IGF-1 and IGF-binding proteins and bone mass, geometry, and strength: relation to metabolic control in adolescent girls with type 1 diabetes.
IGF-1 and IGF-binding proteins and bone mass, geometry, and strength: relation to metabolic control in adolescent girls with type 1 diabetes.
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DOI：
10.1359/jbmr.080713
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发表时间：
2008-12
期刊：
影响因子：
--
通讯作者：
Murray MA
中科院分区：
文献类型：
--
作者：
Moyer-Mileur LJ;Slater H;Jordan KC;Murray MA
1 型糖尿病 (T1DM) 控制不佳的儿童和青少年面临骨量下降的风险。生长激素 (GH) 及其介质 IGF-1 可促进骨骼生长。最近的观察表明，患有 T1DM 的儿童和青少年面临骨矿物质获取减少的风险。我们研究了 12-15 岁患有 T1DM 的少女 (n = 11) 和匹配对照 (n = 10) 中 T1DM 的代谢控制、IGF-1 及其结合蛋白 (IGFBP-1、-3、-5) 和骨量之间的关系。受试者入院过夜并接受标准化饮食。定期获取血液样本，并进行骨骼测量。与对照组相比，T1DM 患者的血清 GH、IGFBP-1 和 -5、糖化血红蛋白 (HbA1c)、葡萄糖和尿镁水平较高，IGF-1 值较低 (p < 0.05)。 T1DM 患者的全身 BMC/骨面积 (BA)、股骨颈面积 BMD (aBMD) 和骨矿物质表观密度 (BMAD) 以及胫骨皮质 BMC 较低 (p < 0.05)。糖尿病控制不佳预示 IGF-1 (r2 = 0.21) 较低，IGFBP-1 (r2 = 0.39)、IGFBP-5 (r2 = 0.38) 和骨特异性碱性磷酸酶 (BALP；r2 = 0.41，p < 0.05) 较高。尿液中镁排泄量越高，则预示着整体骨骼越短、越轻，胫骨皮质骨尺寸、矿物质和密度也越低（r2 = 0.44–0.75，p < 0.05）。在 T1DM 队列中，诊断时年龄越早，IGF-1 越低、尿镁排泄量越高、皮质骨越轻、越薄（r2 ≥ 0.45，p < 0.01）。我们的结论是，不良的代谢控制会改变 GH/IGF-1 轴，而尿镁排泄量增加可能反映了肾功能和/或糖尿的微妙变化，导致患有 T1DM 的青春期女孩骨大小和密度的改变。
Children and adolescents with poorly controlled type 1 diabetes mellitus (T1DM) are at risk for decreased bone mass. Growth hormone (GH) and its mediator, IGF-1, promote skeletal growth. Recent observations have suggested that children and adolescents with T1DM are at risk for decreased bone mineral acquisition. We examined the relationships between metabolic control, IGF-1 and its binding proteins (IGFBP-1, -3, -5), and bone mass in T1DM in adolescent girls 12–15 yr of age with T1DM (n = 11) and matched controls (n = 10). Subjects were admitted overnight and given a standardized diet. Periodic blood samples were obtained, and bone measurements were performed. Serum GH, IGFBP-1 and -5, glycosylated hemoglobin (HbA1c), glucose, and urine magnesium levels were higher and IGF-1 values were lower in T1DM compared with controls (p < 0.05). Whole body BMC/bone area (BA), femoral neck areal BMD (aBMD) and bone mineral apparent density (BMAD), and tibia cortical BMC were lower in T1DM (p < 0.05). Poor diabetes control predicted lower IGF-1 (r2 = 0.21) and greater IGFBP-1 (r2 = 0.39), IGFBP-5 (r2 = 0.38), and bone-specific alkaline phosphatase (BALP; r2 = 0.41, p < 0.05). Higher urine magnesium excretion predicted an overall shorter, lighter skeleton, and lower tibia cortical bone size, mineral, and density (r2 = 0.44–0.75, p < 0.05). In the T1DM cohort, earlier age at diagnosis was predictive of lower IGF-1, higher urine magnesium excretion, and lighter, thinner cortical bone (r2 ≥ 0.45, p < 0.01). We conclude that poor metabolic control alters the GH/IGF-1 axis, whereas greater urine magnesium excretion may reflect subtle changes in renal function and/or glucosuria leading to altered bone size and density in adolescent girls with T1DM.
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