Insulin-like Growth Factor-1 In Patients Research Articles

Relationship between insulin-like growth factor-1 and cerebral small vessel disease and its mechanisms: advances in the field

Insulin-like growth factor-1 (IGF-1) is an active polypeptide protein that closely resembles the structural sequence of insulin and is involved in a variety of metabolic processes in the body. Decreased IGF-1 circulation levels are associated with an increased risk of stroke and a poorer prognosis, but the relationship with cerebral small vessel disease (cSVD) is unclear. Some studies found that the level of IGF-1 in patients with cSVD was significantly reduced, but the clinical significance and underlying mechanisms are unknown. This article reviews the correlation between IGF-1 and cerebrovascular disease and explores the potential relationship and mechanism between IGF-1 and cSVD.

Elevated insulin-like growth factor-1 in patients without clinical evidence of acromegaly.

To 1) identify the frequency of IGF-1 elevation in a cohort of patients without clinically suspected GH excess, in a state-based reference laboratory over a 24-month period, and 2) to examine potential differences in comorbidities and relevant medications between people with an elevated IGF-1 compared to a matched control group. All IGF-1 measurements at Pathology Queensland between 1/12/2018 - 1/12/2020 were identified. The medical records of those with IGF-1 ≥1.1x the upper limit of the reference range were appraised to determine: 1) documentation of acromegalic features, 2) relevant comorbidities and medication use, and 3) further investigations to exclude pathological GH excess. There were 2759 IGF-1 samples measured in 1963 people ≥18 years, over the specified period. Of these, 204 had IGF-1 ≥1.1x the upper limit of the age-matched reference range; 102 cases (61M, 41F) met inclusion criteria, and were matched to 102 controls with a normal IGF-1 based on age, sex, gonadal status and pituitary anatomy on MRI. There were significant differences in the frequency of dopamine agonist use (19/102 cases vs 6/102 controls, OR=3.66, 95%CI: 1.45-9.29, P=0.009) and chronic kidney disease (CKD) (14/102 cases vs 4/102 controls, OR = 3.90, 95%CI: 1.28-11.14, P=0.024). Out of 1963 patients having IGF-1 measured, 102 (5.2%) had an elevated IGF-1 where there was no known acromegaly, GH replacement or endogenous glucocorticoid excess. Intra-individual biological variability, assay imprecision and physiological factors are known contributors to falsely elevated IGF-1, dopamine agonist therapy and CKD should also be considered. This article is protected by copyright. All rights reserved.

Zofenopril Treatment Efficacy on Survival, Endostatin and Insulin-Like Growth Factor-1 in Patients with Diabetes Mellitus Type 2 After Acute Myocardial Infarction

The aimto study zofenopril treatment effect on survival and endostatin and insulin-like growth factor-1 levels in patients with acute myocardial infarction with ST elevation (STEMI) with concomitant diabetes mellitus type 2(T2DM) in 6-month follow up. MethodsThe study was performed in 103 hospitalized patients with T2DM after myocardial infarction with ST elevation. Serum endostatin and IGF-1 levels were measured by enzyme-linked immunosorbent assay on the first day and 24-25 weeks. Two groups were analysed: the first one – treated with inclusion of zofenopril, and the second one –treatment with inclusion of enalapril with the same rest treatment. Cox proportional hazards regression analyses were used to estimate hazard ratios (HRs) and 95% Confident Intervals (CI). ResultsAs a result of a 6-month follow-up in a group of patients with complicated STEMI who received the recommended therapy with zofenopril, compared with another, similar in all parameters, group of patients who received therapy with enalapril, hazard ratio, 0.81; 95% CI, 0.61–0.95, p=0.041, after multivariable adjustment. There was a statistically significant increase of the IGF-1 level in patients who received zofenopril: first day 154.07 ± 11.15 ng / ml and at the end of follow-up 202.07 ± 12.22 ng / ml, p <0.001. ConclusionsTreatment with zofenopril compared to enalapril has significantly better survival effect in patients with T2DM after STEMI in 6 month follow up. The activation of angiogenesis proved by significant increase of IGF-1 level was more pronounced in the zofenopril group.

