Insulin-like growth factor-1 and chronic kidney disease in patients with type 2 diabetes mellitus
Background. Diabetes mellitus (DM) and chronic kidney disease (CKD) are two major medical and socioeconomic problems of recent years that the world community has faced in the context of a chronic disease pandemic. CKH leads not only to the development of terminal renal failure, which requires the application of hemodialysis and kidney transplantation, but also to complex metabolic and hormonal disorders in the axis of growth hormone (GH) — insulinlike growth factor (IGF), binding protein (IGFBP) (GH — IGF — IFRBP). The purpose of the study was to evaluate the relationship between serum IGF1 levels and glomerular filtration rate (GFR) in patients with type 2 DM. Materials and methods. The study involved 150 patients with type 2 DM, the age range of 23 to 86 years. The control group consisted of 57 patients without DM, matched by age and sex with the basic group. In the study, patients with type 2 DM were classified into three subgroups, depending on the stage of albuminuria: the first subgroup consisted of 38 persons with normalbuminuria, the second subgroup included 79 patients with microalbuminuria, the third subgroup consisted of 33 patients with proteinuria. Results. The patients with normal albuminuria did not differ in the level of total cholesterol from the patients in the control group, but the patients with type 2 DM with microalbuminuria and proteinuria had higher values of total cholesterol. By the level of triglycerides, the differences were already noticeable at the stage of normalbuminuria: the patients with type 2 DM had higher levels of triglycerides compared with the control group. The IGF1 level elevated with increased urinary protein excretion. Correlation analysis showed a significant negative correlation between IGF1 and GFR and positive one with albumin/creatinine levels. The probability of having GFR < 50 ml/min/1.73 m2 grew with an increase in IGF1 levels. Conclusions. The elevated levels of IGF1 and reduced levels of GFR in patients with type 2 DM were found to be associated. Further research is needed to clarify the pathogenetic mechanisms of this interaction.
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