Decreased Serum Insulin-like Growth Factor-I is a Risk Factor for Non-vertebral Fractures in Diabetic Postmenopausal Women.
Objective Previous studies have shown that serum insulin-like growth factor-I (IGF-I) is involved in diabetes-related bone fragility. Although lower serum levels of IGF-I are reported to be associated with a higher risk of vertebral fractures in patients with type 2 diabetes, it is unknown whether or not the serum level of IGF-I is associated with the incidence of non-vertebral fractures. Methods We investigated the relationships between the serum levels of IGF-I and the incidence of non-vertebral osteoporotic fractures in 188 men and 168 postmenopausal women with type 2 diabetes. Results A multiple logistic regression analysis adjusted for age, duration of diabetes, observation period, body mass index, HbA1c, serum creatinine, and the bone mineral density at the lumbar spine showed that the serum IGF-I level was significantly and inversely associated with the incidence of non-vertebral osteoporotic fractures in postmenopausal women (odds ratio =0.48, 95% confidential interval [CI] 0.23-0.99 per SD increase; p=0.047), but not in men. Moreover, the inverse association between the serum IGF-I level and the incidence of non-vertebral fractures remained significant after additional adjustment for insulin use, and the serum calcium and phosphate levels (odds ratio =0.48, 95% CI 0.23-0.99 per SD increase; p=0.046). Conclusion This is the first study to show that decreased serum IGF-I levels are associated with a higher risk of non-vertebral osteoporotic fractures in postmenopausal women with type 2 diabetes. Serum IGF-I could be a useful marker for assessing the incidence of osteoporotic fractures.
Department of Internal Medicine 1, Shimane University Faculty of Medicine, Japan.
Hitomi
H
Miyake
Ippei
I
Kanazawa
Toshitsugu
T
Sugimoto
D000368:Aged; D015415:Biomarkers / Q000097:blood*; D015519:Bone Density; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D015994:Incidence; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications*; D058866:Osteoporotic Fractures / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D012307:Risk Factors
D015415:Biomarkers; D007334:Insulin-Like Growth Factor I