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Serum IGF-1 and the Risk of Cardio-Kidney Outcomes in Metabolic Dysfunction-Associated Steatotic Liver Disease

Yongin Cho1, Hye-Sun Park2, Tae Seop Lim3,4

  • 1Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Republic of Korea.

Diabetes, Obesity & Metabolism
|April 28, 2026
PubMed

Insights

Metabolic dysfunction-associated steatotic liver disease (MASLD) significantly increases cardio-kidney risks, especially in individuals with low Insulin-like Growth Factor 1 (IGF-1) levels. Monitoring IGF-1 may improve risk assessment for these patients.

Area of Science:

  • Cardiovascular and Metabolic Diseases
  • Nephrology
  • Hepatology

Background:

  • Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing concern, linked to increased risks of cardiovascular and kidney disease.
  • Insulin-like Growth Factor 1 (IGF-1) plays a role in metabolic and vascular health, but its specific impact on long-term cardio-kidney outcomes (CKO) in MASLD patients is not well understood.

Purpose of the Study:

  • To investigate the association between MASLD, serum IGF-1 levels, and the risk of developing cardio-kidney outcomes (CKO).
  • To determine if IGF-1 levels modify the risk of CKO in individuals with MASLD.

Main Methods:

  • A prospective cohort study utilizing UK Biobank data from 214,512 participants without pre-existing cardiovascular or chronic kidney disease (CKD).
  • Participants were stratified into MASLD and non-MASLD groups, further categorized by age- and sex-specific tertiles of serum IGF-1.
  • Primary outcome was a composite CKO, with secondary outcomes including incident CKD and major adverse cardiovascular events (3P-MACE).

Main Results:

  • Over a median 13-year follow-up, MASLD was associated with increased CKO rates across all IGF-1 tertiles, with a significant interaction between MASLD and IGF-1 (P=0.014).
  • MASLD independently predicted CKO, with the highest risk observed in the lowest IGF-1 tertile (aHR 1.24). Similar trends were noted for incident CKD and 3P-MACE.
  • Associations remained consistent across subgroups, with notably higher CKD risk in those with baseline albuminuria.

Conclusions:

  • MASLD is an independent predictor of cardio-kidney outcomes, particularly in individuals with low IGF-1 levels.
  • Integrating IGF-1 measurements into clinical assessments could enhance risk stratification for MASLD patients beyond traditional metabolic markers.
Abstract

Keywords:
3P‐MACEIGF‐1MASLDcardio‐kidney outcomesincident CKD

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