scholarly journals Changes in Serum Insulin-Like Factor 3 during Normal Male Puberty

2006 ◽  
Vol 91 (9) ◽  
pp. 3426-3431 ◽  
Author(s):  
Alberto Ferlin ◽  
Andrea Garolla ◽  
Franco Rigon ◽  
Lucia Rasi Caldogno ◽  
Andrea Lenzi ◽  
...  
Keyword(s):  
Leydig Cells ◽  
Prolonged Exposure ◽  
Serum Insulin ◽  
Plasma Concentrations ◽  
Tanner Stage ◽  
Normal Male ◽  
Pubertal Stage ◽  
Cross Sectional ◽  
Male Puberty ◽  
Pubertal Stages

Abstract Context: Insulin-like factor 3 (INSL3) is produced by the Leydig cells, and in adults, its secretion is dependent on the state of differentiation of these cells, which, in turn, is dependent on LH. However, the secretion and regulation of INSL3 during puberty is unknown. Objective: Our objective was to evaluate INSL3 concentrations during normal male puberty and the relation of INSL3 to LH, FSH, and testosterone. Design and Setting: We conducted a cross-sectional study from January to December 2005 at academic clinics. Patients: Participating in the study were 75 healthy male subjects aged 9.5–17.5 yr, homogeneously distributed into five pubertal groups of 15 according to Tanner stages. Main Outcome Measures: We assessed mean testicular volume and LH, FSH, testosterone, and INSL3 concentrations in relation to age and pubertal stage. Results: We observed an increase of INSL3 and LH levels from Tanner stage 2 to 4, and an increase of FSH from stage 2 to 3. Testosterone levels increased from stage 3 to 4. No differences were seen for all measured hormones between stages 4 and 5. The increase in INSL3 seemed therefore to anticipate the increase in testosterone. However, INSL3 plasma concentrations at pubertal stages 4 and 5 are about one fourth of adult levels, whereas FSH, LH, and testosterone reached adult levels by stage 4. Positive significant correlations were found between INSL3 and LH for all pubertal stages. Conclusions: This study provides information on the physiological dynamics of INSL3, showing that the serum concentrations of this hormone increased progressively throughout puberty under the differentiating action of LH on Leydig cells. INSL3 is therefore confirmed to represent a marker of Leydig cell differentiation and function. However, a prolonged exposure to LH seems to be necessary to reach INSL3 concentrations of adults. A possible use of INSL3 in puberty disorders is promising.

scholarly journals Age, maturation and serum lipid parameters: findings from the German Health Survey for Children and Adolescents

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Anja Schienkiewitz ◽  
Julia Truthmann ◽  
Andrea Ernert ◽  
Susanna Wiegand ◽  
Karl Otfried Schwab ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Sexual Maturation ◽  
Serum Lipid ◽  
Serum Lipids ◽  
Physical Growth ◽  
Pubertal Stage ◽  
Cross Sectional ◽  
Pubertal Stages ◽  
The Impact ◽  
Lipid Parameters

Abstract Background Recommendations on preventive lipid screening among children and adolescents remain controversial. The aim of the study was to assess age and puberty-related changes in serum lipids, including total cholesterol (TC), and high-density (HDL-C) and non-high-density lipoprotein cholesterol (Non-HDL-C). Methods Using cross-sectional data from the National Health Interview and Examination Survey for Children and Adolescents in Germany (KiGGS 2003–2006; N = 13,676; 1–17 years), changes in distributions of serum lipids were visualized according to sex, age and maturation. Youth aged 10–17 years were classified as prepubescent, early/mid-puberty, and mature/advanced puberty. Multiple linear regressions were used to quantify the impact of pubertal stage on serum lipid levels, adjusted for potential confounding factors. Results Among children 1–9 years mean serum lipid measures increased with age, with higher mean TC and Non-HDL-C among girls than boys. Among children 10–17 years, advanced pubertal stage was independently related to lower lipid measures. Adjusted mean TC, HDL-C and Non-HDL-C was 19.4, 5.9 and 13.6 mg/dL lower among mature/advanced puberty compared to prepubescent boys and 11.0, 4.0 and 7.0 mg/dL lower in mature/advanced puberty compared to prepubescent girls. Conclusions Lipid concentrations undergo considerable and sex-specific changes during physical growth and sexual maturation and significantly differ between pubertal stages. Screening recommendations need to consider the fluctuations of serum lipids during growth and sexual maturation.

