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Original Articles

Contribution of Growth Hormone and IGF-I to Early Diabetic Nephropathy in Type 1 Diabetes

  1. Elizabeth A Cummings,
  2. Etienne B Sochett,
  3. Maria G Dekker,
  4. Margaret L Lawson and
  5. Denis Daneman
  1. Department of Pediatrics, the Hospital for Sick Children, University of Toronto Toronto, Ontario, Canada
  1. Address correspondence and reprint requests to Etienne B. Sochett, Division of Endocrinology, the Hospital for Sick Children, 555 University Ave., Toronto, Ontario M5G 1X8, Canada. E-mail: ebs{at}sickkids.on.ca
Diabetes 1998 Aug; 47(8): 1341-1346. https://doi.org/10.2337/diab.47.8.1341
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Abstract

In children and adolescents with type 1 diabetes, we have reported an association between duration of puberty and the prevalence of nephromegaly and microalbuminuria (MA), which are early markers of diabetic nephropathy. Growth hormone (GH), IGF-I, testosterone, and prorenin are potential mediators of this effect. This study examined the relationship of these hormonal factors to kidney volume (KV) and MA in 155 subjects (78 males, age 13.2 ± 3.5 years [mean ± SD]) with similar diabetes duration (6.83 ± 1.6 years) but varying pubertal experience (0–10 years). KV (by ultrasound), plasma IGF-I, testosterone, prorenin, and NaLi countertransport, and urinary albumin, urinary GH, and urinary IGF-I from three 24-h collections were measured. Multiple regression analysis showed that BSA (P < 0.0001) and urinary IGF-I (P = 0.001) were significantly associated with KV. MA subjects (albumin excretion rate 15–200 μg/min) had higher urinary IGF-I (P = 0.005) and urinary GH (P = 0.05) compared with normoalbuminuric subjects. Only 9% of the variance in urinary IGF-I could be attributed to plasma IGF-I (r = 0.30, P < 0.0001). Testosterone and prorenin were not associated with MA, but they were associated with KV in univariate analyses. The strong association of urinary IGF-I with KV, a marker for glomerular hypertrophy, and of both urinary IGF-I and urinary GH with MA suggests a role for these growth factors in the development of human diabetic nephropathy. Together, these data support animal studies that have shown that renal GH and IGF-I may contribute significantly to the pathogenesis of early diabetic nephropathy.

  • Received November 14, 1997.
  • Revision received April 8, 1998.
  • Accepted April 8, 1998.
  • Copyright © 1998 by the American Diabetes Association

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August 1998, 47(8)
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Contribution of Growth Hormone and IGF-I to Early Diabetic Nephropathy in Type 1 Diabetes
Elizabeth A Cummings, Etienne B Sochett, Maria G Dekker, Margaret L Lawson, Denis Daneman
Diabetes Aug 1998, 47 (8) 1341-1346; DOI: 10.2337/diab.47.8.1341

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Contribution of Growth Hormone and IGF-I to Early Diabetic Nephropathy in Type 1 Diabetes
Elizabeth A Cummings, Etienne B Sochett, Maria G Dekker, Margaret L Lawson, Denis Daneman
Diabetes Aug 1998, 47 (8) 1341-1346; DOI: 10.2337/diab.47.8.1341
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