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

clinicians to focus on the effects of IGF-1 and IGFBP-3 to produce nitric oxide, which, further, leads to changes
on renal function in patients with type 2 diabetes and to in renal hemodynamics. In addition, IGF-1 can interact
understand the association of IGF-1 and IGFBP-3 with with the renin-angiotensin system to cause changes in
eGFR, which might be important for renal function glomerular hemodynamics [36,37] .
assessment and early diagnosis. By observing the There are inconsistent results reported on the relationship
indicators of all patients, serum IGF-1 and IGFBP-3 between serum IGF-1, IGFBP-3, and diabetes risk. In a
were positively correlated with eGFR. This suggests study that included normoglycemic patients between the
that serum IGF-1 and IGFBP-3 play a key role in renal ages of 45 and 65 years, it was observed that serum IGF-1
function.
was associated with a reduced risk of type 2 diabetes after
The relationship between serum IGF-1 and GFR is a glucose tolerance test . In contrast, it has also been
[38]
unclear. So far, only one study has been conducted to found that serum IGF-1or IGFBP-3 was not associated with
investigate the correlation between serum IGF-1, IGFBP- diabetes risk . In our study, serum IGF-1 and IGFBP-3
[39]
3, and GFR in patients with type 2 diabetes, showing that levels were not correlated with FBG, 2-h OGTT and HbA1c,
the levels of these two proteins are not related to GFR in which is consistent with previous reports [40,41] . However,
all patients . In addition, another study found that serum in univariate regression analysis, FPG and HbA1c were
[21]
IGF-1 reduction was associated with lower eGFR in insulin- significantly positively correlated with eGFR.
[22]
resistant obese patients . On the contrary, in 4028 (2048
women) subjects between the age of 20 and 81 years, IGF-1 In comparison, only FPG was statistically significant
was inversely correlated with BMI, presence of diabetes, in multivariate regression analysis. Weil et al. found that
and GFR [23,24] . Hence, the association between IGF-1 and GFR was positively associated with fasting glucose and
[42]
eGFR in patients with type 2 diabetes is not yet understood. glycated hemoglobin in patients with type 2 diabetes .
In this study, we studied 521 Chinese patients with type 2 Hyperglycemia may cause hyperfiltration in diabetic
diabetes. Spearman correlation analysis found that both patients when they do not develop the end-stage renal
serum IGF-1 and IGFBP-3 are positively linked with eGFR. disease in the early stages of diabetes.
Then, we established the linear regression model of IGF- Dyslipidemia is the basis of cardiovascular disease.
1and the linear regression model of IGFBP-3. Interestingly, The concentration of serum HDL-c is inversely correlated
IGF-1and IGFBP-3 were still related to eGFR. In summary, with the risk of coronary heart disease [43,44] . Each 1 mg/
we speculate that serum IGF-1and IGFBP-3 may be factors dL increase in HDL-c reduces the risk of coronary heart
that affect the level of eGFR in type 2 diabetes. disease by approximately 2 – 3% . It was previously
[45]
This study shows that IGF-1 and IGFBP-3 are positively reported that IGF-1 is a protective factor for coronary
[46]
correlated with eGFR. The physiological link between heart disease in patients with type 2 diabetes .
IGF-1 levels and renal disease in type 2 diabetes is not fully Song et al. showed that serum IGF-1 was positively
[47]
understood; however, it is generally believed that the GH/ correlated with HDL-c. Our study showed a positive
IGF-1 axis affects renal function [25,26] . correlation between serum IGFBP-3 and TG, TC, and
IGF-1 promotes the division of mesangial cell in LDL-c in correlation analysis. However, no correlation was
glomeruli , and it can inhibit the apoptosis of mesangial found in linear regression. Further studies need to confirm
[27]
and podocyte cells . IGF-1 may increase glomerular the role of serum IGFBP-3 on lipid metabolism in type 2
[28]
perfusion by reducing the resistance of the arterioles [29,30] . It diabetic patients.
is worth noting that micro-puncture studies have also shown Although there are overlaps in the current findings with
that IGF-1 increases single nephron GFR and blood flow by previous epidemiological and laboratory data, the present
expanding the ultrafiltration coefficient and reducing the study has several limitations that must be considered in the
resistance of the efferent arterioles . Furthermore, IGF-1 interpretation of its findings. First, the small sample size
[26]
can increase extracellular volume and plasma volume [31,32] , does not allow for a comprehensive assessment of the entire
which also helps increase glomerular filtration. In most population, and the findings may be biased. This bias may
patients with decreased renal function, the expression of be reflected in the correlation between IGF-1 and eGFR,
growth hormone receptor and IGF-1 gene in the kidney is and large-scale population data are needed to confirm our
diminished, which is a cause of reduced GFR [33,34] . results in the future. Furthermore, nutrition is an essential

Similarly, Jorgensen et al. found that the reduction of factor in the regulation of IGF-1. Another limitation of
[35]
renal plasma flow and glomerular filtration was related to this study may be the lack of data concerning nutritional
the lack of IGF-1 and growth hormone. The role of IGF-1 status . In addition, we need to include more patients
[48]
in a high glucose environment induces mesangial cells with eGFR of < 60 ml/min/1.73 m , and then conduct a
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Volume 1 Issue 2 (2022) 7 https://doi.org/10.36922/gtm.v1i2.62