Insulin-like growth factors and their binding proteins: biological actions.
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Biomedical subjects
Publications and source records attributed to D R Clemmons.
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Smooth muscle cells have been shown to migrate in response to insulin-like growth factor I (IGF-I). However, the role of IGF-binding proteins (IGFBPs) in this process has not been determined. As IGFBPs are synthesized and secreted by smooth muscle cells and bind to IGFs with high affinity, this study was undertaken to determine the ability of IGFBP-1 and -2 to modulate cellular migration in response to IGF-I and -II. Confluent monolayers of porcine vascular smooth muscle cells were wounded with a razor blade. After wounding, IGF-I and -II induced increases of 159 +/- 49% (mean +/- SD) and 108 +/- 33%, respectively, above control values in the number of cells migrating over a fixed distance in 4 days. The addition of IGFBP-1 caused a 19-21% inhibition of IGF-I- or IGF-II-stimulated migration, whereas the addition of IGFBP-2 inhibited the effect of both by greater than 60%. The addition of IGFBP-2 alone had no effect, whereas IGFBP-1 addition was associated with a 42 +/- 12% increase. In contrast, [Trp221]IGFBP-1 in which the RGD sequence was changed to WGD, thus eliminating its capacity to bind to the alpha 5 beta 1 integrin, inhibited IGF-I-stimulated migration by 67 +/- 17%. An IGF analog that has a reduced affinity for IGFBP-2-stimulated migration equally well as IGF-I alone even in the presence of IGFBP-2. Likewise, the addition of insulin, which cannot bind to IGFBPs, at supraphysiological concentrations that are adequate to activate the IGF-I receptor resulted in a similar increase in migration. In summary, IGF-I and -II stimulate smooth muscle cell migration after wounding. This migratory response is modulated by IGFBPs. Both IGFBP-1 and IGFBP-2 appear to neutralize the effects of the IGFs by inhibiting their interaction with IGF receptors, but IGFBP-1 also has a direct stimulatory effect that requires an intact RGD integrin recognition sequence.
Smooth muscle cells (SMC) secrete insulin-like growth factor (IGF)-binding protein-4 (IGFBP-4) and an IGFBP-4 protease. The purpose of this study was to determine the characteristics of this IGFBP-4 protease and to compare its inhibitor profile to those of IGFBP-5 and IGFBP-2 proteases, which are also present in SMC-conditioned medium. Cultured SMC were exposed to serum-free medium for periods of 24-72 h, and the amount of proteolytic activity in the conditioned medium was assessed by its capacity to degrade pure IGFBP-4. Minimal activity (e.g. < 20% of IGFBP-4 degraded in 24 h at 37 C) was present in conditioned medium unless IGF-I or IGF-II was added. This resulted in more than 60% of the intact IGFBP-4 being degraded in 14 h. The activity was a calcium-dependent serine protease and was inhibited by EDTA or 3,4-dicloroisocoumarin. Calcium, but not zinc, could restore proteolytic activity. Heparin alone inhibited IGFBP-4 proteolysis by more than 60%. When heparin cofactor-II and antithrombin-III (AT-III) were added alone, they each had an effect. The combination of heparin plus AT-III was no more active than heparin alone, but the combination of heparin cofactor-II and heparin resulted in near complete inhibition. Peptides that contained the active sites of AT-III or alpha 1-antichymotrypsin were potent inhibitors of the IGFBP-4 protease. The medium also contained proteolytic activities for IGFBP-2 and IGFBP-5. Comparison of the inhibitor profiles for the IGFBP-4 and IGFBP-5 proteolytic activities revealed major differences, but the IGFBP-2 proteolytic activity was very similar to that of the IGFBP-4 protease. IGFBP-4 zymography showed a band with a molecular mass estimate of 48 kilodaltons. In contrast, when IGFBP-2 was used as the substrate, a single band at 36 kilodaltons was visualized. These data taken together with the protease inhibitor results suggest that the IGFBP-2, IGFBP-4, and IGFBP-5 proteases are members of a similar family of calcium-dependent serine proteases, but they are distinct proteases. As IGFBP-4 is a potent inhibitor of IGF action, and the activity of this protease is regulated by IGF exposure, the protease represents a novel system for regulating the actions of IGF-I in this cell type.
