301. High insulinlike growth factor binding protein 1 level predicts incident congestive heart failure in the elderly
- Author
-
Lewis H. Kuller, Anne R. Cappola, Robert C. Kaplan, Xiao Nan Xue, Michael Pollak, Bruce M. Psaty, Thomas E. Rohan, Aileen P. McGinn, and Howard D. Strickler
- Subjects
medicine.medical_specialty ,Anabolism ,Heart disease ,business.industry ,Growth factor ,medicine.medical_treatment ,Insulin ,medicine.disease_cause ,medicine.disease ,Endocrinology ,Framingham Heart Study ,Internal medicine ,Heart failure ,medicine ,Risk factor ,Cardiology and Cardiovascular Medicine ,business ,hormones, hormone substitutes, and hormone antagonists ,Oxidative stress - Abstract
The insulin-like growth factor (IGF) system is highly conserved across species and plays a central role in cellular differentiation, cellular proliferation, apoptosis, metabolism, wound repair, and somatic growth (1–6). IGF-I, the main effector peptide of the IGF system and the principal mediator of growth hormone (GH) effects, may influence the development of age-related cardiovascular diseases (7–11). A report from the Framingham Heart Study identified low IGF-I as a risk factor for incident congestive heart failure (CHF) in the elderly (7). IGF binding proteins (IGFBPs) modulate IGF-I activity and may also have IGF-I-independent effects. Circulating IGFBP-3, like IGF-I, is responsive to GH status (12) and in older adults IGFBP-3 and IGF-I decline in concert with decreased GH. Most IGF-I in circulation is bound to IGFBP-3, suggesting a role of IGFBP-3 in determining the circulating half-life of IGF-I and its delivery to target tissues. IGFBP-1 is less abundant than IGFBP-3, but appears particularly important in regulating IGF-I bioavailability, with strong inverse correlations between circulating IGFBP-1 and free IGF-I (13) (14). IGFBP-1 has a very different system of regulation than IGFBP-3, with hepatic IGFBP-1 production strongly (inversely) regulated by insulin. Aging, cachectic conditions, malnutrition, inflammatory cytokines, and oxidative stress all increase IGFBP-1 expression (15–21), which may in turn lead to inhibition of anabolic IGF-I effects by IGFBP-1 during catabolic states. High circulating IGFBP-1 levels predict cardiovascular events after myocardial infarction (22) and cardiovascular mortality among apparently healthy older men (23). Prior data also indicate increased IGFBP-1 levels in CHF patients (24) which suggests that high circulating IGFBP-1 levels may be a CHF risk factor, although no prior studies of IGFBP-1 and incident CHF are available. We assessed the association between fasting IGF-I, IGFBP-1, IGFBP-3, and insulin levels and incident CHF among older adults in the Cardiovascular Health Study (CHS).
- Published
- 2008