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High insulinlike growth factor binding protein 1 level predicts incident congestive heart failure in the elderly

Robert C Kaplan1, Aileen P McGinn, Michael N Pollak

  • 1Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA. rkaplan@aecom.yu.edu

American Heart Journal
|June 3, 2008
PubMed

Insights

High insulinlike growth factor binding protein 1 (IGFBP-1) levels predict congestive heart failure (CHF) risk in older adults. This finding was independent of other known risk factors and inflammation markers, suggesting IGFBP-1 as a potential CHF indicator.

Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Geriatrics

Background:

  • Low insulinlike growth factor 1 (IGF-I) may link to age-related cardiovascular diseases like congestive heart failure (CHF).
  • Insulinlike growth factor binding protein 1 (IGFBP-1) is elevated in CHF patients and linked to mortality in older adults and myocardial infarction survivors.
  • IGFBP-1 inhibits anabolic IGF-I effects and rises in catabolic states.

Purpose of the Study:

  • To investigate the association between fasting plasma levels of IGF-I, IGFBP-1, IGFBP-3, and insulin and the risk of incident CHF.
  • To determine if IGFBP-1 is an independent predictor of CHF in older adults.

Main Methods:

  • Prospective study of 5,888 adults aged 65+ from the Cardiovascular Health Study.
  • Analysis included 566 incident CHF cases and 1,072 controls, excluding underweight individuals and insulin users.
  • Hazard ratios (HRs) for CHF were calculated, adjusting for numerous cardiovascular risk factors, inflammation, and health status.

Main Results:

  • High baseline IGFBP-1 levels significantly predicted CHF risk, independent of established risk factors and inflammation.
  • Each standard deviation increase in IGFBP-1 corresponded to a 22% increased HR for CHF (HR=1.22).
  • Individuals in the highest tertile of IGFBP-1 had a 47% increased HR for CHF compared to the lowest tertile (HR=1.47).

Conclusions:

  • Elevated circulating IGFBP-1 levels may serve as a risk factor for developing congestive heart failure in older adults.
  • Fasting plasma IGF-I, IGFBP-3, or insulin levels were not associated with CHF risk after adjustments.
Abstract

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