Serum concentrations of insulin-like growth factor-I (IGF-I) and IGF-binding protein-1 (IGFBP-1), -2, and -3 are influenced by dietary intake in normal adults. These studies were undertaken to determine the influence of dietary factors on these proteins in children and to compare the responses in children to those in adults. Eight adults and eight pubertal children underwent energy restriction (50% reduction intake) for 6 days and were refed a normal diet for an additional 6 days. Basal energy intakes during the prerestriction periods were 70 Cal/kg in children and 35 Cal/kg in adults. A second group of 8 adults and 6 children underwent protein restriction (decreased from 1.0 to 0.66 g/kg in both groups) for 6 days and were refed a normal diet for 6 days. Calorie restriction resulted in a significant decrease in nitrogen balance in adults and children. Likewise, IGF-I concentrations declined significantly in both adults and children. In contrast, IGFBP-1 concentrations were significantly increased in adults (from 40 +/- 6 to 62 +/- 4 ng/mL; P < 0.05), but not in children. Serum concentrations of IGFBP-2 did not change in either group in response to energy restriction. IGFBP-3 declined significantly in the children (3189 +/- 90 to 2843 +/- 96 ng/mL; P < 0.05), but not in the adults. Protein restriction also caused negative nitrogen balance in both children and adults and a decline in the mean IGF-I concentration in the adults. IGFBP-2 concentrations rose significantly in both adults (131 +/- 15 to 164 +/- 15 ng/mL; P < 0.005) and children (126 +/- 13 to 158 +/- 15 ng/mL; P < 0.05) in response to protein restriction and returned to normal during refeeding. IGFBP-3 was slightly, but significantly, reduced in response to protein restriction in adults (3518 +/- 180 to 3328 +/- 151 ng/mL; P < 0.05), but not children. The findings indicate that protein or energy restriction in children leads to changes in IGF-I or specific IGFBPs. Changes in IGFBP-2 are sensitive to protein restriction, and measurement of IGFBP-2 may be useful in monitoring the response to refeeding in children who have been ingesting suboptimal amounts of protein.
Three lines of transgenic (Tg) mice carrying a fusion gene linking the mouse metallothionein-I promoter to a cDNA encoding human insulin-like growth factor binding protein-1 (hIGFBP-1) were found to express the transgene in brain. As judged by comparing Tg brain weights to those of non-transgenic littermates, adult hemizygotic Tg mice of each line exhibited brain growth retardation (16.2%, 14.4% and 8.1% reductions in weight, respectively in each line). In two lines, total brain DNA and protein content were decreased. Further analysis indicated that the brain growth retardation was manifested in the second week of postnatal life. Given that the insulin-like growth factors (IGFs) stimulate cell proliferation and/or survival in neural cultures and that hIGFBP-1, when present in a molar excess, inhibits IGF interactions with their cell surface receptors, the brain growth retardation in hIGFBP-1 Tg mice likely results from hIGFBP-1 inhibition of IGF-stimulated growth-promoting actions. These hIGFBP-1 Tg mice should prove useful in defining IGF actions during postnatal brain maturation.
