Abstract
Aims/hypothesis: IGFs and their binding proteins are increasingly recognised as important in understanding
the pathogenesis of cardiovascular disease. Low IGFBP-1, particularly coupled with
low IGF‐I, is associated with increased cardiovascular risk. In relation to structural
and regulatory parallels between IGFBP-1 and ‐ 2 we have now examined the hypothesis
that IGFBP-2 may be a marker for cardiovascular risk. Methods: Fasting IGFBP-2, IGFBP-1, IGFBP-3, IGF‐I, IGF‐II, insulin, C-peptide, glucose, lipids,
NEFAs, and HbA1c were measured in a cohort of 163 patients with type 2 diabetes. Individuals
were categorised according to the presence or absence of the metabolic syndrome. Results: Patients with the metabolic syndrome had a lower IGFBP-2 concentration. Low circulating
IGFBP-2 was associated with elevated fasting glucose (ρ = - 0.23, p = 0.003). IGFBP-2
correlated negatively with triglycerides (ρ = - 0.19, p = 0.01) and LDL-cholesterol
(ρ = - 0.20, p = 0.01), and positively with insulin sensitivity (HOMA‐S) (ρ = 0.26,
p = 0.02). Multivariate logistic regression demonstrated that low IGFBP-2 was independently
associated with an increased risk of the metabolic syndrome (OR 0.31 [95 % CI 0.11
- 0.90]; p = 0.03). IGFBP-3 did not differ according to the presence or absence of
metabolic syndrome. Conclusion/interpretation: Low IGFBP-2 is associated with multiple cardiovascular risk factors similarly to
IGFBP-1. Such associations were not apparent for IGFBP-3. Lack of marked prandial
regulation of IGFBP-2, in contradistinction to IGFBP-1, may make IGFBP-2 a more robust
biomarker for identification of insulin-resistant individuals at high cardiovascular
risk in epidemiological studies.
Key words
IGFBP - metabolic syndrome - type 2 diabetes - cardiovascular disease
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Dr A. H. Heald
Department of Diabetes and Endocrinology
Salford Royal Hospitals University Trust
Hope Hospital
Stott Lane
Salford M6 8HD
United Kingdom
Phone: 01612065157
Fax: 0 16 12 06 59 89
Email: aheald@fs1.ho.man.ac.uk