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Dysregulated growth hormone-insulin-like growth factor-1 axis in adult type 1 diabetes with long duration
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology.
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Rheumatology.
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
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2018 (English)In: Clinical Endocrinology, ISSN 0300-0664, E-ISSN 1365-2265, Vol. 89, no 4, p. 424-430Article in journal (Refereed) Published
Abstract [en]

ContextIn type 1 diabetes (T1D), dysregulation of the GH-IGF-1 axis has been reported. Whether this is related to upper extremity impairments (UEI) is unknown. ObjectiveExamine differences in GH-IGF-1 axis between T1D on subcutaneous insulin treatment and matched controls without diabetes and possible associations between GH-IGF-1 axis and UEI. DesignCross-sectional population-based study. Patients with T1D, onset amp;lt;35years, duration 20years, amp;lt;67years old and controls were invited to answer questionnaires and take blood samples. SubjectsA total of 605 patients with T1D and 533 controls accepted to participate. OutcomesFasting levels of IGF-1, IGF-1 Z-score, IGFBP-1, IGFBP-3, C-peptide, GH and UEI. ResultsPatients with T1D had lower IGF-1 and IGFBP-3 and higher IGFBP-1 and GH than controls. The difference in IGF-1 persisted with age. Insulin dose was associated with increasing IGF-1 Z-score but even at a very high insulin dose (amp;gt;1U/kg) IGF-1 Z-score was subnormal compared to controls. IGF-1 Z-score was unaffected by glycaemic control (HbA1c) but increased with residual insulin secretion, (C-peptide 1-99 pmol/L). IGFBP-1 was associated with fasting blood glucose, negatively in controls and positively in patients with T1D probably reflecting insulin resistance and insulin deficiency, respectively. There was no association between lower IGF-1 Z-score and UEI in T1D. ConclusionIn adult T1D with fair glycaemic control, the GH-IGF-1 axis is dysregulated exhibiting GH resistance, low IGF-1 and elevated IGFBP-1. Subcutaneous insulin cannot normalize these changes while endogenous insulin secretion has marked effects on IGF-1 pointing to a role of portal insulin.

Place, publisher, year, edition, pages
WILEY , 2018. Vol. 89, no 4, p. 424-430
Keywords [en]
GH; insulin-like growth factor-1; insulin-like growth factor-binding protein-1; insulin; type 1 diabetes; upper extremity impairments
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:liu:diva-151773DOI: 10.1111/cen.13810ISI: 000444539600006PubMedID: 29989677OAI: oai:DiVA.org:liu-151773DiVA, id: diva2:1254097
Note

Funding Agencies|Medical Research Council of Southeast Sweden FORSS; County council and Stiftelseforvaltningen of Region Ostergotland, Sweden

Available from: 2018-10-08 Created: 2018-10-08 Last updated: 2018-10-08

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Gutefeldt, KerstinHedman, ChristinaThyberg, IngridBachrach Lindström, MargaretaSpångeus, AnnaArnqvist, Hans
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Division of Cardiovascular MedicineFaculty of Medicine and Health SciencesDepartment of EndocrinologyDivision of Neuro and Inflammation ScienceDepartment of RheumatologyDivision of Nursing ScienceDivision of Cell Biology
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