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The mechanisms by which insulin-like growth factor-I (IGF-I) is released from insulin-like growth factor binding proteins (IGFBPs) and then binds to its receptor have not been defined. This study was designed to determine the role of glycosaminoglycans in altering the formation of the IGF-I.IGFBP complexes. Heparin inhibited formation of the IGF-I.IGFBP-5 complex and also separated preformed IGF-I.IGFBP-5 complexes. Heparin also inhibited formation of the IGF-I.IGFBP-3 complex; however, it did not inhibit formation of complexes between IGF-I and IGFBP-1, -2, or -4. Heparin exposure was associated with a 17-fold decrease in the affinity of IGFBP-5 for IGF-I. A synthetic peptide that contains residues from Arg221 to Arg238 of IGFBP-5, and a heparin binding domain prevented the inhibitory effects of heparin on formation of the IGF-I.IGFBP-5 complex. It did not directly compete with IGF-I for binding to IGFBP-5, suggesting that heparin binding to this region of IGFBP-5 resulted in a conformational change in IGFBP-5 which lowered its affinity for IGF-I. Other glycosaminoglycans that contained O-linked sulfates in the 2 or 3 carbon positions of iduronic acid, e.g. heparan sulfate and dermatan sulfate, also inhibited the IGF-I.IGFBP-5 complex formation, whereas those that did not, such as keratan sulfate or hyaluronic acid, had minimal effects. Anionic polysaccharides that contained O-sulfate groups in the 2 or 3 positions, such as dextran sulfate, pentosan polysulfate, and fucoidan, also had inhibitory activity. The findings suggest a role for these compounds in inhibiting IGF-I.IGFBP interactions, thus making IGF-I available to bind to its receptor.
Insulin-like growth factor I (IGF-I) has acute insulin-like metabolic effects and long-term anabolic actions. The therapeutic potential of recombinant human IGF-I treatment is being investigated in various growth hormone-resistant and insulin-resistant disorders. Recent studies have shown that IGF-I may substitute for growth hormone in promoting linear growth in children with growth hormone insensitivity. The anabolic, protein-sparing action of IGF-I is being evaluated as a potential therapy for adults with catabolic diseases. Patients with insulin-dependent diabetes mellitus have reduced endogenous IGF-I production, and studies are in progress to determine whether treatment with IGF-I in addition to insulin may improve their metabolic/anabolic status. Insulin-like growth factor I treatment may reduce glucose and triglyceride levels in adults with non-insulin-dependent diabetes mellitus and in some patients with extreme insulin resistance. Further studies are needed to evaluate the efficacy and safety of IGF-I treatment in these and other conditions and to provide a better understanding of this hormone's normal physiologic role(s) and complex relations with growth hormone and insulin.
The kidney epithelial cell line (MDBK) secretes primarily insulin-like growth factor binding protein (IGFBP)-2 under basal conditions, but exposure to forskolin decreases the synthesis of and induces IGFBP-3. Since IGFBP-3 has been shown to both potentiate and inhibit insulin-like growth factor (IGF) bioactivity, MDBK cells were transfected with an expression vector containing bovine IGFBP-3 cDNA and the dihydrofolate reductase (DHFR) gene as a selectable marker, with the goal of obtaining an epithelial cell line which constitutively secreted IGFBP-3. Stable clones which secreted greater than 100 ng/ml of IGFBP-3 were obtained and designated MDBKpMONBP-3. Northern blotting indicated that endogenous IGFBP-3 mRNA, which was undetectable in wild-type (WT) MDBK cells, was expressed in MDBKpMONBP-3 cells while the IGFBP-3 transgene did not appear to be expressed. DHFR mRNA transcripts were also expressed by MDBKp-MONBP-3 cells, whereas these transcripts were not detected in WT MDBK cells, suggesting that gene amplification of DHFR may have allowed cells to survive in methotrexate (MTX) without taking up the expression vector. In addition to the altered pattern of IGFBP-3 secretion, a marked alteration in cell morphology was observed. MDBKpMONBP-3 cells grew in distinct islands and exhibited dome formation (a characteristic of differentiated epithelial cells) whereas the WT cells did not. The alterations in morphology and IGFBP-3 expression were irreversible, since MDBKpMONBP-3 cells failed to revert to the WT phenotype upon removal of MTX and dialyzed