Endocrine Abstracts

Low IGFBP2 is associated with the metabolic syndrome, but high IGFBP2 is longitudinally associated with worsening renal function. IGFBP2 binds IGF2 (and IGF1) and modified IGF bioavailablilty. The aim of our study was to identify whether baseline IGFBP2 concentrations were associated with all-cause and cardiovascular mortality in type 2 diabetes.

554 subjects (59.3% male, mean age 63.7 (S.D. 10.7)) with type 2 diabetes from the Salford Diabetes cohort were studied. IGFBP2 as well as IGF1, IGF2, IGFBP-one and IGFBP-three were measured once-in samples withdrawn at baseline in 2002-2003. Clinical data regarding these 554 subjects were then followed up for death until August 2011.

Clinical data was obtained from electronic records and death data from Office of National Statistics. 132 deaths were recorded in the study population, with cause of death available in 124 of them. Main causes of death were – 51 cardiovascular deaths (including myocardial infarction (19), stroke (7), heart failure (6), others (9); cancer (35); Sepsis (15), COPD (6), renal failure (2).

Cox regression analyses done separately for each IGF protein, age, baseline cardiovascular variables and diabetes duration, log rank assessments done for gender, previous history of MI or stroke. Positively associated variables studied in Cox-proportional hazard regression model after satisfying proportionality assessments.

60% of deceased were male. High baseline IGFBP2 wasignificantly associated with higher all-cause mortality (hazard ratio 1.001, 95% CI 1.000–1.003, P=0.005). IGF1 (HR 1.003, 95% CI 1.00001–1.007, P=0.044) and IGFBP2 (HR 1.004, 95% CI 1.002–1.007, P=0.001) were significantly associated with cardiovascular mortality.

IGFBP2 is predictor of all-cause and cardiovascular mortality. The nature of the association remains to be clarified, it may be related to decreased IGF2 bioavailability and increased frailty.