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Attenuated IGF-1 predicts all-cause and cardiovascular mortality in a Black population: A five-year prospective study
Aletta E Schutte1, Elena Conti2, Catharina Mc Mels3
1Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa Medical Research Council, Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa alta.schutte@nwu.ac.za.
Insights
Higher insulin-like growth factor-1 (IGF-1) levels were associated with a lower risk of cardiovascular and all-cause mortality in a Black South African population. This study found IGF-1 to be protective against hypertension but not carotid wall thickness.
Area of Science:
- Endocrinology
- Cardiovascular Epidemiology
- Public Health
Background:
- Conflicting evidence exists regarding the role of insulin-like growth factor-1 (IGF-1) in hypertension, carotid wall thickness, and mortality.
- This study investigated the five-year prognostic value of IGF-1 in a large Black population with a high predisposition to hypertension and cardiovascular disease.
Purpose of the Study:
- To determine the prognostic significance of IGF-1 for hypertension, carotid intima-media thickness, and mortality over five years.
- To examine the independent association of IGF-1 with these cardiovascular outcomes in a specific demographic.
Main Methods:
- A longitudinal study involving 1038 HIV-uninfected participants from the PURE study in South Africa.
- Measurement of IGF-1 and IGF binding protein-3 (IGFBP-3) at baseline, with assessment of blood pressure, carotid intima-media thickness, and mortality over five years.
Main Results:
- High baseline IGF-1 was independently associated with a reduced risk of all-cause mortality (HR 0.45) and cardiovascular mortality (HR 0.26) after adjusting for IGFBP-3 and covariates.
- High IGF-1 was also linked to normotension at follow-up (HR 0.68) when considering baseline normotensives and hypertensives.
- No significant association was found between IGF-1 and carotid intima-media thickness.
Conclusions:
- In a Black South African population characterized by low socioeconomic status and adverse health behaviors, IGF-1 demonstrated a protective association with hypertension and mortality.
- The study found no association between IGF-1 and carotid wall thickness.
- IGF-1 may play a protective role in cardiovascular health and survival within this population.
Background:
Inconsistent findings are reported on whether insulin-like growth factor-1 (IGF-1) is protective or harmful in predicting hypertension, carotid wall thickness and mortality. We determined the five-year prognostic value of IGF-1 for these outcomes in a large Black population prone to hypertension and cardiovascular disease.
Design:
A longitudinal study as part of the PURE (Prospective Urban and Rural Epidemiology) study, North West Province, South Africa.
Methods:
We measured IGF-1 and IGF binding protein-3 (IGFBP-3) in 1038 HIV-uninfected participants (age range 32-94 years) and assessed blood pressure, carotid intima-media thickness and mortality.
Results:
Over five years 116 deaths occurred. Baseline IGF-1 was similar in survivors and non-survivors (p = 0.50), but tended to be higher in survivors upon adjustment for IGFBP-3 and covariates (p = 0.061). Normotensives and hypertensives (p = 0.072), and those with carotid intima-media thickness < 0.9 mm and ≥ 0.9 mm also displayed similar baseline IGF-1 (p = 0.55). Multivariable-adjusted Cox-regression indicated high IGF-1 predicting lower risk for all-cause mortality (hazard ratio 0.45; 0.23-0.88) and cardiovascular mortality (hazard ratio 0.26; 0.08-0.83) when also adjusting for IGFBP-3. When including normo- and hypertensives at baseline, high IGF-1 was related to normotension at follow-up (hazard ratio 0.68; 0.49-0.95). We found no association with carotid intima-media thickness (hazard ratio 0.59; 0.31-1.14).
Conclusion:
In a Black South African population with low socio-economic status and harmful health behaviours, we found a protective independent association between IGF-1 and hypertension, cardiovascular and all-cause mortality, with no association with carotid wall thickness.
