Clinical Rheumatology

, Volume 26, Issue 10, pp 1635–1639 | Cite as

Effects of dynamic exercise on circulating IGF-1 and IGFBP-3 levels in patients with rheumatoid arthritis or ankylosing spondylitis

  • Saliha Karatay
  • Kadir Yildirim
  • Meltem Alkan Melikoglu
  • Fatih Akcay
  • Kazım Şenel
Original Article


This study was performed to determine the effects of short-term dynamic exercise on serum insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) levels in the patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Patients with RA or AS and healthy controls were recruited. Dynamic treadmill exercise therapy was accomplished for 20 min/session with all of the participants. There were five sessions per week for 2 weeks. Morning stiffness duration, body pain, Stanford health assessment questionnaire, Ritchie articular index, Bath ankylosing spondylitis disease activity index (BASDAI), and Bath ankylosing spondylitis functional index (BASFI) were evaluated in the RA and AS patients. Laboratory assessments included: erythrocyte sedimentation rate, serum C-reactive protein, IGF-1, and IGFBP-3. Clinical and laboratory assessments were recorded at baseline and during exercise treatment on days 7 and 15. Twenty patients with RA, 15 with AS, and 14 healthy controls were included in this study. The pain evaluation, Ritchie, BASDAI, and BASFI scores were significantly improved by the exercise treatment in both patient groups. The important increases were found in circulating IGF-1 in RA (p < 0.001) and AS (p = 0.001) at the end of 2 weeks. In control individuals, serum IGF-1 levels showed a significant decline in the first week (p < 0.05). No significant changes were observed on serum IGFBP-3 levels. Our data suggest that serum IGF-1 levels are increased by the dynamic exercise program in RA and AS patients. The increased IGF-1 may play an important role in the beneficial effects of dynamic exercise therapy in these patients.


