title: Low levels of insulin-like growth-factor-binding protein-1 (IGFBP-1) are prospectively associated with the incidence of type 2 diabetes and impaired glucose tolerance (IGT): the Söderåkra Cardiovascular Risk Factor Study.
abstract: OBJECTIVE
  To explore the association between baseline levels of insulin-like growth-factor-binding protein-1 (IGFBP-1), a marker of insulin sensitivity, and the development of type 2 diabetes or impaired glucose tolerance (IGT) in a specifically defined middle-aged population.
  
  
  METHODS
  This cross-sectional population-based screening study was conducted in 1989-1990 and included baseline data for 664 non-diabetic subjects aged 40-59 years. Clinical data were collected and blood samples analyzed for blood glucose, serum lipids and insulin. Blood specimens were frozen at baseline and later analyzed for IGF-I, IGFBP-1 and C-reactive protein (CRP). At the follow-up in 2006, the incidence of type 2 diabetes and IGT was reported based on primary-care medical records.
  
  
  RESULTS
  During the 17-year observation period, 42 subjects (6.3%) developed type 2 diabetes/IGT. Those in the lowest quintile of IGFBP-1 (< or =24 microg/L) at baseline had a diabetes incidence of 12.6% while, in the highest quintile of IGFBP-1 (> or =59 microg/L), the incidence was 1.5%. Cox's proportional-hazards model regression analyses were used to determine the incidence of type 2 diabetes/IGT, corrected for age and gender, in relation to IGFBP-1, CRP and waist circumference. Subjects in the lowest IGFBP-1 quintile showed an independently increased risk of type 2 diabetes/IGT [hazards ratio (HR): 3.54; 95% CI 1.18-10.6; P=0.024]. For CRP and waist circumference, the corresponding figures were HR: 6.81; 95% CI 2.50-18.6; P<0.001 and HR: 3.33; 95% CI 1.47-7.6; P=0.004, respectively.
  
  
  CONCLUSIONS
  Low levels of IGFBP-1 predicted the long-term development of type 2 diabetes or IGT in a middle-aged population. The association was independent of CRP and abdominal obesity.
authors.affiliation: Primary Health Care Centre, Kalmar County Council, Kyrkvägen 28, 38551 Söderåkra, Sweden. ullape@ltkalmar.se
authors.forename: U
authors.initials: U
authors.lastname: Petersson
authors.forename: C J
authors.initials: CJ
authors.lastname: Ostgren
authors.forename: L
authors.initials: L
authors.lastname: Brudin
authors.forename: K
authors.initials: K
authors.lastname: Brismar
authors.forename: P M
authors.initials: PM
authors.lastname: Nilsson
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood* / Q000172:deficiency*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
chemical_list: D018970:Insulin-Like Growth Factor Binding Protein 1