Insulin resistance and insulin-like growth factor-1 in patients with nodular goiter

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Features of changes in insulin-like growth factor-1 in patients with coronary heart disease in combination with type 2 diabetes mellitus

The purpose of the study was to study the level of insulin-like growth factor-1 in the blood of patients with coronary heart disease with type 2 diabetes mellitus, in patients with coronary heart disease without type 2 diabetes mellitus and in almost healthy individuals. Materials and methods. We examined 73 patients (30 men, 43 women) with coronary heart disease aged 49 to 75 years (mean age –58.3 ± 1.8). All patients were treated in the therapeutic department of the prof. А. А. Shalimov Kharkiv Municipal Clinical Hospital No. 2. Examination of patients was performed using clinical, laboratory and instrumental methods. All patients had ischemic heart disease in the form of stable angina pectoris of I – II functional classes, I functional class was diagnosed in 27 patients, II – in 46 patients. From the group of examined patients in 36 patients the disease was accompanied by concomitant type 2 diabetes mellitus (group 1). Mild diabetes was detected in 15 people, moderate – in 21 patients. 37 patients did not have diabetes mellitus (group 2). Diagnosis of diabetes was based on the criteria of the World Diabetes Federation. The control group consisted of 20 people of the same age, who according to the results of clinical and additional studies were found to be practically healthy. Determination of insulin-like growth factor-1 and insulin levels in the blood was performed by enzyme-linked immunosorbent assay on a «Humareader photometer-analyzer». DRG kits (USA) were used to study the level of insulin-like growth factor-1. Results and discussion. It was found that patients with coronary heart disease with concomitant type 2 diabetes had higher levels in serum triglycerides (p &lt;0.05) and very low density lipoprotein cholesterol (p &lt;0.05) compared with patients with coronary heart disease without diabetes. Patients with coronary heart disease and concomitant type 2 diabetes showed a statistically significant increase in blood insulin levels compared with patients with coronary heart disease without diabetes. The results of the analysis of insulin-like growth factor-1 showed that the content of insulin-like growth factor-1 in the blood of patients with coronary heart disease and type 2 diabetes was probably lower compared with patients with coronary heart disease without diabetes and with practically healthy individuals (p &lt;0.01). At the same time, the levels of insulin-like growth factor-1 in almost healthy individuals and patients with coronary heart disease without type 2 diabetes did not differ significantly. Conclusion. In patients with coronary heart disease with type 2 diabetes the level of insulin-like growth factor-1 is probably lower than in patients with coronary heart disease without diabetes and almost healthy individuals. Given the antiapoptotic, antiatherosclerotic, anabolic properties of this growth factor, it can be argued that the development of relative insulin-like growth factor-1 deficiency in the combination of coronary heart disease with type 2 diabetes causes a significant increase in the risk of cardiovascular complications in this category of patients

Активація внутрішньоклітинних ферментних систем під впливом патогенетичних факторів канцерогенезу у хворих на цукровий діабет 2-го типу

