Relationship between insulin-like growth factor-1 and radiographic disease in patients with primary osteoarthritis: a systematic review

Claessen, K.M.J.A.; Ramautar, S.R.; Pereira, A.M.; Smit, J.W.A.; Biermasz, N.R.; Kloppenburg, M.

doi:10.1016/j.joca.2011.11.012

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Volume 20, Issue 2 , Pages 79-86, February 2012

Relationship between insulin-like growth factor-1 and radiographic disease in patients with primary osteoarthritis: a systematic review

K.M.J.A. Claessen
- Department of Endocrinology & Metabolic Diseases, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
- Address correspondence and reprint requests to: K.M.J.A. Claessen, Department of Endocrinology and Metabolic Diseases C4-R, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands. Tel: 31-71-5266896; Fax: 31-71-5248136.
- K.M.J.A.C. and S.R.R. contributed equally to this work.
S.R. Ramautar
- Department of Endocrinology & Metabolic Diseases, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
- K.M.J.A.C. and S.R.R. contributed equally to this work.
A.M. Pereira
- Department of Endocrinology & Metabolic Diseases, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
J.W.A. Smit
- Department of Endocrinology & Metabolic Diseases, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
N.R. Biermasz
- Department of Endocrinology & Metabolic Diseases, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
M. Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands

Received 25 July 2011; accepted 23 November 2011. published online 26 December 2011.

Summary

Objective

To evaluate the association between radiographic osteoarthritis (OA) and either serum insulin-like growth factor-1 (IGF-1) levels or IGF-1 gene polymorphisms in patients with primary OA.

Methods

We conducted a systematic review of reported associations between circulating IGF-1 and/or IGF-1 gene polymorphisms and radiographic OA. Studies were eligible when: (1) investigating serum IGF-1 and/or IGF-1 gene polymorphisms in relation to prevalent or incident radiographic OA; (2) written in English; (3) full-text article or abstract; (4) patients had primary OA in knee, hip, hand or spine; (5) longitudinal, case-control or cross-sectional design. Quality assessment was done using a standardized criteria set. Best-evidence synthesis was performed based on guidelines on systematic review from the Cochrane Collaboration Back Review Group, using five evidence levels: strong, moderate, limited, conflicting and no evidence.

Results

We included 11 studies with more than 3000 primary OA cases. Data on the relationship between serum IGF-1 and radiographic OA were inconsistent. Adjustment for body mass index (BMI) was often omitted. Of four high-quality studies, three studies reported no association, one study found significantly higher IGF-1 levels in OA patients compared to controls. Patients with IGF-1 gene promoter polymorphisms and a genetic variation at the IGF-1R locus had an increased OA prevalence compared to controls.

Conclusions

Observational data showed no association between serum IGF-1 and occurrence of radiographic OA (moderate level of evidence), and a positive relationship between IGF-1 gene polymorphisms and radiographic OA (moderate level of evidence); however the confounding effect of BMI was insufficiently addressed. Future well-designed prospective studies should further elaborate the role of the complex GH/IGF-1 system in primary OA.

Keywords: Insulin-like growth factor (IGF-1), Polymorphisms, Primary osteoarthritis