IGF-1, IGFBP-3 and ALS in adult patients with chronic kidney disease.
BACKGROUND
Insulin-like growth factor I (IGF-1) is for the most part bound in a ternary complex with IGF-binding protein-3 (IGFBP-3) and acid-labile subunit (ALS). This ternary complex is a storage form of IGF-1 in blood and passes not through the renal glomerulus. Little information is available in regard to the components of the ternary complex in adult renal disease.


OBJECTIVE
To investigate levels of serum IGF-1, IGFBP-3 and ALS in relation to renal function and extent of proteinuria.


METHODS
We measured IGF-1, IGFBP-3 and ALS concentrations in 137 patients who were investigated due to proteinuria and/or haematuria and/or renal impairment. The patients received renal biopsies and the histological diagnosis was documented. Urinary albumin excretion and relevant clinical parameter were evaluated.


RESULTS
IGF-1 showed a highly positive correlation to IGFBP-3 and ALS, and the latter to IGFBP-3. IGF-1, IGFBP-3 and ALS decreased with increasing age. IGF-1 and IGFBP-3 showed no significant change depending on the creatinine clearance. However, ALS decreased with decreasing renal function. In patients with heavy proteinuria ALS levels, but not IGF-1 and IGFBP-3 levels, decreased significantly. Patients with chronic ischaemic renal damage and diabetic glomerulopathy showed higher IGF-1 and IGFBP-3 levels compared to patients with thin glomerular basement membrane disease despite their older age.


CONCLUSIONS
IGF-1 and IGFBP-3 levels seem to be independent of renal function and severity of proteinuria. However, ALS levels are altered in renal failure and nephrotic syndrome, which may be due to increased renal loss or diminished hepatic production or both.
Lepenies
Julia
J
KfH Dialysis Center Bismarckstrasse, Berlin, Germany.
Wu
Zida
Z
Stewart
Paul M
PM
Strasburger
Christian J
CJ
Quinkler
Marcus
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002352:Carrier Proteins / Q000097:blood / Q000378:metabolism* / Q000652:urine; D015331:Cohort Studies; D003404:Creatinine / Q000652:urine; D005260:Female; D006023:Glycoproteins / Q000097:blood / Q000378:metabolism* / Q000652:urine; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3; D018969:Insulin-Like Growth Factor Binding Proteins / Q000097:blood / Q000378:metabolism* / Q000652:urine; D007334:Insulin-Like Growth Factor I / Q000032:analysis / Q000378:metabolism* / Q000652:urine; D007677:Kidney Function Tests; D008111:Liver Function Tests; D008297:Male; D008657:Metabolic Clearance Rate / Q000502:physiology; D008875:Middle Aged; D011507:Proteinuria / Q000097:blood / Q000378:metabolism / Q000473:pathology; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000378:metabolism* / Q000473:pathology / Q000652:urine; D055815:Young Adult
D002352:Carrier Proteins; D006023:Glycoproteins; C515497:IGFBP3 protein, human; D018972:Insulin-Like Growth Factor Binding Protein 3; D018969:Insulin-Like Growth Factor Binding Proteins; C075944:insulin-like growth factor binding protein, acid labile subunit; D007334:Insulin-Like Growth Factor I; D003404:Creatinine