Актуальність. У пацієнтів із цукровим діабетом (ЦД) доведено підвищений ризик онкологічних захворювань. Основними чинниками онкогенезу при ЦД визнано ожиріння, цитокіновий дисбаланс, гіпер­інсулінемію, гіперглікемію. Вказані розлади зумовлюють дисфункцію внутрішньоклітинних регуляторних сигнальних шляхів, основним з яких є шлях PI3K/Akt/mTOR. Мета. Дослідження ролі фосфорильованої Akt­протеїнкінази (фосфо­Akt) у процесах онкогенезу у пацієнтів із ЦД 2­го типу. Матеріали та методи. Обстежені 75 осіб. Хворі розподілені на групи: І — здорові, ІІ — пацієнти з ЦД 2­го типу, ІІІ — хворі на рак, IV — хворі на рак, що виник на тлі ЦД 2­го типу. Були залучені пацієнти з раком молочної залози (МЗ), ендометрія (РЕ), підшлункової залози та кишечника. Визначали рівень інсуліну, інсуліноподібного фактора росту 1 (IGF­1) та фосфо­Akt. Результати. Пацієнти ІІ і ІV груп мали декомпенсований ЦД із рівнем HbA1с &gt; 8,0 %. Вірогідну гіперінсулінемію виявлено у хворих на ЦД ІІ та IV груп (p &lt; 0,05), а підвищений рівень IGF­1 — в усіх групах дослідження (p &lt; 0,05). Показники фосфо­Akt у пацієнтів ІІІ групи були підвищеними (p &lt; 0,05), а в ІV групі — зниженими (p &lt; 0,05). У ІІІ групі виявлено гіперінсулінемію у хворих на РЕ, МЗ і кишечника (p &lt; 0,05) та підвищення рівня IGF­1 незалежно від локалізації (p &lt; 0,05). У ІV групі підвищені рівні інсуліну та IGF­1 виявлені у хворих на рак МЗ та РЕ (p &lt; 0,05). У жінок ІІІ групи, хворих на рак МЗ та РЕ, рівень IGF­1 був вищим від показників ІV групи (p &lt; 0,05). У пацієнтів IV групи, які отримували монотерапію метформіном, рівень фосфо­Akt був вірогідно нижчим (p &lt; 0,05). Виявлено прямий кореляційний зв’язок між фосфо­Akt та IGF­1 у пацієнтів ІІ групи (r = 0,50, p &lt; 0,05) і між фосфо­Akt та інсуліном у ІІІ групі (r = 0,45, p &lt; 0,05). Висновки. ГІ та IGF­1 є спільними патогенетичними факторами ЦД 2­го типу та онкологічних захворювань. Підвищений рівень фосфо­Akt може бути лабораторною ознакою онкоризику в здорових осіб. Поєднання ЦД 2­го типу та онкологічних захворювань зумовлює зниження рівня фосфо­Akt через конкурентну взаємодію внутрішньоклітинних сигнальних шляхів. Терапія метформіном сприяє зниженню рівня фосфо­Akt та може розглядатись як один із засобів протиракової профілактики.

Effects of Insulin-Like Growth Factor (IGF-1) in Patients with Sensorineural Hearing Loss.

Objectives:(1) To test the effect of local administration of insulin-like growth factor-1 (IGF-1) in patients with sensorineural hearing loss (SNHL). (2) To test the effect of local administration of IGF-1 in patients with ototoxicity.Methods:Forty patients with SNHL were included in the study. Their hearing thresholds at different frequencies (0.5, 1, 2, and 4 kHz) along with the average hearing threshold were noted. The patients were then randomly allocated to 2 groups and were treated with IGF-1 via one of the following routes: (1) intratympanic injection and (2) Gelfoam.

Effect of non-invasive brain stimulation on behavior and serum brain-derived neurotrophic factor and insulin-like growth factor-1 levels in autistic patients.

Aberrant neural connectivity and intra-cortical inhibitory dysfunction are key features of autism. Non-invasive brain stimulation (NIBS) protocols have been proposed that modulate this aberrant plasticity. However, additional investigations are needed to evaluate the impact of this intervention on biological biomarkers of the disease. We recently demonstrated alterations in serum insulin-like growth factor-1 (IGF-1) and brain-derived neurotrophic factor (BDNF) immunoreactivity in subjects with autism compared to controls. The aim of this pilot study was to explore the change in serum levels of the neurotrophic factors BDNF and IGF-1 in patients undergoing NIBS therapy. Sixteen subjects with autism spectrum disorder (ASD) were tested 1 week before and 1 week after NIBS to determine the short-term outcome on behavior using the total score on the autism behavior checklist, autism treatment evaluation checklist, clinical global impression severity and the autism diagnostic interview. ASD subjects younger than 11 years old (n=11) were treated with transcranial direct current stimulation (tDCS), and those 11 years and older (n=5) were treated with repetitive transcranial magnetic stimulation (rTMS). Serum levels of BDNF and IGF-1 were evaluated by Enzyme-Linked Immuno-Sorbent Assay before and after the intervention with NIBS. A significant reduction in scores on the clinical behavioral scales was observed in patients treated with NIBS (ABC-T p=.002, CGI-S p=.008, ADI-T and ATEC-T p < .0001). There was a trend towards reduced serum BDNF levels after NIBS (p=.061), while there was no change in IGF-1 levels. These data support further studies on the potential of BDNF as a biomarker to measure the effectiveness of NIBS in autism.