Ankylosing spondylitis Dynamic exercise IGF-1 IGFBP-3 Rheumatoid arthritis 


  1. 1.
    Ekdahl C, Broman G (1992) Muscle strength, endurance, and aerobic capacity in rheumatoid arthritis: a comparative study with healthy subjects. Ann Rheum Dis 51:35–40PubMedCrossRefGoogle Scholar
  2. 2.
    Ekdahl C, Andersson SI, Moritz U, Svensson B (1990) Dynamic versus static training in patients with rheumatoid arthritis. Scand J Rheumatol 19:17–26PubMedGoogle Scholar
  3. 3.
    van den Ende CH, Breedveld FC, le Cessie S, Dijkmans BA, de Mug AW, Hazes JM (2000) Effect of intensive exercise on patients with active rheumatoid arthritis: a randomised clinical trial. Ann Rheum Dis 59:615–621PubMedCrossRefGoogle Scholar
  4. 4.
    Fernandez-de-Las-Penas C, Alonso-Blanco C, Morales-Cabezas M, Miangolarra-Page JC (2005) Two exercise interventions for the management of patients with ankylosing spondylitis: a randomized controlled trial. Am J Phys Med Rehabil 84:407–419PubMedCrossRefGoogle Scholar
  5. 5.
    Elyan M, Khan MA (2006) The role of nonsteroidal anti-inflammatory medications and exercise in the treatment of ankylosing spondylitis. Curr Rheumatol Rep 8:255–259 (Review)PubMedCrossRefGoogle Scholar
  6. 6.
    Heemskerk VH, Daemen MA, Buurman WA (1999) Insulin-like growth factor-1 (IGF-1) and growth hormone (GH) in immunity and inflammation. Cytokine Growth Factor Rev 10:5–14PubMedCrossRefGoogle Scholar
  7. 7.
    Rosen CJ (1999) Serum insulin-like growth factors and insulin-like growth factor-binding proteins: clinical implications. Clin Chem 45:1384–1390PubMedGoogle Scholar
  8. 8.
    Poehlman ET, Rosen CJ, Copeland KC (1994) The influence of endurance training on insulin-like growth factor-1 in older individuals. Metabolism 43:1401–1405PubMedCrossRefGoogle Scholar
  9. 9.
    Pyka G, Taaffe DR, Marcus R (1994) Effect of a sustained program of resistance training on the acute growth hormone response to resistance exercise in older adults. Horm Metab Res 26:330–333PubMedCrossRefGoogle Scholar
  10. 10.
    Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324PubMedCrossRefGoogle Scholar
  11. 11.
    van der Linden S, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum 27:361–368PubMedCrossRefGoogle Scholar
  12. 12.
    Fries JF, Spitz P, Kraines RG (1980) Measurement of patient outcome in arthritis. Arthritis Rheum 23:137–145PubMedCrossRefGoogle Scholar
  13. 13.
    Ritchie DM, Boyle JA, McInnes JM, Jasani MK, Dalakas TG, Grieveson P (1968) Clinical studies with an articular index for the assessments of joint tenderness in patients with rheumatoid arthritis. Q J Med 147:768–769Google Scholar
  14. 14.
    Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A (1994) A new approach to defining disease status in ankylosing spondylitis: the Bath ankylosing spondylitis disease activity index. J Rheumatol 21:2286–2291PubMedGoogle Scholar
  15. 15.
    Calin A, Garrett S, Whitelock H, Kennedy LG, O’Hea J, Mallorie P, Jenkinson T (1994) A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath ankylosing spondylitis functional index. J Rheumatol 21:2281–2285PubMedGoogle Scholar
  16. 16.
    Jackson A, Ross R (1992) Understanding exercise for health and fitness, 2nd edn. D. Armstrong Book Printing, Houston, p 32Google Scholar
  17. 17.
    Fisker S, Jorgensen JO, Vahl N, Orskov H, Christiansen JS (1999) Impact of gender and androgen status on IGF-I levels in normal and GH-deficient adults. Eur J Endocrinol 141:601–608PubMedCrossRefGoogle Scholar
  18. 18.
    Steinbröcker O, Traeger CH, Batterman RC (1949) Therapeutic criteria in rheumatoid arthritis. JAMA 140:562–659Google Scholar
  19. 19.
    van den Ende CH, Vliet Vlieland TP, Munneke M, Hazes JM (1998) Dynamic exercise therapy in rheumatoid arthritis: a systematic review. Br J Rheumatol 37:677–687PubMedCrossRefGoogle Scholar
  20. 20.
    Mariacher-Gehler S, Wyss-Nather A, Aeschlimann AG (2001) Physiotherapy in rheumatoid arthritis and ankylosing spondylitis. Ther Umsch 58:503–508PubMedCrossRefGoogle Scholar
  21. 21.
    Stenstrom CH, Minor MA (2003) Evidence for the benefit of aerobic and strengthening exercise in rheumatoid arthritis. Arthritis Rheum 49:428–434PubMedCrossRefGoogle Scholar
  22. 22.
    Eliakim A, Brasel JA, Mohan S, Barstow TJ, Berman N, Cooper DM (1996) Physical fitness, endurance training, and the growth hormone-insulin-like growth factor I system in adolescent females. J Clin Endocrinol Metab 81:3986–3992PubMedCrossRefGoogle Scholar
  23. 23.
    Lemmey A, Maddison P, Breslin A, Cassar P, Hasso N, McCann R, Whellams E, Holly J (2001) Association between insulin-like growth factor status and physical activity levels in rheumatoid arthritis. J Rheumatol 28:29–34PubMedGoogle Scholar
  24. 24.
    Neidel J (2001) Changes in systemic levels of insulin-like growth factors and their binding proteins in patients with rheumatoid arthritis. Clin Exp Rheumatol 19:81–84PubMedGoogle Scholar
  25. 25.
    Toussirot E, Nguyen NU, Dumoulin G, Regnard J, Wendling D (1998) Insulin-like growth factor-I and insulin-like growth factor binding protein-3 serum levels in ankylosing spondylitis. Br J Rheumatol 37:1172–1176PubMedCrossRefGoogle Scholar
  26. 26.
    Juul A (2003) Serum levels of insulin-like growth factor I and its binding proteins in health and disease. Growth Horm IGF Res 13:113–170PubMedCrossRefGoogle Scholar
  27. 27.
    Dohm GL, Elton CW, Raju MS, Mooney ND, DiMarchi R, Pories WJ, Flickinger EG, Atkinson SM Jr, Caro JF (1990) IGF-I-stimulated glucose transport in human skeletal muscle and IGF-I resistance in obesity and NIDDM. Diabetes 39:1028–1032PubMedCrossRefGoogle Scholar
  28. 28.
    Jones JI, Clemmons DR (1995) Insulin-like growth factors and their binding proteins: biological actions. Endocr Rev 16:3–34PubMedCrossRefGoogle Scholar
  29. 29.
    Tsukahara H, Gordienko DV, Tonshoff B, Gelato MC, Goligorsky MS (1994) Direct demonstration of insulin-like growth factor-I-induced nitric oxide production by endothelial cells. Kidney Int 45:598–604PubMedCrossRefGoogle Scholar
  30. 30.
    Wuster C, Blum WF, Schlemilch S, Ranke MB, Ziegler R (1993) Decreased serum levels of insulin-like growth factors and IGF binding protein 3 in osteoporosis. J Intern Med 234:249–255PubMedCrossRefGoogle Scholar
  31. 31.
    Pedersen BK (2000) Special feature for the Olympics: effects of exercise on the immune system: exercise and cytokines. Immunol Cell Biol 78:532–535PubMedCrossRefGoogle Scholar
  32. 32.
    Lazarus DD, Moldawer LL, Lowry SF (1993) Insulin-like growth factor-1 activity is inhibited by interleukin-1 alpha, tumor necrosis factor-alpha, and interleukin-6. Lymphokine Cytokine Res 12:219–223PubMedGoogle Scholar
  33. 33.
    Evans WJ, Meredith CN, Cannon JG, Dinarello CA, Frontera WR, Hughes VA, Jones BH, Knuttgen HG (1986) Metabolic changes following eccentric exercise in trained and untrained men. J Appl Physiol 61:1864–1868PubMedGoogle Scholar

Copyright information

© Clinical Rheumatology 2007

Authors and Affiliations

  • Saliha Karatay
    • 1
  • Kadir Yildirim
    • 1
  • Meltem Alkan Melikoglu
    • 1
  • Fatih Akcay
    • 2
  • Kazım Şenel
    • 1
  1. 1.Department of Physical Medicine and Rehabilitation, Medical FacultyAtatürk UniversityErzurumTurkey
  2. 2.Department of Biochemistry, Medical FacultyAtatürk UniversityErzurumTurkey

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