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Association between the Insulin Resistance of Puberty and the Insulin-Like Growth Factor-I/Growth Hormone Axis

Department of Pediatrics (A.M., J.S., A.S.) and School of Public Health (D.J., C.-P.H.), University of Minnesota, Minneapolis, Minnesota 55455; Department of Pediatrics (P.C.), University of California, Los Angeles, Los Angeles, California 90095; and Department of Public Health Sciences (R.P.), Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157

Address all correspondence and requests for reprints to: Antoinette Moran, M.D., University of Minnesota Pediatric Department, Box 404, 516 Delaware Street SE, Minneapolis, Minnesota 55455. E-mail: moran001{at}umn.edu.

Abstract

To test the hypothesis that the relative insulin resistance of puberty is associated with changes in IGF-I levels, we compared IGF-I, IGF binding protein-3 (IGFBP-3), and IGFBP-1 levels to insulin resistance [M_lbm, milligrams glucose used per kilogram of lean body mass (LBM) per minute] measured during euglycemic, hyperinsulinemic clamp studies in 342 children and adolescents.

IGF-I levels rose and fell during the Tanner stages of puberty in a pattern that closely followed the rise and fall of insulin resistance. IGF-I levels were significantly related to M_lbm in boys (P = 0.0006) and girls (P = 0.02). IGF-I was significantly related to fasting insulin levels only in girls (P = 0.006; boys, P = 0.26), and this relation was significantly influenced in girls by body fat (P = 0.007), with the strongest association between IGF-I and fasting insulin seen in thin girls. IGFBP-1 correlated negatively with insulin resistance in both boys (P = 0.0004) and girls (P = 0.04), whereas IGFBP-3 correlated positively with insulin resistance in boys (P = 0.0004) but not girls (P = 0.85).

These data suggest that the GH/IGF-I axis is an important contributor to the insulin resistance of puberty.

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