Clinical significance of expression of serum insulin-like growth factor-1 in patients with primary liver cancer and diabetes mellitus

Clinical significance of expression of serum insulin-like growth factor-1 in patients with primary liver cancer and diabetes mellitus

Serum Levels of Insulin Like Growth Factor-1(IGF-1) in Patients with Seborrheic Dermatitis

Seborrheic dermatitis (SD) is a chronic inflammatory skin disease affecting sebaceous areas of the face, scalp, upper chest and back .Five factore are believed to play a key role in the development of SD lesions: excess sebum production, malassezia colonies over areas covered with lipids, lipase secreted by malassezia, release of inflammatory cytokines into the skin, keratinocyte proliferation and differentiation. Evaluation of serum levels of Insulin Like Growth Factor-1(IGF-1) in seborrheic dermatitis patients. Serum IGF-1 concentrations were measured in 50 patients with SD and 30 healthy controls using enzyme-linked immunosorbent assay (ELISA). Serum levels of IGF-1 in patients with SD were found to be higher than in healthy controls (P =0.045). Increased serum IGF-1 levels probably reflect the role of IGF-1 in the pathogenesis of SD.

Gender differences of growth hormone and insulin-like growth factor-1 in patients with acromegaly after radiation therapy

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

P378Heart rhythm disorders in Acromegaly

Abstract Aim to evaluate the prevalence of heart rhythm disorders among hospitalized patients with acromegaly Methods we enrolled patients with acromegaly hospitalized in our Endocrinology Research Center in 2018. Acromegaly was established based on the clinical signs and symptoms, elevated levels of insulin-like growth factor-1 (IGF-1) and presence of pituitary adenoma. All patients underwent clinical examination, routine electrocardiogram (ECG). In patients with changes in the resting ECG and/or complaints of heart rhythm disorders, echocardiography and Holter ECG monitoring were performed. We also performed cardiac magnetic resonance imaging (MRI) with contrast in cases of arrhythmia confirmation. Results Among 107 enrolled patients with acromegaly (61 women, mediana of age 51 [40; 58] years) arrhythmia was first diagnosed in 21 (19,6%) patients: 7 patients had sick sinus syndrome, 5 patients suffered from atrial fibrillation, 4 patients had AV block, 5 patients - ventricular arrhythmias (1 patient had sustained ventricular tachycardia). The median level of the GH was 1,77 [0,8; 5,4] ng/ml, and the median of IGF-1 - 348,95 [233,4; 557,4] ng/ml, 16 (76,1%) patients with arrhythmia had active acromegaly. 21 patients underwent MRI of the heart: median of ejection fraction 54 [48; 60] %, in 8 patients we revealed focal fibrosis of left ventricle myocardium. Diffuse accumulation of contrast agent was observed in 11 patients of different severity and localization, mainly endocardium of mitral and tricuspid valves. We didn’t find a clear correlation between the levels of hormones, changes in the MRI of the heart and the type of cardiac arrhythmia. We implanted pacemakers in 4 patients, 1 patient – implantable cardioverter defibrillator. Conclusion The prevalence of cardiac arrhythmia in hospitalized patients with acromegaly is about 20%. New cases of arrhythmia could occur despite normal level of GH and IGF-1 in patients with acromegaly. Patients with acromegaly and cardiac arrhythmia often have abnormalities in MRI of the heart, which requires further investigation.

