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J Clin Endocrinol Metab. 2017 Jan 1;102(1):267-278. doi: 10.1210/jc.2016-2779.

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

Author information

1
Department of Epidemiology and Population Health and.
2
Department of Biostatistics and.
3
Department of Medicine and Oncology, McGill University, Montreal, Quebec, Canada H4A 3J1.
4
Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania 15261.
5
Division of Cardiology, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York 10461.
6
Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104.
7
Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington 98195.
8
Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109; and.
9
Cardiovascular Health Research Unit, Departments of Epidemiology and Health Services, University of Washington & Group Health Research Institute, Group Health Cooperative, Seattle, Washington 98101.

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.

PMID:
27820656
PMCID:
PMC5413102
DOI:
10.1210/jc.2016-2779
[Indexed for MEDLINE]
Free PMC Article

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