Circulating IGF-I and its protective role in the pathogenesis of diabetic angiopathy
Poor glycaemic control in type I diabetes is associated with elevated serum IGFBP-1 levels and reduced rather than elevated serum IGF-I levels. Increasing age is accompanied by a further decrease in serum IGF-I levels as well as an increase in IGFBP-I levels in adult diabetic type 1 and type 2 subjects. This is especially observed in diabetic type I subjects with manifest microvascular complications. IGFBP-I has been proposed as one of the IGF-I inhibitors in the serum of diabetics. Lowered IGF-I and increased IGFBP-1 levels in the blood may thus result in decreased IGF-I bioavailability at the tissue level. We hypothesize that the premature and progressive decline in serum IGF-I bioactivity during ageing in diabetics ultimately results in insufficient protective effects by IGF-I in the kidneys, eyes and neurones, and thus the progression of diabetic microvascular complications. If this hypothesis is proven to be right, treatment of diabetic patients with IGF-I (eventually complexed to IGFBPs) as an adjunct to insulin might prevent and not worsen the development of diabetic microvascular complications.
|Persistent URL||dx.doi.org/10.1046/j.1365-2265.2000.00922.x, hdl.handle.net/1765/31857|
Janssen, J.A.M.J.L., & Lamberts, S.W.J.. (2000). Circulating IGF-I and its protective role in the pathogenesis of diabetic angiopathy. Clinical Endocrinology, 52(1), 1–9. doi:10.1046/j.1365-2265.2000.00922.x