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Global Translational Medicine IGF-1 and IGFBP-3 levels are correlated with eGFR

excretion . However, this view has been challenged, ketoacidosis (n = 15); (iv) patients with diabetic foot
[3]
because many patients with type 2 diabetes mellitus suffer (n = 8); and (v) patients with impaired glucose tolerance
from a decline in glomerular filtration rate (GFR) in the (n = 13). Finally, complete data from 521 patients were
absence of proteinuria, as confirmed by Kramer et al. , analyzed (Figure 1). This study was approved by the Ethics
[4]
[5]
Garg et al. and MacIsaac et al. Therefore, in many cases, Committee of the First Affiliated Hospital of Xinjiang
[6]
CKD is defined as a continuous decrease in GFR. Medical University.
Insulin-like growth factors (IGFs) are proteins The diagnostic criteria for type 2 diabetes are based on
with multiple functions, including stimulation of cell the 1999 World Health Organization criteria: (i) Typical
proliferation, inhibition of apoptosis, and enhancement of symptoms of diabetes (polydipsia, polyuria, polyphagia,
cell motility as well as the regulation of cell differentiation and and weight loss); and (ii) random venous plasma blood
transformation . Among the IGFs, the IGF-1 gene encodes glucose ≥ 11.1 mmol/L (200 mg/dL) or fasting blood
[7]
a small protein made up of 70 amino acid residues. IGF-1 glucose ≥ 7.0 mmol/L (126 mg/dL) or oral glucose
is an anabolic hormone and a primary mediator for growth tolerance test (OGTT) 2h glucose in venous plasma
hormone (GH)-related signaling pathways . It also plays a (for those without diabetic symptoms, repeat the test on
[8]
versatile role in regulating many cellular processes, such as another day) ≥ 11.1 mmol/L (200 ng/dL).
cellular metabolism, growth, proliferation, and apoptosis in 2.2. Data collection
multiple organs, and promoting the growth, development, and
maintenance of cells . The kidney can produce and release Clinical variables that were reviewed from electronic
[9]
IGF-1 and is also the target organ of the GH/IGF-1 axis. Free medical records include age, sex, body mass index (BMI),
IGF-1 in the blood is biologically active; more than 90% of and blood pressure. Height and weight were measured
IGF-1 binds to the IGF factor-binding protein-3 (IGFBP-3) to the nearest 0.5 cm and 0.1 kg, respectively. BMI was
in plasma. Therefore, IGFBP-3 is the primary regulator of the calculated as body weight (kg) divided by the square
biological activity of plasma IGF-1 [10-12] . In the literature, we of height (m). Readings of blood pressure (BP) were
can find that the molar ratio of IGF-1/IGFBP-3 is commonly obtained using a mercury sphygmomanometer from the
used to reflect the bioactivity of IGF-1 [13,14] . left arm of patients in supine position, after 5 min of quiet
rest. Values were calculated as the average of the last two
A prospective study observed that the serum IGFBP-3 of three consecutive measurements obtained at 3-min
levels were positively correlated with the risk of type 2 intervals.
diabetes independent of IGF-1 levels . IGF-1 and
[15]
IGFBP-3 not only are correlated to diabetes but also have
specific effects on the kidneys. It has been shown that
serum IGF-1 levels are related to GFR . Furthermore, the
[16]
administration of intravenous recombinant human IGF-1
(rhIGF-1) stimulates the kidney in healthy subjects by
increasing GFR and renal plasma flows [17,18] . Nevertheless,
few studies have explored the level of IGF-1 in patients
with type 2 diabetes and its relationship with kidney
disease.

This cross-sectional study aimed to assess the
association of IGF-1 and IGFBP-3 with indicators of renal
function.

2. Materials and methods

2.1. Patients and study design
We reviewed the records of 614 patients who visited and
completed type 2 diabetes screening at the Endocrinology
Department of the First Affiliated Hospital of Xinjiang
Medical University from March 1, 2021, to December 20,
2021. The exclusion criteria are as follows: (i) Patients whose Figure 1. Flow chart of this study.
The relationship between insulin-like growth factor (IGF)-1, IGF factor-
data were incomplete or missing (n = 40); (ii) patients with binding protein-3, and estimated glomerular filtration rate was clarified
other types of diabetes (n = 17); (iii) patients with diabetic by correlation analysis and linear regression.

Volume 1 Issue 2 (2022) 2 https://doi.org/10.36922/gtm.v1i2.62