Expression and clinical value of miR-128 and IGF-1 in patients with acute ischemic stroke.

The aim of this study is to investigate the expression and clinical value of miRNA-128 (miR-128) and insulin-like growth factor-1 (IGF-1) in patients with acute ischemic stroke (AIS). Eighty patients with acute ischemic stroke hospitalized in Rizhao Hospital of TCM from August 2016 to August 2018 were selected as the experimental group. Sixty healthy patients with normal physical examination during the same period were selected as the control group. The expression levels of miR-128 and IGF-1 were compared between the two groups and between AIS patients with different levels of nervous functional defects, different infarct size and different prognosis. ROC curve of serum miR-128 and IGF-1 expressions for AIS diagnosis alone and in combination was analyzed. The expression level of miR-128 in the serum of patients in the experimental group was higher than that of the control group, and the expression level of IGF-1 was lower than that of the control group (P<0.001). The serum miR-128 expression of patients in the ineffective group was higher than that of the effective group, and the expression of IGF-1 was lower than that of the effective group (P<0.001). The expression level of serum miR-128 in AIS patients was higher than that in healthy subjects and increased with the aggravation of the disease. The expression level of IGF-1 of AIS patients was lower than that of healthy subjects and decreased with the aggravation of the disease. The two factors were involved in the formation and deterioration of the disease. The expression levels can reflect the severity of the disease to a certain extent and provide references for the early diagnosis and prognostic treatment in patients with acute ischemic stroke.

The Role of Insulin-Like Growth Factor-1 and Pregnancy-Associated Plasma Protein-A in Diagnosis of Acute Coronary Syndrome and Its Related Morbidities.

Introduction:Pregnancy-associated plasma protein-A (PAPP-A) is a metalloproteinase that plays a role in atherosclerotic plaque destabilization. In recent studies, insulin-like growth factor-1 (IGF-1) has been introduced as a mediator of atherosclerosis. PAPP-A and IGF-1 level may be important diagnostic indicators of acute coronary syndrome (ACS).Objective:The present study tried to assess the diagnostic role of IGF-1 and PAPP-A biomarkers in ACS spectrum.Methods:The serum level of IGF-1, PAPP-A and troponin I was determined in 121 consecutive patients with ACS. Relationships were assessed by t-test, ANOVA and the non-parametric equivalent. Accuracy of biomarkers was measured by the area under the ROC curve (AUC) and optimal cut-off points to diagnose STEMI and NSTEMI using Youden index.Results:In patients with acute ST segment elevation myocardial infarction (STEMI), all of these three biomarkers were significantly higher than those in patients with unstable angina (P= 0.028 for IGF-1, P<0.001 for PAPP-A and Troponin-I). Mean level of IGF-1 in patients with renal failure was significantly higher than that in patients without renal failure (137.9±35.1 vs 105.1±46.9, P=0.003), but PAPP-A and serum Troponin-I level had no significant difference in renal failure groups (P>0.05). ROC curve analysis showed that after Troponin-I, PAPP-A was a good discriminator between patients with STEMI and patients with unstable angina (AUC=0.79). Optimum cut-off value for PAPP-A was found to be 89.2 ng/ml, with sensitivity and specificity of 66.7% and 83.8%, respectively.Conclusion:PAPP-A can be a novel biomarker for both identification of patients with STEMI and risk stratification in patients with ACS.

Is preoperative level of insulin-like growth factor 1 (IGF-1) connected with immunohistochemical phenotype of pituitary adenoma in patients with acromegaly?

