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IGF-I deficiency among obese women linked to adiponectin, BMI, ALT, steatosis

Obese, nondiabetic women with low levels of adiponectin and high BMI and ALT levels are more likely to have insulin-like growth factor I-deficiency, according to recent results.

In a cross-sectional study, researchers evaluated 201 obese women (mean age, 41.1 years; mean BMI, 44.1 kg/m2) evaluated as bariatric surgery candidates at a Romanian medical facility between June 2008 and December 2011. Levels of adiponectin, C-reactive protein (CRP), insulin-like growth factor (IGF-I) and insulin were measured, and significant steatosis (SS) was determined via hepatic ultrasound.

A majority of the cohort (60.7%) had SS, and 33.3% were considered IGF-I deficient. Significant associations were observed between SS and lower levels of total adiponectin (P<.001) and increased prevalence of IGF-I deficiency (P<.05). Participants who were IGF-I deficient had significantly higher BMI (P<.001), waist circumference (WC; P=.023), ALT levels (P=.042) and gamma glutamyltransferase (GGT; P=.045) compared with those with normal IGF-I values. Those with IGF-I deficiency also were at greater risk for metabolic syndrome (OR=1.728; 95% CI, 1.00-2.95) and SS (OR=1.802; 95% CI, 1.017-3.192).

Investigators noted negative correlations between IGF-I z scores and ALT levels (r=–0.130, P=.032), GGT (r=–0.158; P=.018), WC (r=–0.196; P=.002), log CRP (r=–.232; P=.001) and BMI (r=–0.283; P<.001). Quantitative Insulin Sensitivity Check Index (QUICKI; r=0.148; P=.023) and log adiponectin (r=0.216; P=.003) were positively correlated with IGF-I z scores. Adjustment for age, ALT levels, QUICKI, log CRP and BMI did not alter the significance of the association between IGF and adiponectin (r=0.183; P=.012).

Multivariate analysis indicated independent associations between IGF-I deficiency and BMI and log adiponectin (P<.001 for each), along with ALT levels (P=.003) and SS (P=.043).

“This study shows that high BMI, high ALT and low adiponectin levels, as well as significant hyperechogenicity on liver ultrasound, are independently associated with IGF-I deficiency in nondiabetic obese women,” the researchers wrote. “For the first time we describe a positive correlation between adiponectin and IGF-I concentrations in extremely obese women that deserves further validation and clarification in large-scale prospective studies.”