IGF-I/IGFBP-3 ratio: A mechanistic insight into the metabolic syndrome

Justo Sierra-Johnson, Abel Romero-Corral, Virend K. Somers, Francisco Lopez-Jimenez, Anders Mälarstig, Kerstin Brismar, Anders Hamsten, Rachel M. Fisher, Mai Lis Hellénius

Research output: Contribution to journalArticlepeer-review

42 Scopus citations


Recent reports suggest that IGF (insulin-like growth factor)-I and IGFBP-3 (IGF-binding protein-3) have independent and opposing mechanistic effects on insulin. The aim of the present study was to assess the relationship between the IGF-I/IGFBP-3 ratio and the metabolic syndrome. We examined 3281 subjects (1463 men and 1818 women, aged 20-49 years), otherwise healthy adults, who participated in NHANES III (Third National Health and Nutrition Examination Survey), which has released measurements of IGF-I and IGFBP-3. Insulin resistance was estimated using the computer HOMA2 (homoeostatic model assessment 2) model. The updated ATP-III (Adult Treatment Panel III) definition of the metabolic syndrome was used. We applied adjusted logistic and linear regression models. After adjusting for age and race, men and women in the lowest quartile of the IGF-I/IGFBP-3 ratio were 3-fold more likely to meet the ATP-III definition of the metabolic syndrome and twice as likely to be insulin-resistant. Mean values of the IGF-I/IGFBP-3 ratio decreased significantly as the number of metabolic syndrome components increased (P<0.0001, as determined by ANOVA). The area under the ROC (receiver operating characteristic) curve for detecting insulin resistance using the IGF-I/IGFBP-3 ratio was 0.760, significantly improving upon either protein alone (P=0.01). In conclusion, the IGF-I/ IGFBP-3 ratio is significantly associated with the metabolic syndrome. Calculating the ratio of these two proteins may provide insight into the metabolic syndrome clustering phenomenon.

Original languageEnglish (US)
Pages (from-to)507-512
Number of pages6
JournalClinical Science
Issue number6
StatePublished - Mar 2009


  • Cardiovascular disease
  • Insulin resistance
  • Insulin-like growth factor-I (IGF-I)
  • Insulin-like growth factor-binding protein-3 (IGFBP-3)
  • Metabolic syndrome
  • Third National Health and Nutrition Examination Survey (NHANES III)

ASJC Scopus subject areas

  • General Medicine


Dive into the research topics of 'IGF-I/IGFBP-3 ratio: A mechanistic insight into the metabolic syndrome'. Together they form a unique fingerprint.

Cite this