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Insulinlike Growth Factor Binding Protein-1 and Ghrelin Predict Health Outcomes Among Older Adults: Cardiovascular Health Study Cohort.

Citation
Kaplan, R. C., et al. “Insulinlike Growth Factor Binding Protein-1 And Ghrelin Predict Health Outcomes Among Older Adults: Cardiovascular Health Study Cohort.”. The Journal Of Clinical Endocrinology And Metabolism, pp. 267-278.
Center Albert Einstein College of Medicine
Author Robert C Kaplan, Garrett Strizich, Chino Aneke-Nash, Clara Dominguez-Islas, Petra Buzkova, Howard Strickler, Thomas Rohan, Michael Pollak, Lewis Kuller, Jorge R Kizer, Anne Cappola, Christopher I Li, Bruce M Psaty, Anne Newman
Abstract

Context: Multiple diseases may explain the association of the growth hormone/insulinlike growth factor-I (GH/IGF-I) axis with longevity.

Objective: To relate circulating GH/IGF-I system protein levels with major health events.

Design and Setting: This is a cohort study set in 4 US communities.

Participants: Adults (N = 2268) 65 years and older free of diabetes and cardiovascular disease.

Measurements: We assessed insulinlike growth factor binding protein-1 (IGFBP-1) and ghrelin in fasting and 2-hour oral glucose tolerance test (OGTT) blood samples, as well as fasting IGF-I and IGFBP-3. Hazard ratios for mortality and a composite outcome for first incident myocardial infarction, stroke, heart failure, hip fracture, or death were adjusted for sociodemographic, behavioral, and physiological covariates.

Results: During 13,930 person-years of follow-up, 48.1% of individuals sustained one or more components of the composite outcome and 31.8% died. Versus the lowest quartiles, the highest quartiles of fasting and 2-hour ghrelin were associated with 27% higher (95% confidence interval [CI]: 6%, 53%) and 39% higher (95% CI: 14%, 71%) risks of the composite outcome, respectively. The highest quartile of 2-hour IGFBP-1 was associated with 35% higher (95% CI: 1%, 52%) risk of the composite end point. Similarly, higher mortality was significantly associated with higher fasting and 2-hour ghrelin levels and with 2-hour IGFBP-1 level. When examined together, 2-hour post-OGTT levels of IGFBP-1 and ghrelin tended to predict outcomes better than fasting levels.

Conclusions: Circulating IGFBP-1 and ghrelin measured during an OGTT predicted major health events and death in older adults, which may explain the influence of the GH/IGF-I axis on lifespan and health.

Year of Publication
2017
Journal
The Journal of clinical endocrinology and metabolism
Volume
102
Issue
1
Number of Pages
267-278
Date Published
12/2017
ISSN Number
1945-7197
DOI
10.1210/jc.2016-2779
Alternate Journal
J. Clin. Endocrinol. Metab.
PMID
27820656
PMCID
PMC5413102
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