Chino S Aneke-Nash1, Xiaonan Xue1, Qibin Qi1, Mary L Biggs2, Anne Cappola3, Lewis Kuller4, Michael Pollak5, Bruce M Psaty6,7, David Siscovick8, Kenneth Mukamal9,10,11, Howard D Strickler1, Robert C Kaplan1. 1. Department of Epidemiology and Population Health, Albert Einstein College of Medicine. 2. Department of Biostatistics, University of Washington. 3. Division of Endocrinology, Diabetes, and Metabolism, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine. 4. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh. 5. Departments of Experimental Medicine and Oncology, McGill University, Canada. 6. Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services, University of Washington. 7. Group Health Research Institute, Group Health Cooperatives. 8. The New York Academy of Medicine. 9. Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center. 10. Harvard Medical School. 11. Harvard School of Public Health.
Abstract
Context: Insulin-like growth factor-I (IGF-I) has structural and functional similarities to insulin and may play a role in glucose homeostasis, along with insulin-like growth factor binding protein-3 (IGFBP-3), which binds the majority of circulating IGF-I. Objective: To assess whether IGF-I and IGFBP-3 are associated with a higher risk of incident diabetes in older adults. Design: Participants in the Cardiovascular Health Study (n = 3133), a cohort of adults aged ≥65 years, were observed for 16 years (n = 3133) for the development of incident diabetes. Statistical models were fit separately for men and women because of interactions with sex (P interaction: IGF-I, 0.02; IGFBP-3, 0.009) and were adjusted for relevant covariates. Setting: General community. Participants: Older adults who were nondiabetic at baseline and who did not develop diabetes within the first year of follow-up. Interventions: Not applicable. Main Outcome Measure: Incident diabetes as measured by fasting plasma glucose (FPG) ≥126 mg/dL, non-FPG ≥200 mg/dL, use of pharmacological treatment of diabetes, or existence of two or more inpatient or three or more outpatient or (at least one inpatient and at least one outpatient) Centers for Medicare & Medicaid Services claims with the diagnostic International Classification of Diseases, Ninth Revision, Clinical Modification code of 250.xx. Results: In women, higher IGFBP-3 (hazard ratio tertile 3 vs tertile 1 = 2.30; 95% confidence interval, 1.55 to 3.40; P trend < 0.0001) was significantly associated with incident diabetes. Total IGF-I was not significantly associated with incident diabetes. In men, neither IGF-I nor IGFBP-3 was significantly associated with incident diabetes. Conclusions: We confirmed a previously reported association between circulating IGFBP-3 and diabetes risk in the older adult population, establishing that this association is present among women but could not be shown to be associated in men.
Context:Insulin-like growth factor-I (IGF-I) has structural and functional similarities to insulin and may play a role in glucose homeostasis, along with insulin-like growth factor binding protein-3 (IGFBP-3), which binds the majority of circulating IGF-I. Objective: To assess whether IGF-I and IGFBP-3 are associated with a higher risk of incident diabetes in older adults. Design: Participants in the Cardiovascular Health Study (n = 3133), a cohort of adults aged ≥65 years, were observed for 16 years (n = 3133) for the development of incident diabetes. Statistical models were fit separately for men and women because of interactions with sex (P interaction: IGF-I, 0.02; IGFBP-3, 0.009) and were adjusted for relevant covariates. Setting: General community. Participants: Older adults who were nondiabetic at baseline and who did not develop diabetes within the first year of follow-up. Interventions: Not applicable. Main Outcome Measure: Incident diabetes as measured by fasting plasma glucose (FPG) ≥126 mg/dL, non-FPG ≥200 mg/dL, use of pharmacological treatment of diabetes, or existence of two or more inpatient or three or more outpatient or (at least one inpatient and at least one outpatient) Centers for Medicare & Medicaid Services claims with the diagnostic International Classification of Diseases, Ninth Revision, Clinical Modification code of 250.xx. Results: In women, higher IGFBP-3 (hazard ratio tertile 3 vs tertile 1 = 2.30; 95% confidence interval, 1.55 to 3.40; P trend < 0.0001) was significantly associated with incident diabetes. Total IGF-I was not significantly associated with incident diabetes. In men, neither IGF-I nor IGFBP-3 was significantly associated with incident diabetes. Conclusions: We confirmed a previously reported association between circulating IGFBP-3 and diabetes risk in the older adult population, establishing that this association is present among women but could not be shown to be associated in men.
Authors: N Vaessen; P Heutink; J A Janssen; J C Witteman; L Testers; A Hofman; S W Lamberts; B A Oostra; H A Pols; C M van Duijn Journal: Diabetes Date: 2001-03 Impact factor: 9.461
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