Insulin‐like Growth Factor Binding Protein‐1 Levels in Diabetic Adolescents and their Relationship to Metabolic Control

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Abstract
Circulating levels of the low molecular weight insulin‐like growth factor binding protein‐1 (IGFBP‐1) are insulin dependent and vary markedly throughout the day. IGFBP‐1 levels are abnormally high in diabetes but the relationship between this and the metabolic status of the patient has not been defined. We have therefore measured fasting IGFBP‐1 levels at 0800 h in 32 diabetic adolescents. IGFBP‐1 was measured in 19 of these patients after a normal night and in 27 after a night of euglycaemia, maintained with a glucose clamp. In 13 patients both studies were performed and could be compared. Puberty‐matched control data were obtained from 69 normal children. In normal prepubertal children IGFBP‐1 levels were high; lower levels were found with advancing pubertal development. This fall in IGFBP‐1 correlated with pubertal stage (r = 0.68, p < 0.001) and with fasting insulin levels (r = 0.60, p < 0.001) which rose with pubertal advancement. In the diabetic children IGFBP‐1 levels also correlated inversely with the 0800 h free insulin level but there was no clear relationship with pubertal development. However, when measured after overnight euglycaemia IGFBP‐1 levels correlated inversely with pubertal development (r = 0.67, p < 0.001) as in the normal children. In the patients studied on two comparable occasions the IGFBP‐1 level measured after a normal night relative to that measured under standardized euglycaemic conditions was found to correlate closely with the glycosylated haemoglobin level (r = 0.71, p < 0.005).

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