Background: Preoperative biochemical diagnosis of acromegaly is based on the determination of the serum levels of insulin-like growth factor 1 (IGF-1) and growth hormone (GH) in the oral glucose tolerance test. In turn, although assumptions concerning the tumour hormonal phenotype may be made on the basis of biochemical tests, the final determination of the exact adenoma profile is possible only on the basis of postoperative immunohistochemical evaluation. Due to the high importance of both – preoperative determination of the concentration of IGF-1 and postoperative immunohistochemical examination of pituitary tumour, the aim of this study was to compare these parameters. Material and methods: The study group consisted of 21 patients with acromegaly and 15 with clinically nonfunctioning pituitary adenoma (CNFPA). In all the patients IGF-1 and prolactin (PRL) concentrations in serum were measured by enzyme–amplified chemiluminescent immunoassay. The immunohistochemical diagnose of the adenoma was achieved with the primary antibodies against the pituitary hormones, the α-subunit and Ki-67 – proliferation indicator. Results: In patients with acromegaly immunohistochemistry besides monohormonal tumours – “pure” somatotropinoma, also somatoprolactinoma and adenoma plurihormonale have revealed. The mean concentrations of IGF-1 were 702, 1480 and 915 ng/mL respectively in each of these groups. In most cases the proliferation index Ki-67 was less than one. In patients with CNFPA, the IGF-1 levels were mostly in reference values and almost in half of cases the Ki–67 value was above one. Conclusions: There are statistically significant differences between preoperative serum IGF-1 concentrations in the somatoprolactinoma group and other adenoma phenotypes in acromegaly patients. This result may suggest the possible link between additional prolactin component with very high concentration of IGF-1 in patients with acromegaly.

Study on Insulin Like Growth Factor-1 As a Marker of Severity of Liver Dysfunction in Patients with Liver Cirrhosis

Background: Insulin Like Growth Factor-1 (IGF-1) is a polypeptide hormone predominantly synthesized in liver. It has been reported that serum IGF-1 concentrations low in hypopitutuitarism, malnutrition and various diseases particularly in patients with chronic liver disease. The aim of the study was to see the level of IGF-1 in patients with cirrhosis and its relation with severity of liver dysfunction.&#x0D; Materials and Methods : This study was carried out in the Department of Hepatology, Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka, Bangladesh. 40 persons (30 patients of cirrhosis of liver and 10 healthy individuals) were selected and grouped as Group-1 : 10 Child grade A patient, Group - 2 : 10 Child grade B patient, Group - 3 : 10 Child grade C cirrhotic patients and Group - 4 : 10 healthy subjects. Patients with recent antiviral therapy, acute illness, hepatocellular carcinoma and spontaneous bacterial peritonitis were excluded from the study. IGF-1 was measured using IMMULITE, DPC, USA which employs automated chemiluminescent immunoassays.&#x0D; Results : Among 30 cirrhotic patients 26 were male and 4 were female. Mean age was 38.83 ± 14.08 years. Etiology of cirrhosis was hepatitis B virus in 23 patient, hepatitis C virus in 1 patient, Cryptogenic in 6 patients. Healthy subjects were hepatitis B and C virus negative with normal liver function test and mean age was 36.40 ± 7.76 years, Mean serum IGF-1 was 82 ± 10.85 ng/ml in Child grade A, 50.77 ± 7.47 ng/ml in Child grade B, 29.69 ± 3.17 ng/ml in Child grade C patients and 130.96 ± 2.43 ng/ml in healthy individuals.&#x0D; Conclusion : Serum level of IGF -1 is low in patients with cirrhosis of liver than healthy individuals and reflects the severity of liver dysfunction in different clinical stage.&#x0D; Chatt Maa Shi Hosp Med Coll J; Vol.18 (1); Jan 2019; Page 3-7

Insulin-like growth factor-1 and non-alcoholic fatty liver disease: a systemic review and meta-analysis.

