/- 1.7 vs. 34.5 +/- 0.5 years; P = 0.026), with lower serum levels of IGF-1 (215.1 +/- 22.4 vs. 278.8 +/- 9.4 ng/ml; P = 0.02) and less lean mass (33.1 +/- 0.6 vs. 34.8 +/- 0.2 kg; P = 0.010) than the normal ones. After controlling for age, the serum level of IGF-1 had a weak, but still significant, positive correlation with lean mass (r = 0.17, P < 0.001). In conclusion, measurement of serum IGF-1 in young women may help in the early identification of those at risk for developing low bone mass and osteoporosis.
Liu
Jian-min
JM
Department of Endocrine and Metabolic Diseases, Rui-jin Hospital, Shanghai Jiao-tong University Medical School, 197 Shanghai Rui-jin Er Road, Shanghai 200025, China.
Zhao
Hong-yan
HY
Ning
Guang
G
Chen
Ying
Y
Zhang
Lian-zhen
LZ
Sun
Li-hao
LH
Zhao
Yong-ju
YJ
Xu
Man-yin
MY
Chen
Jia-lun
JL
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000375:Aging; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D001842:Bone and Bones / Q000503:physiopathology*; D016207:Cytokines / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D020738:Leptin / Q000097:blood; D008875:Middle Aged; D009929:Organ Size; D010024:Osteoporosis / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D053244:Osteoprotegerin / Q000097:blood; D017698:Postmenopause / Q000502:physiology*; D017697:Premenopause / Q000502:physiology*; D012372:ROC Curve
D015415:Biomarkers; D016207:Cytokines; D020738:Leptin; D053244:Osteoprotegerin; D007334:Insulin-Like Growth Factor I