scholarly journals The Association of Obesity and Hyperandrogenemia during the Pubertal Transition in Girls: Obesity as a Potential Factor in the Genesis of Postpubertal Hyperandrogenism

2006 ◽  
Vol 91 (5) ◽  
pp. 1714-1722 ◽  
Author(s):  
Christopher R. McCartney ◽  
Kathleen A. Prendergast ◽  
Sandhya Chhabra ◽  
Christine A. Eagleson ◽  
Richard Yoo ◽  
...  
Keyword(s):  
Polycystic Ovary ◽  
Dehydroepiandrosterone Sulfate ◽  
Normal Weight ◽  
Total Testosterone ◽  
Early Puberty ◽  
Pubertal Stage ◽  
Cross Sectional ◽  
Pubertal Stages ◽  
Potential Factor ◽  
Sectional Analysis

Context: Adolescent hyperandrogenemia is considered a forerunner of adult polycystic ovary syndrome, but its etiology remains uncertain. Objective: Our objective was to explore the hypothesis that peripubertal obesity is associated with hyperandrogenemia. Design and Setting: We performed a cross-sectional analysis of data obtained at General Clinical Research Centers. Subjects: Subjects were 41 obese [body mass index (BMI) for age, ≥95%] and 35 normal-weight (BMI for age, <95%) peripubertal girls. Intervention: We used pooled blood samples (∼0500–0700 h; n = 64) while fasting or single morning (fasting) samples (n = 12). Main Outcome Measures: We assessed adiposity and androgen concentrations. Results: BMI correlated with total testosterone (T) (rs = 0.59), SHBG (rs = −0.69), and free T (rs = 0.69); free T was three times as great in obese girls compared with normal-weight girls (P < 0.0001 for all). BMI correlated with insulin (rs = 0.52); both insulin and LH correlated with free T (rs = 0.45 and 0.44, respectively; P < 0.001 for all). When analyzing early pubertal girls (pubertal stages 1–3; n = 36) alone, BMI correlated with total T (rs = 0.65), SHBG (rs = −0.74), and free T (rs = 0.75); free T was five times as great in obese early-pubertal girls (P < 0.001 for all). BMI correlated with insulin (rs = 0.65), and insulin correlated with free T (rs = 0.63, P < 0.01 for both). BMI correlated with free T while simultaneously adjusting for age, pubertal stage, insulin, LH, and dehydroepiandrosterone sulfate. Conclusion: Peripubertal obesity is associated with marked hyperandrogenemia, which is especially pronounced in early puberty.

scholarly journals Twenty-Four-Hour Profiles of Luteinizing Hormone, Follicle-Stimulating Hormone, Testosterone, and Estradiol Levels: A Semilongitudinal Study throughout Puberty in Healthy Boys*

1997 ◽  
Vol 82 (2) ◽  
pp. 541-549 ◽  
Author(s):  
Kerstin Albertsson-Wikland ◽  
Sten Rosberg ◽  
Birgitta Lannering ◽  
Leo Dunkel ◽  
Gunnar Selstam ◽  
...  
Keyword(s):  
Diurnal Rhythm ◽  
Pubertal Development ◽  
Tanner Stage ◽  
Testicular Volume ◽  
Early Puberty ◽  
Pubertal Stage ◽  
Pubertal Stages ◽  
Prepubertal Boys ◽  
Stage 1 ◽  
Estradiol Levels