serum. Since vectorial secretion of proteins is often associated with epithelial cell differentiation, cells were plated on tissue culture inserts which allowed conditioned media (CM) to be collected from both the apical and basal surfaces of confluent monolayers. Release of IGFBP-2 was approximately equal from apical and basal surfaces in WT MDBK cells. In contrast, release of both IGFBP-2 and IGFBP-3 was greater (3.1-fold and 3.5-fold, respectively) from basal as compared to apical surfaces of the MDBKpMONBP-3 cells. To determine if cells which were secreting IGFBP-3 had altered growth responses to IGF-I, cells were grown in serum-free media in the presence of IGF-I (0 to 100 ng/ml). Treatment of MDBKpMONBP-3 cells with 100 ng/ml of IGF-I increased cell number 138 +/- 37% above serum-free controls compared to 73 +/- 10% in WT MDBK cells.(ABSTRACT TRUNCATED AT 400 WORDS)
The genes for insulin-like growth factor binding proteins (IGFBPs) encode secreted proteins that bind insulin-like growth factors I and II with high affinity and modulate their biological activities. In this report we have used interspecific backcross mapping and gene cloning to define the chromosomal locations of 4 mouse Igfbp genes. Igfbp1 and 3 are found in the proximal part of chromosome 1. In the human genome these two loci map within 20 kb of one another on chromosome 7p14-p12, and the genes are organized in a tail-to-tail configuration. Mouse Igfbp2 and 5 colocalize to a proximal region of chromosome 1 that is syntenic with human chromosome 2q33-q36, and the two genes are 5 kb apart in a tail-to-tail orientation. These results suggest an evolutionary scheme in which a primordial IGFBP gene duplicated to form a cluster that was later replicated to create second linkage group.
We investigated the effect of administration of somatotropin (ST) and/or eCG on insulin-like growth factor I (IGF-I) and IGF-binding proteins (IGFBP) in serum and follicular fluid (FFL) of cattle actively immunized against growth hormone-releasing factor (GRF). Cyclic beef cattle, previously immunized against GRF-(1-29)-Gly-Gly-Cys-NH2 conjugated to human serum albumin (synthesized and provided by Hoffmann-LaRoche, Inc., Nutley, NJ; GRFi, n = 31) or to human serum albumin alone (HSAi, n = 26), received (i.m.): 1) 25 mg recombinantly derived methionyl somatotropin (rbST, n = 14; sometribove provided by Monsanto Co., St. Louis, MO); 2) 1100 IU eCG (n = 10); 3) rbST and eCG (rbST-eCG, n = 15); or 4) vehicle (VEH, n = 17) at 0 and 24 h after receiving prostaglandin F2 alpha (PGF2 alpha). Serum samples were collected at 0 and 40 h after PGF2 alpha, and the ovary bearing the largest follicle (DOM) was removed 44.0 +/- 0.5 h after PGF2 alpha; FFL was harvested from DOM and the subordinate follicle (SUB). Before treatment (0 h), GRFi cows had lower serum ST (0.6 +/- 0.2 vs. 2.2 +/- 0.2 ng/ml; p < 0.01) and IGF-I (26 +/- 4 vs. 72 +/- 4 ng/ml; p < 0.01), but greater IGFBP-2 (594 +/- 48 vs. 384 +/- 52 ng/ml; p < 0.01) than HSAi cows. Serum and FFL concentrations of IGF-I or IGFBP-2 were not different between rbST- and rbST-eCG-treated cows or between VEH- and eCG-treated cows at Hour 40 after the initial treatment injection; therefore, data were combined and designated as rbST and VEH, respectively. Serum IGF-I was increased to a greater extent (percentage increase above 0 h) by rbST treatment in GRFi (362 +/- 24) than in HSAi (176 +/- 16) cows (immunization by treatment, p < 0.01). Across GRFi and HSAi, rbST lowered serum IGFBP-2 (342 +/- 31 vs. 541 +/- 27 ng/ml, rbST vs. VEH; p < 0.01). Diameters of DOM or SUB were not affected by immunization or treatment. Concentrations of IGF-I and IGFBP-3 (determined by ligand blot analysis) in FFL from both DOM and SUB were lower (p < 0.05) in GRFi than in HSAi cows. In contrast, IGFBP-2 in FFL was elevated in SUB, but not DOM, in GRFi compared to HSAi cows.(ABSTRACT TRUNCATED AT 400 WORDS)
The influence of nutrition on growth seems likely to be mediated in part through IGF-I. Restriction of dietary nutrients adversely effects IGF-I synthesis and action at multiple steps, including decreased GH receptors, postreceptor defects in GH action, decreased steady state levels of IGF-I mRNA, and attenuation of IGF-I action. In addition, undernutrition affects the IGF binding proteins in ways that vary from one tissue to another. Understanding the alterations in IGFBPs that are caused by nutritional insufficiency may provide insight into the actions of the IGFBPs.
