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Proinsulin and IGFBP-1 predicts mortality in an elderly population

Simona I Chisalita1, Ulf Dahlström2, Hans J Arnqvist3

  • 1Department of Acute Healthcare, County Council of Östergötland, Linköping, Cell Biology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Sweden.

International Journal of Cardiology
|May 6, 2014
PubMed

Insights

In elderly individuals, high Insulin-like Growth Factor Binding Protein-1 (IGFBP-1) is linked to mortality. Proinsulin, not IGFBP-1 or insulin, independently predicts both all-cause and cardiovascular mortality in older adults.

Area of Science:

  • Gerontology
  • Cardiovascular Medicine
  • Endocrinology

Background:

  • Elevated Insulin-like Growth Factor Binding Protein-1 (IGFBP-1) in elderly individuals is associated with increased all-cause and cardiovascular (CV) mortality.
  • The relationship between IGFBP-1, cardiometabolic risk factors, and mortality in the elderly requires further investigation.
  • The potential impact of proinsulin and insulin on the association between IGFBP-1 and mortality is not fully understood.

Purpose of the Study:

  • To investigate the association of IGFBP-1 with cardiometabolic risk factors and mortality in an unselected elderly primary health care population.
  • To examine the impact of proinsulin and insulin on the relationship between IGFBP-1 and all-cause and CV mortality in the elderly.

Main Methods:

  • A cross-sectional and prospective study involving 851 elderly individuals (aged 66-81 years) from a rural Swedish population.
  • Comprehensive evaluations included medical history, clinical examination, electrocardiography, echocardiography, and fasting plasma samples.
  • Prospective follow-up for up to 12 years to ascertain mortality outcomes.

Main Results:

  • Multivariate analysis at baseline showed IGFBP-1 associated with gender, NT-proBNP, blood glucose, BMI, insulin, proinsulin, eGFR, and Hb.
  • During follow-up, 230 deaths (27%) occurred, with 134 (16%) due to CV mortality.
  • Proinsulin and IGFBP-1 impacted all-cause mortality, while only proinsulin significantly predicted CV mortality after adjusting for known risk factors.

Conclusions:

  • Proinsulin emerges as the sole independent predictor for both all-cause and cardiovascular mortality in this elderly cohort.
  • IGFBP-1 and insulin did not independently predict mortality when compared to proinsulin.
  • These findings highlight proinsulin's critical role as a prognostic biomarker in elderly populations.
Abstract

Keywords:
Elderly populationInsulinInsulin-like growth factor binding protein-1Proinsulin

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