Abstract To follow and correlate gonadotropin and sex steroid changes throughout puberty, 24-h profiles of LH, FSH, testosterone, and estradiol were taken on several occasions for between 2–9.5 yr in 12 healthy boys, aged 8.7–18.2 yr. Serum concentrations of LH and FSH were measured every 20 min, whereas testosterone and estradiol were measured every 2–4 h during the 24-h period. The prepubertal boys (Tanner stage 1) were subdivided into two groups: Pre 1, with a testicular volume of 1–2 mL, and Pre 2, with a testicular volume of 3 mL. Pubertal stages were classified, according to testicular volume, as early puberty (pubertal stage 2; 4–9 mL), midpuberty (pubertal stages 3–4; 10–15 mL), and late puberty (pubertal stage 5; ≥16 mL). Mean levels of LH and FSH increased with pubertal development, although the increase in LH was greater than that in FSH. These increases were due to elevated basal levels of LH and FSH as well as to increases in the number of peaks and the peak amplitudes of LH. No diurnal rhythm was found in boys at stage Pre 1. Thereafter, a clear diurnal rhythm appeared for LH, and later in puberty, an ultradian rhythm was superimposed, as shown by time-sequence analyses. A diurnal rhythm also existed for FSH, but was much less marked than that for LH despite a clear covariation between LH and FSH, as shown from cross-correlation studies. Testosterone also showed diurnal variations from the late prepubertal stage, followed by increasing levels during both day and night in puberty. We conclude that during puberty, gonadotropin levels rise differently for LH and FSH, which may be due to the development of differences in feedback mechanisms. Despite covariation between LH and FSH, only LH showed a clear diurnal variation. In parallel, nocturnal variations in testosterone and estradiol were found. Changes in mean levels of LH, testosterone, and estradiol as well as their mean daytime and nighttime levels follow each other from the prepubertal stages to late puberty.

scholarly journals Stage-Dependent Expression of Protein Gene Product 9.5 in Donkey Testes

Animals ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 2169
Author(s):  
Yeonju Choi ◽  
Youngwook Jung ◽  
Seongmin Kim ◽  
Junyoung Kim ◽  
Heejun Jung ◽  
...  
Keyword(s):  
Gene Product ◽  
Western Blotting ◽  
Leydig Cells ◽  
Protein Gene ◽  
Expression Patterns ◽  
Seminiferous Tubules ◽  
Pubertal Stage ◽  
Protein Gene Product ◽  
Testicular Cells ◽  
Pubertal Stages

Molecular markers can be used to identify and isolate specific developmental stages of germ cells and Leydig cells. Protein gene product (PGP)9.5 expression in spermatogonia and Leydig cells has been reported in several species. The stages of spermatogonia and Leydig cells expressing PGP9.5 vary depending on the species and reproductive stages. Thus, the objectives of this study were (1) to identify the localization of PGP9.5 in donkey testicular cells, and (2) to compare the expression patterns of PGP9.5 in donkey testicular cells between pre- and post-pubertal stages. Testes samples were collected following the routine field castration of six donkeys. Western blotting was performed to verify the cross-reactivity of the rabbit anti-human PGP9.5 antibody to donkey testes. Immunofluorescence was performed to investigate the expression pattern of PGP9.5 in testicular tissues at different reproductive stages. In Western blotting, the protein band of the PGP9.5 antibody appeared at approximately 27 kDa, whereas the band was not observed in the negative control treated with normal mouse IgG. In the pre-pubertal stage, the expression of deleted in azoospermia-like (DAZL) was found in some spermatogonia in pre-pubertal testicular tissues. However, the immunolabeling of PGP9.5 in testicular tissue was not observed in the seminiferous tubules. In stages 1 and 2, spermatogonia were immunolabeled with either PGP9.5 or DAZL. In contrast, PGP9.5 and DAZL were co-immunolabeled in some of the spermatogonia in stages 3 to 8. Interestingly, some Leydig cells were immunolabeled with PGP9.5 in both pre- and post-pubertal stages. In conclusion, the PGP9.5 antibody can be used as a tool to identify and isolate spermatogonia from seminiferous tubules.

Adiposity and adipocytokines: the moderator role of cardiorespiratory fitness and pubertal stage in girls

2019 ◽  
Vol 32 (3) ◽  
pp. 239-246 ◽  
Author(s):  
Caroline Brand ◽  
Neiva Leite ◽  
Wendell Arthur Lopes ◽  
Arieli Fernandes Dias ◽  
Larissa Rosa da Silva ◽  
...  
Keyword(s):  
Cardiorespiratory Fitness ◽  
Positive Association ◽  
Cardiometabolic Health ◽  
Linear Regression Models ◽  
Pubertal Stage ◽  
Cross Sectional ◽  
Pubertal Stages ◽  
Moderator Role ◽  
The Relationship