The prevalence of non-alcoholic fatty liver disease (NAFLD) is rapidly increasing worldwide. A number of researchers have studied the relationship between Insulin-like growth factor-1(IGF-1) and NAFLD. However, the results are controversial. This meta-analysis, aimed to systemically evaluate the correlation between IGF-1 and NAFLD. We searched for four online databases: PubMed, Web of Science, Embase and CNKI up to Feb 2018. We then applied a random-effects model to evaluate the overall effect sizes by calculating Standard mean difference (SMD) and its 95% confidence intervals (CIs). Twelve articles were included in this meta-analysis. The pooled analysis showed that the level of IGF-1 in the control group was significantly higher than that in the NAFLD group. (SMD: 1.00, 95% CI: 0.54-1.46, P < 0.00001). However, significant heterogeneity was discovered among the included studies (P < 0.00001, I2 = 96%). Then a series of subgroup analyses were performed. Compared to the nonalcoholic steatohepatitis (NASH) group, the level of IGF-1 was significantly higher in the Non- or probable-NASH group (SMD: 1.42, 95% CI: 0.25-2.58, P = 0.02). The level of IGF-1 in patients with increased insulin resistance (SMD: 0.49; 95% CI: 0.36-0.63; P < 0.00001) and high Body Mass Index (SMD: 0.50; 95% CI: 0.22-0.79; P < 0.05) were significantly lower than healthy control. In addition, the same conclusion were found in studies carried out in Asia and Europe (Asia: SMD: 0.69, 95% CI: -0.29-1.66, P = 0.17; Europe: SMD: 0.89, 95% CI: 0.41-1.38, P < 0.05). The level of IGF-1 is down-regulated in NAFLD patients compared to healthy controls, suggesting that IGF-1 might be used as a potential biomarker and therapeutic target for NAFLD.

Features of changes in insulin-like growth factor-1 in patients with chemoresistant pulmonary tuberculosis who are on palliative treatment

One of the causes of death of patients with pulmonary tuberculosis is cachexia. In the available literature, there are no data on the study of changes in the significate of insulin-like growth factor-1 (IGF-1) in patients with chemo-resistant pulmonary tuberculosis (CRTB) with a body mass deficit. The purpose of the work is to determine the level of IGF-1 in the serum of patients with CRHT of the lungs who are under palliative treatment, and to establish the features of its change depending on the body mass index (BMI). Materials and methods . The main group of follow-up consisted of 52 patients with CRTB of lungs, who are on palliative treatment (mean age 39.4 ± 1.8 years). The comparison group included 29 patients who receive anti-mycobacterial therapy for category 4 in accordance with the profile of drug resistance, the average age was 41.3 ± 1.8 years. The difference in P 18.1 kg/m 2 and 1.7 times than in the comparison group. It was established that, in patients with CRTB, who got the palliative care, a decrease in the level of IGF-1 in serum was significantly directly dependent on a decrease in BMI: in main group 1 (r = 0.91; P = 0.001) and in main group 2 (r = 0.97; P = 0.001). Conclusions . In patients with CRTB of the lungs who got palliative treatment, a significant decrease in the serum IGF-1 level of 1.4 times is determined compared to patients with CRTB of the lungs who receive antimycobacterial therapy. At the same time, in patients CRTB of the lungs, who got palliative care and had a body mass index of ≤18.1 kg/m 2 , the level of serum IGF-1 is significantly lower by 1.9 times compared with patients with a body mass index of >18.1 kg/m 2 . In patients CRTB, who got palliative care, a decrease in serum IGF-1 levels reliably depends on a decrease in body mass index. Significate of serum IGF-1 can be used as an early marker of the increase and progression of cachexia.

Serum levels of insulin-like growth factor 1 are negatively associated with log transformation of thyroid-stimulating hormone in Graves' disease patients with hyperthyroidism or subjects with euthyroidism: A prospective observational study.

