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Increased IGF-1 levels in an elderly population in relation to heart failure and cardiovascular mortality. Impact of ACE-inhibitors.
MedLine Citation:
PMID:  21976623     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AbstractObjective. There are conflicting results regarding the association of circulating insulin-like growth factor-1 (IGF-1) with cardiovascular (CV) morbidity and mortality. We assessed the relationship between IGF-1 levels and heart failure (HF), ischemic heart disease (IHD) and CV mortality in an elderly population taking into account the possible impact of angiotensin- converting enzyme inhibitors (ACE-inhibitors).Design and methods. 851 persons aged 66-81 years, in a rural Swedish municipality were evaluated by medical history, clinical examination, electrocardiography, echocardiography and fasting plasma samples. They were then followed for 8 years.Results and conclusion. Patients on ACE-inhibitors had elevated IGF-1 levels compared to those without.In patients on ACE-inhibitors higher IGF-1 values were found in those with an EF<40% compared to EF≥40%, in those with higher pro-BNP levels in quartile 4 versus 1, and in patients with IHD when compared to those without (p<0.001). In patients without ACE-inhibitors, no relationship was found between IGF-1 levels and HF or IHD. In multivariate regression only ACE-inhibitors, EKG-changes characteristic for IHD and gender had a significant impact on IGF-1.Persons with higher IGF-1 levels in quintiles 4 and 5 compared to quintiles 1 and 2 had a 50% higher risk for cardiovascular death (p=0.03). This was significant after adjustment for well-known CV risk factors and ACE-inhibitors (p=0.03).Our results show that treatment with ACE-inhibitors in an elderly population is associated with increased IGF-1 levels especially in patients with impaired cardiac function or IHD. High IGF-1 levels tend to be associated with an increased risk for CV mortality.Keywords. Insulin-like growth factor-1, heart failure, ischemic heart disease, elderly population.
Authors:
Simona I Chisalita; Ulf Dahlström; Hans J Arnqvist; Urban Alehagen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-5
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  -     ISSN:  1479-683X     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
S Chisalita, Department of Acute Health Care, Linköping, 58535, Sweden.
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