Introduction: Insulin-like Growth Factor-1 (IGF1) and its primary binding protein IGFBP3 are markers of insulin resistance and may characterize an internal milieu affecting the course of diabetes. We examined if IGF1 and IGFBP3 levels modify the efficacy of intensive weight-reducing lifestyle intervention on glucose metabolism among people with overweight/obese and Type 2 Diabetes.
Methods: The Look AHEAD Study randomized persons aged 45-74 years with BMI ≥ 25 kg/m2 and verified Type 2 diabetes, to assigned to Intensive Lifestyle Intervention (ILI) versus Diabetes Support and Education (DSE). A random sample (n=80, male 50%, African Americans 16%) had measurement of IGF1 and IGFBP3 by ELISA at baseline. We examined changes in fasting glucose levels from baseline to 1 year by treatment assignment and biomarker levels.
Results: In the ILI group, lower baseline IGFBP3 levels predicted larger decreases in fasting glucose (p = 0.02), while there was no significant association in the DSE group (Figure, baseline IGFBP3 by treatment interaction, p = 0.055). There was no treatment by baseline level interaction for IGF1.
Conclusion: In overweight/obese Type 2 diabetes, the efficacy of ILI in reducing fasting glucose level is greater at lower IGFBP3 levels. Our findings, if confirmed, can guide personalization of intensive treatment of diabetes.
P. Maurya: None. J. Yang: None. A.D. Everett: Advisory Panel; Merck & Co., Inc. W.L. Bennett: None. D. Vaidya: None.
National Institutes of Health (DK127222)
