IGF-1
(insulin-like growth factor) is a protein produced by the liver
in response to growth hormone stimulus. For this reason, IGF-1 is
often used to assess the body's natural biochemical source for proper
bone, muscle and tissue development. Both IGF-1 and growth hormone
levels usually decline with age.
One important key in effectively preventing
and treating osteoarthritis, is establishing
a healthy balance of IGF-1. Numerous
clinical studies suggest that IGF-1
works to protect and repair cartilage
tissue.
1-3 One
researcher has cited this protein as "the
major anabolic mediator for articular
cartilage."4 This
regenerative effect of IGF-1 is believed
to offset the damage inflicted by reactive
immune mediators, such as cytokines,
to the cartilage. Thus diminished serum
levels have been discovered in patients
with osteoarthritis as compared with
controls, 5,6 although
one study found that the correlation
with these low levels was age-related.7
Within the arthritic joint itself, dysfunctional
mechanisms involving IGF-1 may manifest
in a variety of ways. Specific genotypes
of the IGF-1 gene are significantly associated
with the presence of osteoarthritis.8 The
most damaged osteoarthritic tissue shows
a heightened genetic expression for
increased sensitivity to IGF-1 receptor
messages.9 It
may be as a response to progressive cartilage
degradation that IGF-1 levels within
the damaged joint itself are much higher
than they are in normal cartilage tissue.10,11 However,
some investigators have speculated that
despite these increased local levels,
the chondrocytes--cartilage cells--are
unresponsive to these elevations due
to increased binding of IGF-1 to binding
proteins, rendering IGF-1 biologically
unavailable.12
Because high bone density is associated
with increased risk of osteoarthritis,
however, large excess of growth hormone
in the body is also thought to exert
a detrimental effect on development of
osteoarthritis.13
IGF-1
Assessment provides important information
about the body's levels of this crucial hormonal mediator
in osteoarthritis, and also helps assess
the general functioning integrity and
homeostasis of the nervous system.
References:
1 Bellometti S, Giannini S, Sartori L,
Crepaldi G. Cytokine levels in osteoarthritis
patients undergoing
mud bath therapy. Int J Clin Pharmacol
Res 1997;17(4):149-53.
2 Keyszer GM, Heer AH, Kriegsmann J,
Geiler T, Keysser C, Gay RE, Gay S. Detection
of insulin-like growth factor I and II
in synovial tissue specimens of patients
with rheumatoid arthritis and osteoarthritis
by in situ hybridization. J Rheumaol
1995;22(2):275-281.
3 Trippel SB. Growth factor actions on
articular cartilage. J Rheumatol Suppl
1995;43:129-32.
4 Olney RC, Tsuchiya K, Wilson DM, Mohtai
M, Maloney WJ, Schurman DJ, Smith RL.
Chondrocytes from osteoarthritic cartilage
have increased expression of insulin-like
grwoth factor I (IGF-1) and IGF-binding
protein-3 (IGFBP-3) and -5, but not IGF-II
or IGFBP-4. J Clin Endocrinol Metab 1996;81(3):1096-103.
5 Moskowitz RW, Boja B, Denko CW. The
role of growth factors in degernative
joint disorders. J Rheumtol Suppl 1991;27:147-8.
6 Denko CW, Boja B, Moskowitz RW. Growth
promoting peptides in osteoarthritis:
insulin, insulin-like growth factor-1,
growth hormone. J Rheumatol
1990;17(9):1217-21.
7 Hochberg MC, lehtbridge-Cejku M, Scott
WW Jr, Reichle R, Plato CC, Tobin JD.
Serum levels of insulin-like growth factor
in subjects with osteoarthritis of the
knee. Data form the Baltimore Longitudinal
Study of Aging. Arthritis Rheum 1994;37(8):1177-1180.
8 Meulenbelt I, Bijkerk C, Meidema HS,
Breeveld FC, Hofman A, Valkenburg HA,
et. al. A genetic association study of
the IGF-1 gene and radiological osteoarthritis
in a population-based cohort sutdy (the
Rotterdam Study). Ann Rheum Dis 1998;57(6):371-4.
9 Middleton J, Manthey A, Tyler J. Insulin-like
growth factor (IGF-1) receptor, IGF-1,
interleukin-1 beta (IL-1 beta), and IL-6
m RNA expression in osteoarthritic and
normal human cartilage. J Histochem Cytochem
1996;44(2):133-141.
10 Schneiderman R, Rosenberg N, Hiss
J, Lee P, Liu F, Hintz RL, Maraoudas
A. Concentration and size distribution
of insulin-like growth factor-1 in human
normal and osteoarthritic synovial fluid
and cartilage. Arch Biochem Biophys 1995;324(1):173-88.
11 Lloyd ME, Hart DJ, Nandra D, McAlindon
TE, Wheeler M, Doyle DV, Spector TD.
Relation between insulin-like growth
factor-I concentrations, osteoarthritis,
bone density, and fractures in the general
population: the Chingford study. Ann
Rheum Dis 1996;55(12):870-4.
12 Martel-Peletier J, Di Battista JA,
Lajeunesse D, Pelletier JP. IGF/IGFBP
in carilage and bone in osteoarthritis
pathogenesis. Inflamm Res
1998;47(3):90-100.
13 Bouillon R. Growth hormone and bone.
Horm Res 1991;36 Suppl 1:49-55.
Call
to set up a nutritional consultation so that tests can be performed
and a comprehensive strategy of lifestyle, dietary modification
and nutrient supplementation can be implemented to aid you in reversing
this disorder.
For
an appointment, contact our office at: 800-956-7083 and visit our
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Dr.
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Her programs work because she is so thorough in testing and providing
a nutritional approach. Remember that the body can heal itself if
given the proper nutrients. |