Abstract Background Cardiorespiratory fitness (CRF) and pubertal stages have been related to many health outcomes, including obesity and adipocytokines. Thus, the present study aimed to analyze the moderator role of CRF and pubertal stage in the relationship between adiposity and adipocytokines in girls. Method This cross-sectional study was performed with 42 pre-pubertal girls aged from 7 to 11 years and 54 post-pubertal girls aged from 13 to 17 years. Blood samples were collected to determine the serum levels of leptin and adiponectin, and then the leptin/adiponectin ratio (L/A ratio) was calculated. CRF, anthropometric and body composition indicators were assessed. For statistical analysis, descriptive statistics and several linear regression models were used. The moderation analysis was tested using the PROCESS macro. Results An interaction between body mass index (BMI) and CRF (β: –0.70; confidence interval [CI]: –1.29, –0.12), as well as between BMI and pubertal stage (β: 0.79; CI: 0.28, 1.30) with leptin, was found. Regarding the L/A ratio, an interaction was found only in BMI × CRF (β: –0.56; CI: –1.06, –0.06). Using a combined interaction (CRF and pubertal stage), the results showed a positive association between BMI with leptin and L/A ratio only in low CRF, pre-pubertal and post-pubertal stages. Conclusion This study suggests a protective role of high levels of CRF in the relationship between BMI and adipocytokines. Despite the effect of pubertal stage, the results suggest that youth should be engaged in physical activity in order to improve CRF levels and consequently improve cardiometabolic health.

scholarly journals Sexual dimorphism in cortisol metabolism throughout pubertal development: a longitudinal study

2020 ◽  
Vol 9 (6) ◽  
pp. 542-551
Author(s):  
Britt J van Keulen ◽  
Conor V Dolan ◽  
Bibian van der Voorn ◽  
Ruth Andrew ◽  
Brian R Walker ◽  
...  
Keyword(s):  
Sexual Dimorphism ◽  
Excretion Rate ◽  
Reductase Activity ◽  
Pubertal Development ◽  
Tanner Stage ◽  
Early Morning ◽  
Considerable Decrease ◽  
Pubertal Stage ◽  
Cortisol Metabolism ◽  
Pubertal Stages

Objective Sex differences in disease susceptibility might be explained by sexual dimorphism in hypothalamic-pituitary-adrenal axis activity, which has been postulated to emerge during puberty. However, studies conducted thus far lacked an assessment of Tanner pubertal stage. This study aimed to assess the contribution of pubertal development to sexual dimorphism in cortisol production and metabolism. Methods Participants (n = 218) were enrolled from a population-based Netherlands Twin Register. At the ages of 9, 12 and 17 years, Tanner pubertal stage was assessed and early morning urine samples were collected. Cortisol metabolites were measured with GC-MS/MS and ratios were calculated, representing cortisol metabolism enzyme activities, such as A-ring reductases, 11β-HSDs and CYP3A4. Cortisol production and metabolism parameters were compared between sexes for pre-pubertal (Tanner stage 1), early pubertal (Tanner stage 2–3) and late-pubertal (Tanner stage 4–5) stages. Results Cortisol metabolite excretion rate decreased with pubertal maturation in both sexes, but did not significantly differ between sexes at any pubertal stage, although in girls a considerable decrease was observed between early and late-pubertal stage (P < 0.001). A-ring reductase activity was similar between sexes at pre- and early pubertal stages and was lower in girls than in boys at late-pubertal stage. Activities of 11β-HSDs were similar between sexes at pre-pubertal stage and favored cortisone in girls at early and late-pubertal stages. Cytochrome P450 3A4 activity did not differ between sexes. Conclusions Prepubertally, sexes were similar in cortisol parameters. During puberty, as compared to boys, in girls the activities of A-ring reductases declined and the balance between 11β-HSDs progressively favored cortisone. In addition, girls showed a considerable decrease in cortisol metabolite excretion rate between early and late-pubertal stages. Our findings suggest that the sexual dimorphism in cortisol may either be explained by rising concentrations of sex steroids or by puberty-induced changes in body composition.

scholarly journals A cross-sectional survey of adrenal steroid hormones among overweight/obese boys according to puberty stage