Insulin-like growth factor 1 (IGF-1) has a molecular structure similar to that of insulin. As an essential mediator of growth hormone, IGF-1 plays a vital role in growth of children and anabolic effects of adults. We evaluated the serum levels of IGF-1 in patients with hyperthyroidism or euthyroidism.In this study, 30 patients each of Graves’ disease with hyperthyroidism (HY group) and euthyroid individuals (EU group) were recruited. The HY patients were treated with antithyroid regimens as clinically indicated. No medications were given to EU patients. The demographic characteristics and anthropometric and laboratory data of both groups at baseline and 6 months were compared. Associations between levels of IGF-1 and free thyroxine (fT4), thyroid-stimulating hormone (TSH), or log transformation of TSH (logTSH) were analyzed.At baseline, the HY patients had significantly higher serum IGF-1 levels than EU patients (median [Q1, Q3]: 305.4 [257.4, 368.1] vs. 236.7 [184.6, 318.8] ng/mL, P = .007). At 6 months, the HY patients still had higher serum levels of IGF-1 than EU patients (299.5 [249.9, 397.9] vs 222.1 [190.2, 305.4] ng/mL, P = .003). At baseline, the serum levels of IGF-1 in the HY and EU patients were positively associated with fT4 (β = 29.02, P = .002) and negatively associated with TSH (β = −31.46, P = .042) and logTSH (β = −29.04, P = .007). The associations between serum levels of IGF-1 with fT4 or TSH became insignificant at 6 months. However, the serum IGF-1 levels had persistent negative associations with logTSH at 6 months (β = −26.65, P = .021). The negative associations between IGF-1 and logTSH at baseline and 6 months remained significant even after adjustment with sex and age (β = −20.22, P = .023 and β = −20.51, P = .024, respectively).The HY patients had higher serum IGF-1 levels than EU patients. The serum IGF-1 concentrations were negatively associated with logTSH in patients with hyperthyroidism or euthyroidism.

New biomarkers of bone remodelling regulation in patients with acromegaly and endogenous hypercortisolism

Background: Bone tissue is a non-classical endocrine organ, which produces at least two hormones: fibroblast growth factor 23 (FGF-23) and decarboxylated osteocalcin (OC). In addition to this, recent studies demonstrate that specific proteins involved in the paracrine regulation of bone remodelling can be measured in peripheral serum samples and may serve as additional biomarkers of bone metabolism.&#x0D; Aims: to evaluate the serum levels of biomarkers related to endocrine and paracrine function of bone tissue in patients with Cushings disease (CD) and acromegaly.&#x0D; Materials and methods: The study was conducted according to the cross-sectional case-control type. Fasting serum samples were taken between 810 a.m. from patients with CD, acromegaly and age-, sex- and BMI-matched healthy volunteers and stored at -40 C. Commercially available kits for enzyme-linked immunosorbent assay (ELISA) were used to determine the serum levels of FGF-23, co-factor (co-receptor) Klotho, cathepsin K, sclerostin, P1NP. Insulin-like growth factor-1 (IGF-1) was measured by the immunochemiluminescence assay, late-night (11 p.m.) salivary cortisol (LNSC) was evaluated using the electrochemiluminescence method. Non-parametric tests (the Kruskal-Wallis test and the Mann-Whitney test) were used to assess the differences between the groups of patients.&#x0D; Results: The study includes 78 patients, (37.6 years old, 95% CI 34.7540.46): 29 patients with CD (group 1), 22 with acromegaly (group 2), and 27 healthy individuals (group 3), matched by sex, age and BMI (p = 0.432, 0.373 and 0.725 between groups, respectively). LNSC in patients with CD and IGF-1 in patients with acromegaly were significantly higher compared to the control group (p = 0.004 and p 0.001, respectively). In patients with acromegaly, a statistically significant increase in FGF-23 (1.13 (0.78;1.49) vs 0.78 (0.54;1.09)) and phosphorus (1.38 (1.24;1.52) vs 1.16 (1.12;1.29)) (p = 0.01 and p 0.001, respectively) was observed along with increased levels of bone remodelling markers. In patients with CD, bone formation markers were suppressed, but differences in the levels of other biomarkers could not be identified.&#x0D; Conclusions: Acromegaly leads to hyperphosphatemia and increase in FGF-23, which is most likely due to the development of resistance to FGF-23, and the intensification of bone remodelling. With CD, another bone hormone, osteocalcin, is suppressed along with the suppression of P1NP.