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Serum insulin-like growth factor-1 as a potential prognostic biomarker for heart failure with reduced ejection
Tingting Liu1, Fangyu Li2, Yihuan Fei3
1Department of Experimental Animal Laboratory, Xuanwu Hospital of Capital Medical University, Beijing, China.
Insights
Lower insulin-like growth factor-1 (IGF-1) levels are linked to heart failure (HF). This meta-analysis confirms the association, particularly in patients with reduced ejection fraction (HFrEF).
Area of Science:
- Cardiology
- Endocrinology
- Biomarkers
Background:
- Peripheral insulin-like growth factor-1 (IGF-1) levels have shown potential in diagnosing heart failure (HF).
- Previous studies yielded inconsistent results regarding the association between IGF-1 and HF.
- This meta-analysis aimed to resolve the debate on IGF-1's role in HF.
Purpose of the Study:
- To perform a meta-analysis exploring the relationship between IGF-1 levels and heart failure (HF).
- To investigate the diagnostic value of IGF-1 in HF patients.
Main Methods:
- An extensive literature search was conducted across major databases (Embase, Cochrane Library, PubMed, Medline, Web of Science) up to May 30, 2023.
- 16 relevant studies, including 1,380 cases and 1,153 controls, were selected for meta-analysis.
- Random-effects models and subgroup analyses were employed to assess the association.
Main Results:
- A significant association was found between lower IGF-1 levels and HF (SMD -0.598, P=0.015).
- Subgroup analyses indicated associations in specific age and BMI groups, serum samples, and European populations.
- IGF-1 levels were significantly lower in heart failure with reduced ejection fraction (HFrEF) but not in heart failure with preserved ejection fraction (HFpEF).
Conclusions:
- Reduced IGF-1 levels are substantially correlated with the occurrence of HF.
- Further prospective studies are needed to establish IGF-1 as a reliable biomarker for HF diagnosis, especially for HFrEF.
- Caution is advised when considering IGF-1 for HFpEF diagnosis.
Background:
Most studies have indicated that peripheral insulin-like growth levels factor-1 (IGF-1) is valuable in diagnosing heart failure, although the results have been inconsistent. To help solve the debate, we performed a meta-analysis to explore the relationship between IGF-1 and heart failure (HF).
Methods:
We conducted an extensive search across various databases such as Embase, Cochrane Library, Pubmed, Medline, and Web of Science on May 30, 2023. From the extensive pool of studies, we selected 16 relevant articles, encompassing a total of 1,380 cases and 1,153 controls, to conduct a rigorous meta-analysis.
Results:
The total results indicated that there is an association between lower IGF-1 level and HF. The random-effects model yielded a pooled standardized mean difference (SMD) of -0.598 (95% CI: -1.081 to -0.116, P = 0.015). Further subgroup analysis also showed that IGF-1 levels were associated with HF in the age difference ≥5 years subgroup and body mass index difference >1 subgroup. Additionally, significant association between IGF-1 levels and HF were detected in the "serum" samples and "Europe" subgroups. Importantly, we observed IGF-1 showed significant lower levels in patients with reduced ejection fraction (HFrEF) compared to the controls, not in patients with preserved ejection fraction (HFpEF). The Begg's and Egger's tests revealed no indication of publication bias.
Conclusions:
Our meta-analysis has provided evidence suggesting a substantial correlation between reduced levels of IGF-1 and the occurrence of HF. Further prospective studies are necessary to ascertain the use of IGF-1 as a reliable biomarker for diagnosing HF, especially for HFrEF. But the diagnosis of HFpEF should be cautious.
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