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Bingyan Cao ◽  
Chunxiu Gong ◽  
Di Wu ◽  
Xuejun Liang ◽  
Wenjing Li ◽  
...  
Keyword(s):  
Free Testosterone ◽  
Serum Levels ◽  
Normal Weight ◽  
Sex Hormone Binding Globulin ◽  
Cross Sectional Survey ◽  
Pubertal Stage ◽  
Cross Sectional ◽  
Adrenal Steroid ◽  
Testosterone Levels ◽  
Pubertal Stages

Abstract Background Obesity is associated with many chronic diseases including cortisol rhythm disorder and low testosterone. Furthermore, studies on obese children are quite limited and no concordance results have been obtained, especially for boys in puberty. Moreover, the sample sizes of previous studies were small, and were not representative. Methods We conducted a cross-sectional survey including 1148 boys aged 6–14 years, they were divided into overweight/obesity (OW/OB) group and normal weight (NW) group. Puberty status was assessed according to Tanner scale and testicular volume. Serum levels of pregnenolone, 17-OH progesterone, corticosterone, dehydroepiandrosterone (DHEA), and androstenedione were detected by LC-MS. Serum free testosterone and sex hormone-binding globulin (SHBG) levels were measured by chemiluminescence immunoassay. Results The 17-OH progesterone, DHEA, androstenedione and free testosterone levels of OW/OB boys at prepubertal stage or at the age 6 = < 10 years group were higher than those of the NW boys (all the P values were < 0.01). Furthermore, androstenedione and free testosterone levels were lower in OW/OB boys at late puberty, and the trend continued at the post pubertal stage for FT (P < 0.01–0.05). DHEA, androstenedione, and FT levels persisted to be higher at the 10~ < 12 years in OW/OB boys but not for 17-OH progesterone. FT level was lower in the OW/OB group at the 12~ < 15 years group. The SHBG levels in the OW/OB boys were lower than those in the NW ones at the 6~12 years group, and prepubertal to early pubertal stage. Conclusions Premature adrenarche is more likely in OW/OB boys. More attention should be given to the lower androgen levels of OW/OB boys at late pubertal and post pubertal stages.

Iron and Hematological Status among Adolescent Athletes Tracked through Puberty

1995 ◽  
Vol 7 (3) ◽  
pp. 253-262
Author(s):  
Noreen D. Willows ◽  
Susan K. Grimston ◽  
David J. Smith ◽  
David A. Hanley
Keyword(s):  
Adverse Effect ◽  
Iron Deficiency ◽  
Serum Ferritin ◽  
Direct Evidence ◽  
Iron Status ◽  
Normal Range ◽  
Pubertal Stage ◽  
Physically Active ◽  
Pubertal Stages ◽  
Prepubertal Boys

This study assessed change in hematological status among physically active children as they progressed through puberty. Values for serum ferritin, hemoglobin, and hematocrit at all stages of puberty were within the normal range of reference values. Significant changes in serum ferritin were not detected in the different pubertal stages, although serum ferritin was highest in prepubertal boys and girls. There were no significant differences in marginal or deficient iron stores between the sexes at any pubertal stage, suggesting that gender was not predisposing for iron deficiency; however, girls had a greater overall incidence for both measures. With more children under consideration, these trends may have reached significance. Boys in TS4 and TS5 had higher hemoglobin and hematocrit compared with earlier stages of puberty, and compared with girls at the same stages of puberty. This can be explained by testosterone production in boys. Among girls, pubertal progression had no significant effect on hemoglobin or hematocrit. In the absence of controls, there was no direct evidence that involvement in sports had an adverse effect on iron status.

scholarly journals Influence ofABCC2andABCC4Polymorphisms on Tenofovir Plasma Concentrations in Thai HIV-Infected Patients

2015 ◽  
Vol 59 (6) ◽  
pp. 3240-3245 ◽  
Author(s):  
Kanokrat Rungtivasuwan ◽  
Anchalee Avihingsanon ◽  
Narukjaporn Thammajaruk ◽  
Siwaporn Mitruk ◽  
David M. Burger ◽  
...  
Keyword(s):  
Body Weight ◽  
Multivariate Analysis ◽  
Plasma Concentration ◽  
Protease Inhibitors ◽  
Demographic Data ◽  
Plasma Concentrations ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
The Mean

