The insulin‐like growth factor system and the progression of renal complications of type 2 diabetes
Authors' conclusion
This longitudinal study indicated that higher baseline IGF-II, lower IGFBP-1 and higher IGFBP-2 are associated with a greater likelihood of albuminuria progression, independent of standard risk factors; lower IGBFP-1 also associated with greater increase in serum creatinine. Higher circulating IGFBP-2 level was also associated with relatively higher mortality. This study demonstrated the relevance of the IGF system to our understanding of renal complications in diabetes and strongly suggests that further exploration of mechanisms underlying these associations is merited.
Study context
- Population
- Individuals with T2D recruited from primary and secondary care (2002–2004), Salford and Manchester; 59.3% men, age 56.6 ± 9.4 years
- Participants
- 436 individuals
- Exposure
- Baseline IGF/IGFBP profile and renal function trajectory
- Outcome
- Two primary outcomes: (i) change in urine ACR over time (ACR trend slope); (ii) change in serum creatinine over time (creatinine trend slope)
- Follow-up
- Up to 24 years
Methodological detailslongitudinal, follow-up up to 24 years
- Longitudinal
- Follow-up up to 24 years
Main finding
As reported in the abstract
Higher IGFBP-2 independently associated with faster albumin/creatinine ratio (ACR) progression (normalised beta)
Β = 0.007
p = 0.002
IGFBP-1 inverse association with ACR progression
B = −0.057
p = 0.009
IGF-II positively associated with ACR trend
B = 0.005
p = 0.013
IGFBP-1 inverse association with creatinine change, covariate-adjusted (unstandardised B)
B = −0.038
p = 0.04
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| All-cause mortality per 1 SD increase in IGFBP-2Cox proportional hazards; independent association | 1.306 (1.151–1.483) | P = 0.0001 | |
| 0.512Hazard ratio (log scale) |
Original publication
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