The insulin-like growth factors (IGF-I and IGF-II) stimulate muscle cell proliferation and/or differentiation (depending upon the culture conditions). They also increase IGF-binding protein (IGFBP) levels in muscle cell conditioned media and in some instances there is a direct correlation between the apparent rate of IGFBP secretion and muscle cell proliferation. We have investigated the effect of other cytokines on muscle cell IGFBP conditioned media levels using rat skeletal (L6), mouse myocytes (BC3H-I) and porcine vascular smooth (pVSM) muscle cells in vitro to determine if this relationship is maintained. IGFBP levels in conditioned media (CM) were measured by an [125I]IGF-I binding capacity assay and by western blot analysis. Immunoblots indicated that BC3H-1 and L6 cells secrete IGFBP-5 (31-32,000 M(r)), L6 cells secrete IGFBP-4, and pVSM cells secrete IGFBP-2 (34,000 M(r)). Both L6 and BC3H-1 cells responded to transforming growth factor beta 1 (TGF-beta 1), in a dose-dependent manner, with suppressed conditioned media levels of IGFBP-4 and IGFBP-5 but TGF-beta 1 did not affect IGFBP-2 levels in pVSM cell media. TGF-beta 1 (5 ng/ml) suppressed IGFBP levels (CM [125I]IGF-I binding capacity) in L6 and BC3H-1 cell media by 48% and 61%, respectively. IGFBP-5 levels, in BC3H-1 cell media, were decreased by treatment with either basic fibroblast growth factor (bFGF) or epidermal growth factor (EGF). Neither treatment affected IGFBP-2 levels. In contrast in L6 myoblasts, bFGF increased media levels of IGFBP-4 and IGFBP-5; L6 cells were not responsive to EGF. Insulin increased IGFBP-4 and IGFBP-5 levels in L6 and BC3H-1 cell media. This stimulatory effect was markedly suppressed by either TGF-beta 1 (L6 and BC3H-1 cells) or bFGF (BC3H-1 cells). L6 and BC3H-1 cell CM IGFBP levels were also suppressed 34% and 84% by 5 U/ml thrombin, respectively. The inhibitory activity of thrombin was specific, i.e. reversible by hirudin and was not due to direct IGFBP proteolysis. Since suramin and staurosporine increased media levels of the IGFBP, this suggests that constitutive secretion of TGF-beta 1, bFGF, or EGF might provide a tonic suppressive mechanism for controlling IGFBP secretion. Thus, our results support the conclusion that the secretion of IGFBP-4 and IGFBP-5, but not IGFBP-2, by muscle cells was suppressed by several cytokines. Depressed IGFBP secretion may play a key role in determining muscle cell responsiveness to either the mitogenic or differentiation stimulating activity of the IGFs.