ABSTRACTTenofovir (TFV) is eliminated by renal excretion, which is mediated through multidrug-resistant protein 2 (MRP2) and MRP4, encoded byABCC2andABCC4, respectively. Genetic polymorphisms of these transporters may affect the plasma concentrations of tenofovir. Therefore, the aim of this study was to investigate the influence of genetic and nongenetic factors on tenofovir plasma concentrations. A cross-sectional study was performed in Thai HIV-infected patients aged ≥18 years who had been receiving tenofovir disoproxil fumarate at 300 mg once daily for at least 6 months. A middose tenofovir plasma concentration was obtained. Multivariate analysis was performed to investigate whether there was an association between tenofovir plasma concentrations and demographic data, including age, sex, body weight, estimated glomerular filtration rate (eGFR), hepatitis B virus coinfection, hepatitis C virus coinfection, duration of tenofovir treatment, concomitant use of ritonavir-boosted protease inhibitors, and polymorphisms ofABCC2andABCC4. A total of 150 Thai HIV-infected patients were included. The mean age of the patients was 43.9 ± 7.2 years. The mean tenofovir plasma concentration was 100.3 ± 52.7 ng/ml. In multivariate analysis, a low body weight, a low eGFR, the concomitant use of ritonavir-boosted protease inhibitors, and theABCC44131T → G variation (genotype TG or GG) were independently associated with higher tenofovir plasma concentrations. After adjusting for weight, eGFR, and the concomitant use of ritonavir-boosted protease inhibitors, a 30% increase in the mean tenofovir plasma concentration was observed in patients having theABCC44131 TG or GG genotype. Both genetic and nongenetic factors affect tenofovir plasma concentrations. These factors should be considered when adjusting tenofovir dosage regimens to ensure the efficacy and safety of a drug. (This study has been registered at ClinicalTrials.gov under registration no. NCT01138241.)

Abstract T P130: High Serum Insulin-Like Growth Factor 1 is Associated with Lower Risk of Ischemic Stroke: The Framingham Heart Study

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Hamidreza Saber ◽  
Jayandra J Himali ◽  
Alexa Beiser ◽  
Ashkan Shoamanesh ◽  
Alexandra Pikula ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Growth Factor ◽  
Lower Risk ◽  
Serum Insulin ◽  
High Serum ◽  
Community Dwelling ◽  
Insulin Like Growth Factor ◽  
Original Cohort ◽  
Cross Sectional ◽  
Cox Models

Background: Insulin-like growth factor 1 (IGF-1), reduces progression of atherosclerosis and in cross-sectional studies low circulating IGF-1 is associated with increased carotid intima-media thickness. Yet, prospective data linking IGF-1 levels to development of stroke remain sparse and inconsistent. We related circulating IGF-1 levels to risk of incident stroke in a community-dwelling sample. Methods: Serum IGF-1 levels were assayed in 757 stroke-free participants (age 79+5 years, 62% women) from the Framingham original cohort (1990-1994), and related to prospectively ascertained, incident all-stroke and ischemic stroke using Cox models. Results: During a mean follow-up of 10.2 years in 757 participants, 119 developed stroke including 99 with ischemic stroke. After adjustment for age and sex, higher log-IGF1 levels were associated with a lower risk of incident ischemic stroke [hazard ratio (HR): 0.79, 95% confidence interval (CI): 0.63- 0.99, p=0.043]. There was a threshold effect with subjects in the lowest quintile of IGF-1 levels having 2.56-fold higher risk of incident ischemic stroke (95% CI: 1.20, 5.45, p=0.015) compared to all others. We observed significant interaction between diabetes and IGF1 in their relation to ischemic stroke (p=0.016). In pre-specified subgroup analyses the effect was restricted to persons with diabetes and central obesity (waist-to-hip ratio in top quartile) in whom each SD increase in IGF-1 was associated with a 61% (HR: 0.39, 95%CI: 0.20-0.78, p=0.007), and 41% (HR: 0.59, 95%CI: 0.37- 0.95, p=0.031) lower risk of incident ischemic stroke, respectively. Results were similar for all-stroke. Conclusions: IGF-1 may have a protective role in the pathogenesis of ischemic stroke among persons with insulin resistance as manifested by diabetes and/or obesity.

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