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Journal of the Korean Academy of Family Medicine 2007;28(2):127-133.
Published online February 10, 2007.
Association of Insulin-like Growth Factor-1 (IGF-1) and Insulin-like Growth Factor Binding Protein-3 (IGFBP-3) with the Metabolic Syndrome.
Mi Hee Kong, Nam Seok Joo, Kwang Min Kim, Bom Taeck Kim, Sang Man Kim, Duck Joo Lee
1Department of Family Medicine and Community Health, College of Medicin, Ajou University, Korea. gaksi@ajou.ac.kr
2Kangnam CHA General Hospital, Korea.
3HL Clinic, Seoul, Korea.
인슐린유사성장인자-1 및 인슐린유사성장인자 결합단백질-3과 대사증후군의 연관성
공미희,주남석,김광민,김범택,김상만,이득주
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Abstract
Background
Insulin-like growth factor-1 (IGF-1) has been suggested to be involved in the pathogenesis of atherosclerosis. The biological activity of IGF-1 is influenced by IGF binding protein-3 (IGFBP-3). We hypothesized that IGF-1 and IGFBP-3 levels may be associated with the metabolic syndrome which is a cluster of cardiovascular risk factors. Methods: We assessed the circulating levels of IGF-1 and IGFBP-3 in 12,415 individuals (men 6,626, women 5,789), aged 18∼81 years, who visited a hospital for regular health examination. The metabolic syndrome was defined according to the definition of the National Cholesterol Education Program Adult Panel III (NCEP-ATP III). Results: The IGF-1 concentrations were positively correlated with the waist circumference and systolic blood pressure. The IGFBP-3 concentrations were positively correlated with the waist circumference, systolic blood pressure, diastolic blood pressure, fasting blood sugar, and triglyceride, and negatively correlated with HDL cholesterol. The subjects in the lowest IGF-1 quartile had a significantly higher adjusted odds ratio (OR) of the metabolic syndrome compared with the highest IGF-1 quartile group (adjusted for age, smoking, alcohol intake, and physical activity). Conversely, the subjects in the highest IGFBP-3 quartile group had a significantly higher adjusted OR of the metabolic syndrome compared with the lowest IGFBP-3 quartile group. Conclusion: The subjects with low IGF-1 level or high IGFBP-3 level showed increased prevalence of the metabolic syndrome. The metabolic syndrome is recognized as a cluster of cardiovascular risk factors. Therefore, the results of this study suggest that low IGF-1 or high IGFBP-3 can be considered to increase the risk of cardiovascular diseases. (J Korean Acad Fam Med 2007;28:124-133)
Key Words: IGF-1, IGFBP-3, metabolic syndrome
초록
연구배경: 인슐린유사성장인자-1 (insulin like growth factor-I, IGF-I )이 동맥경화증에 영향을 준다는 연구들이 보고되고 있다. IGF-1의 생물학적 활성은 인슐린유사성장인자 결합단백질-3 (insulin like growth factor binding protein-3, IGFBP-3)의 영향을 받는다. 본 연구에서는 혈중 IGF-1 및 IGFBP-3 농도에 따라 심혈관 질환의 군집개념인 대사증후군과 어떠한 연관성이 있는지 알아보고자 하였다. 방법: 건강검진을 위해 내원한 18∼81세 사이의 성인을 대상으로 혈중 IGF-1과 IGFBP-3를 측정하였다. 혈중 IGF-1과 IGFBP-3에 영향을 줄 수 있는 경우를 제외하고 최종대상자로 12,415명(남자 6,626명, 여자 5,789명)을 선정하였다. IGF-1 및 IGFBP-3 농도와 NCEP-ATP III에서 제안한 대사증후군 진단 요인들의 연관성 및 대사증후군에 이환 될 교차곱비(odds ratio)를 비교하였다. 결과: IGF-1과 허리둘레, 수축기혈압이 유의한 양의 상관관계를 보였고(P<0.05), IGFBP-3는 허리둘레, 수축기혈압, 이완기혈압, 공복혈당 및 중성지방과 유의한 양의 상관관계를(P<0.05), 고밀도콜레스테롤과는 유의한 음의 상관관계를 보였다(P<0.05). 혈중 농도에 따라 사분위로 범주화하여 IGF-1 농도가 가장 낮은 최하사분위가 대사증후군에 이환 될 교차곱비는 남자가 1.32 (95% CI 1.06∼1.63), 여자가 1.41 (95% CI 1.08∼1.85)로 최상사분위와 비교하여 볼 때 유의한 증가를 보였다(P<0.05). 반면 IGFBP-3는 최하사분위가 최상사분위와 비교하여 볼 때 대사증후군에 이환될 교차곱비가 유의하게 높았다[남자 2.49 (95% CI 2.02∼3.05), 여자 3.43 (95% CI 2.68∼4.37)]. 결론: 혈중 IGF-1 농도가 낮거나 IGFBP-3 농도가 높은 경우 대사증후군에 이환될 위험이 높았다.
중심 단어: IGF-1, IGFBP-3, 대사증후군


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