Three hemizygous transgenic (Tg) mouse lines were generated with a fusion gene composed of the mouse metallothionein promoter (mMT-I) and a full-length human insulin-like growth factor binding protein-1 (hIGFBP-1) complementary DNA that was truncated in its 3'-untranslated region. Despite high serum hIGFBP-1 levels (120-2570 micrograms/liter) before puberty in two of these lines, no significant alterations were observed in somatic growth, nor were marked alterations noted in fasting or random serum glucose or in the response of young adult Tg mice to ip glucose. The transgene was expressed in a number of tissues from each line, but liver was a significant site of transgene expression in only one line. Unexpectedly, liver hIGFBP-1 messenger RNA (mRNA) expression in this line was regulated in fashion similar to the native liver IGFBP-1 mRNA: 1) its abundance waned with advancing postnatal age and became minimal in early adult life, despite continuous zinc supplementation to stimulate its transcription; and 2) fasting increased its abundance 3- to 4.3-fold. The decline in transgene expression with aging was not due to a deletion, rearrangement, or a change in the methylation of liver transgene DNA. Transcriptional mechanisms also were not likely to account for the observed regulation of the transgene mRNA, because liver expression of the mMT-I gene, which shares identical genomic 5'-regulatory elements with the transgene, was not similarly altered by aging or fasting. Because cycloheximide (CHX) treatment of cultured rat H4IIE cells has been shown to prolong IGFBP-1 mRNA half-life while decreasing its transcription, Tg mice were treated with CHX to test the possibility that instability of the liver transgene mRNA influenced its abundance. After CHX and under conditions of chronic zinc supplementation, liver transgene mRNA abundance increased in parallel with that of the native IGFBP-1 mRNA. Although CHX is known to activate mMT-I transcription by mechanisms involving the 5'-regulatory regions contained in the transgene, CHX-induced transcription only in part accounted for the increase in liver transgene mRNA, because CHX induced an earlier and greater increase in liver transgene mRNA than in mMT-I mRNA. Taken together, these data indicate that both transgene and native IGFBP-1 liver mRNA are regulated by factors that alter mRNA stability. The finding that native liver IGFBP-1 mRNA abundance is influenced by transgene expression further supports the concept that both mRNAs share some common mechanisms of regulation.(ABSTRACT TRUNCATED AT 400 WORDS)
We have previously reported the presence of proteolytic activity in conditioned medium from human fibroblast cultures that cleaves insulin-like growth factor-binding protein-5 (IGFBP-5) into non-IGF-I-binding fragments. Coincubation of IGF-I or IGF-II and IGFBP-5 with fibroblast cultures decreased proteolysis. The protease was purified by heparin-Sepharose affinity chromatography. The purified protease cleaved IGFBP-5 into 22-, 20-, and 17-kilodalton non-IGF-I-binding fragments. Protease inhibitor profiles obtained using partially purified enzyme showed that it was a calcium-dependent serine protease. After chelation with EDTA, the activity could only be partially restored with zinc, indicating that it was probably not a metalloprotease. The protease was specific for IGFBP-5 and did not cleave pure IGFBP-1, -2, -3, or -4. IGF-I and IGF-II caused minimal inhibition of proteolysis in vitro. This suggests that the IGF-I-induced increase in IGFBP-5 in fibroblast medium is only partially due to direct protease inhibition. Heparin, antithrombin-III (AT-III), and heparin cofactor-II had inhibitory activity, and heparin potentiated the activity of AT-III. Synthetic peptides, that contained the active sites of AT-III and alpha 1-antichymotrypsin, were also inhibitory. Peptides containing sequences found in two basic regions of IGFBP-5 were tested, and one had inhibitory activity. In summary, fibroblasts secrete a serine protease that cleaves IGFBP-5 and is specific for this form of IGFBP. The protease has properties that are similar to kallikreins, a family of serine proteases that is known to cleave epidermal and nerve growth factor-binding proteins.
