Serum insulin-like growth factor binding protein-1: an improvement over other simple indices of insulin sensitivity in the assessment of subjects with normal glucose tolerance

This version was published on 1 March 2009

Ann Clin Biochem 2009;46:109-113
© 2009 Association for Clinical Biochemistry


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Original Articles

Anwar Borai1,
Callum Livingstone1,2,
Hawazen Zarif3 and
Gordon Ferns1,2

1 Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH;
2 Department of Clinical Biochemistry, Royal Surrey County Hospital, Guildford GU2 7XX, UK;
3 Department of Medicine, King Khalid National Guard Hospital, P.O. Box 4354, Jeddah 21491, Saudi Arabia

Corresponding author: Dr Callum Livingstone. Email: clivingstone{at}

Background: Insulin resistance is associated with an increased risk of cardiovasculardisease and diabetes. It can be assessed using complex referencetechniques, such as clamp or frequently sampled intravenousglucose tolerance test (FSIVGTT). Therefore, simple indicesderived from fasting insulin and glucose concentrations havebeen proposed. The aim of this study is to assess fasting seruminsulin-like growth factor binding protein-1 (IGFBP-1) as asimple index of insulin sensitivity compared with other simpleindices and FSIVGTT.

Methods: Fasting serum IGFBP-1, fasting plasma insulin (FPI), homeostasismodel assessment (HOMA-IR), quantitative insulin check index(QUICKI), fasting glucose to insulin ratio (FGIR), Raynaud andinsulin glycaemic index (ISI-gly) were correlated with FSIVGTT(Si) in 22 subjects with normal glucose tolerance (NGT) andnine with impaired fasting glucose (IFG).

Results: In NGT individuals, IGFBP-1 correlated more strongly with Si than did any other index both before (r = 0.76) and after (r = 0.79) natural logarithm (ln) transformation. In subjects with IFG, IGFBP-1 was weakly correlated with Si before and after ln-transformation (r = 0.55, r = 0.56, respectively), but ISI-gly was the index most strongly correlated with Si (r = 0.77, r= 0.85, respectively).

Conclusions: In subjects with NGT, fasting serum IGFBP-1 could be used asa simple reliable marker of insulin sensitivity. For more accurateestimation of insulin sensitivity in normal subjects and thosewith IFG, ln-transformation is preferred over raw data.

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