title: Adiponectin, body mass index and hepatic steatosis are independently associated with IGF-I status in obese non-diabetic women.
abstract: OBJECTIVE
  Low IGF-I levels have been associated with obesity, insulin resistance, hepatic steatosis, and were shown to predict cardiovascular mortality. Adiponectin, on the other hand, was proved to have an important protective role against metabolic and cardiovascular diseases. This study investigates the relation between hepatic steatosis, adiponectin and IGF-I levels in a group of non-diabetic obese Romanian women.
  
  
  METHODS
  This cross-sectional study included 201 obese non-diabetic women, with mean age of 41.1±11.9 years and mean body mass index (BMI) of 44.1±8.3 kg/m(2), consecutively admitted to the Endocrinology Department of a University Hospital to be evaluated as candidates for bariatric surgery. Main measured parameters included total adiponectin (detected by ELISA method), insulin, C reactive protein (CRP), and IGF-I (all by chemiluminescence methods). Insulin sensitivity was assessed using the Quantitative Insulin Sensitivity Check Index (QUICKI). Patients were considered IGF-deficient if IGF-I z score was ≤2 standard deviations from mean for age. Hepatic ultrasound was used to determine the presence of significant steatosis (SS+).
  
  
  RESULTS
  Significant steatosis was observed in 60.7% of our patients and this feature was associated with reduced total adiponectin levels (p<0.001) and lower IGF-I z scores (p<0.001). IGF-I z score negatively correlated with BMI (r=-0.283, p<0.001), alanine aminotransferase (ALT) (r=-0.130, p=0.032), gamma glutamyltransferase (GGT) (r=-0.158, p=0.018) and logarithmic transformed (log) CRP (r=-0.232, p=0.001) and positively correlated with QUICKI (r=0.148, p=0.023) and log adiponectin (r=0.216, p=0.003). The relationship between IGF-I z score and log adiponectin remained significant after adjusting for age, BMI, ALT, QUICKI and log CRP (r=0.183, p=0.012). IGF-I deficiency was present in 33.3% of these obese women. In multivariate logistic analysis, BMI (p<0.001), ALT (p=0.003), log adiponectin (p<0.001) and SS (p=0.043) proved to be independently associated with IGF-I deficiency.
  
  
  CONCLUSIONS
  Adiponectin is significantly correlated with IGF-I z scores and, along with BMI, ALT and significant steatosis, is independently associated with IGF-I deficiency in obese non-diabetic women.
authors.affiliation: Carol Davila University of Medicine and Pharmacy, Endocrinology Department, Elias University Hospital, Bucharest, Romania.
authors.forename: A
authors.initials: A
authors.lastname: Sirbu
authors.forename: S
authors.initials: S
authors.lastname: Gologan
authors.forename: T
authors.initials: T
authors.lastname: Arbanas
authors.forename: C
authors.initials: C
authors.lastname: Copaescu
authors.forename: S
authors.initials: S
authors.lastname: Martin
authors.forename: A
authors.initials: A
authors.lastname: Albu
authors.forename: C
authors.initials: C
authors.lastname: Barbu
authors.forename: I
authors.initials: I
authors.lastname: Pirvulescu
authors.forename: S
authors.initials: S
authors.lastname: Fica
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001823:Body Composition / Q000502:physiology; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000097:blood; D005234:Fatty Liver / Q000097:blood* / Q000378:metabolism; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D007334:Insulin-Like Growth Factor I / Q000032:analysis* / Q000378:metabolism; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000378:metabolism; D055815:Young Adult
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D007334:Insulin-Like Growth Factor I