Human dermal fibroblasts secrete insulin-like growth factor-binding protein-3 (IGFBP-3), -4, and -5. Fibroblast-conditioned medium contains minimal intact IGFBP-5, and this form of IGFBP is predominantely a 23-kilodalton fragment, suggesting that the IGFBP-5 fragment is derived from intact IGFBP-5 by proteolysis. In this study we investigated the effects of glycosaminoglycans on IGFBP-5 degradation in fibroblast-conditioned medium. The addition of heparin, heparan sulfate, and dermatan sulfate (100 micrograms/ml) to the medium of fibroblast monolayer cultures inhibited IGFBP-5 degradation, as determined by the conversion of intact IGFBP-5 to a 23-kilodalton fragment. In contrast, hyaluronic acid, keratan sulfate, and chondroitin sulfate-A and -C had no effect. Heparin and heparan sulfate inhibited IGFBP-5 degradation at concentrations of 1 or 2.5 micrograms/ml, but 100 micrograms/ml dermatan sulfate were required. Heparin was also inhibitory in vitro, that is when conditioned medium and heparin were incubated without cells. Experiments with modified forms of heparin showed that O-sulfate groups in the 2 or 3 carbon position were required for heparin to be inhibitory. Completely desulfated heparin had no activity, and N-resulfation of desulfated heparin had only a minimal effect. Dextran sulfate, pentosan polysulfate, and fucoidan, which are composed of different saccharide units but contain O-sulfate groups in the 2 or 3 carbon positions, also inhibited IGFBP-5 degradation. These results demonstrate that heparin-like molecules are important regulators of IGFBP-5 degradation. O-Sulfation of the 2 or 3 position of the saccharide ring is required for inhibitory activity. As glycosaminoglycan side-chains are present in proteoglycans that are present in extracellular matrix and on cell surfaces, these side-chains represent a potential mechanism for regulating IGFBP-5 proteolysis in vivo.
Insulin-like growth factor-I (IGF-I) exerts insulin-like effects on fuel metabolism and suppresses insulin secretion in normal subjects. Unlike insulin, circulating IGF-I is bound to high affinity binding proteins (IGFBPs), which modulate IGF action. We have previously shown that IGF-I administration increases IGFBP-1 and -2 and reduces IGFBP-3 in normal subjects. To determine whether similar effects could be demonstrated in an insulin-resistant state, we administered recombinant human IGF-I for 4 days by sc injection to six obese type II diabetics and determined the effects on fasting concentrations of glucose, C-peptide, IGF-I, and IGFBPs. The changes that occurred in glucose C-peptide and IGFBP levels during oral glucose tolerance testing were also quantified. There was no significant decrease in the mean fasting serum glucose or C-peptide level despite a 7-fold increase in mean fasting IGF-I concentrations (P < 0.01). As expected, during oral glucose tolerance testing, the area under the curve of C-peptide was suppressed after an injection of IGF-I (P < 0.05), but the area under the glucose curve did not change significantly. Mean fasting daily IGFBP-1 and -2 rose 2-fold (P < 0.05) and 1.9-fold (P < 0.05), respectively, whereas IGFBP-3 fell by 16% (P < 0.01) after 4 days of injections. IGFBP-1 was suppressed by 32% after oral glucose alone, whereas an injection of IGF-I plus oral glucose were associated with a more marked fall of 53% (despite suppression of C-peptide). In contrast, mean IGFBP-2 concentrations rose by 40% (P < 0.05) after IGF-I and oral glucose, but there was no change in response to oral glucose alone. These changes in IGFBP-1, -2, and -3 could alter the distribution of IGF-I among the various IGFBPs in the circulation. They may also prove to be a marker of metabolic responsiveness to IGF-I. In a substrate-sufficient state, e.g. after oral glucose, IGFBP-1 and -2 show opposite acute responses to IGF-I, and IGF-I has an apparent acute insulin-like effect on IGFBP-1 concentrations that differs from its longer term effect.
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