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Lin J, Yang L, Huang J, Liu Y, Lei X, Chen R, Xu B, Huang C, Dou W, Wei X, Liu D, Zhang P, Huang Y, Ma Z, Zhang H. Insulin-Like Growth Factor 1 and Risk of Cardiovascular Disease: Results From the UK Biobank Cohort Study. J Clin Endocrinol Metab 2023; 108:e850-e860. [PMID: 36810801 DOI: 10.1210/clinem/dgad105] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023]
Abstract
CONTEXT Relationships between insulin-like growth factor 1 (IGF-1) levels and cardiovascular disease (CVD) in the general population remain unclear. OBJECTIVE This study aims to investigate the association of circulating IGF-1 concentrations with CVD from a population-based cohort study. METHODS A total of 394 082 participants without CVD and cancer at baseline from UK Biobank were included with measurements of serum IGF-1 at baseline. Main outcomes were incidence of CVD, including CVD mortality, coronary heart disease (CHD), myocardial infarction (MI), heart failure (HF), and stroke. RESULTS Over a median 11.6 years of follow-up, UK Biobank documented 35 803 incident CVD cases, including 4231 from CVD-related death, 27 051 from CHD, 10 014 from MI, 7661 from HF, and 6802 from stroke. Dose-response analysis showed a U-shaped relationship between IGF-1 levels and cardiovascular events. Compared with the third quintile of IGF-1, the lowest category of IGF-1 was associated with increased risk of CVD (hazard ratio 1.128; 95% CI, 1.093 to 1.164), CVD mortality (1.294; 1.181 to 1.418), CHD (1.118; 1.078 to 1.159), MI (1.071; 1.008 to 1.139), HF (1.185; 1.107 to 1.268), and stroke (1.149, 1.070 to 1.235); also, the highest category was associated with increased risk of CVD (1.056; 1.020 to 1.094), CVD mortality (1.111; 1.000 to 1.236), CHD (1.070; 1.028 to 1.114), MI (1.111; 1.041 to 1.187) and HF (1.098; 1.015 to 1.188) after multivariable adjustment. CONCLUSION This study indicates that both low and high levels of circulating IGF-1 are associated with increased risk of CVD in general population. These results highlight the importance of monitoring IGF-1 status on cardiovascular health.
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Affiliation(s)
- Jiayang Lin
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Linjie Yang
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Junlin Huang
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Yating Liu
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Xuzhen Lei
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Ruxin Chen
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Bingyan Xu
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Chensihan Huang
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Weijuan Dou
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Xueyun Wei
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Deying Liu
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Peizhen Zhang
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Yan Huang
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Zhimin Ma
- Department of Endocrinology, The Affiliated Suzhou Science & Technology Town Hospital, Nanjing Medical University, Jiangsu 215153, China
| | - Huijie Zhang
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
- Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
- State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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Li T, Zhao Y, Yang X, Feng Y, Li Y, Wu Y, Zhang M, Li X, Hu H, Zhang J, Yuan L, Liu Y, Sun X, Qin P, Chen C, Hu D. Association between insulin-like growth factor-1 and cardiovascular events: a systematic review and dose-response meta-analysis of cohort studies. J Endocrinol Invest 2022; 45:2221-2231. [PMID: 35596917 DOI: 10.1007/s40618-022-01819-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/04/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Insulin-like growth factor-1 (IGF-1) has increasingly been reported as linked to cardiovascular (CV) events; however, reported results have been inconsistent, and no meta-analysis has been undertaken to quantitatively assess this association. METHODS We searched PubMed, Embase, and Web of Science databases for cohort articles published up to December 1, 2020. Fixed or random-effects models were used to estimate the summary relative risks (RRs) and 95% confidence intervals (CIs) of CV events in relation to IGF-1. Restricted cubic splines were used to model the dose-response association. RESULTS We identified 11 articles (thirteen cohort studies) covering a total of 22,995 participants and 3040 CV events in this meta-analysis. The risk of overall CV events reduced by 16% from the highest to the lowest IGF-1 levels (RR 0.83, 95% CI 0.72-0.95), while the occurrence of CV events reduced by 28% (RR 0.72, 95% CI 0.56-0.92), but not for CV deaths, however (RR 1.00, 95% CI 0.65-1.55). We also found linear associations between IGF-1 levels and CV events. With each per 45 μg/mL IGF-1 increase, the pooled RRs were 0.91 (95% CI 0.86-0.96), 0.91 (95% CI 0.85-0.97) and 0.91 (95% CI 0.84-0.98) for overall CV events, for the occurrence of CV events, and for CV deaths, respectively. CONCLUSIONS Our findings based on cohort studies support the contention that any increase in IGF-1 is helpful in reducing the overall risk of CV events. As an important biomarker for assessing the likelihood of CV events, IGF-1 appears to offer a promising prognostic approach for aiding prevention.
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Affiliation(s)
- T Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Y Zhao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - X Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Y Feng
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Y Li
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Y Wu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - M Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - X Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - H Hu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - J Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - L Yuan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Y Liu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, 518001, Guangdong, People's Republic of China
| | - X Sun
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, 518001, Guangdong, People's Republic of China
| | - P Qin
- Department of Endocrinology, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, People's Republic of China
| | - C Chen
- Department of Medical Record Management, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, People's Republic of China
| | - D Hu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China.
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PCOS and Depression: Common Links and Potential Targets. Reprod Sci 2021; 29:3106-3123. [PMID: 34642910 DOI: 10.1007/s43032-021-00765-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 10/04/2021] [Indexed: 12/16/2022]
Abstract
PCOS or polycystic ovary syndrome is a common endocrine disorder that occurs during the reproductive age in females. It manifests in the form of a wide range of symptoms including (but not limited to) hirsutism, amenorrhea, oligomenorrhea, obesity, acne vulgaris, infertility, alopecia, and insulin resistance. The incidence of depression in PCOS population is increasing as compared to the general population. Increased depression in PCOS significantly alters the quality of life (QOL) of affected females. Also, self-esteem is found to be low in both depression and PCOS. The loss in self-esteem in such patients can be largely attributed to the associated factors including (but not limited to) obesity, acne, androgenic alopecia, and hirsutism. The reason behind the occurrence of depression in PCOS remains elusive to date. Literature suggests that there is an overlap of clinical symptoms between depression and PCOS. As the symptoms overlap, there is a possibility of common associations between depression, PCOS, and PCOS-associated abnormalities including insulin resistance (IR), obesity, CVD, and androgen excess. Studies demonstrate that depression is an inflammatory disorder marked with increased levels of inflammatory markers. On the other hand, PCOS is also regarded as a pro-inflammatory state that is characterized by increased levels of pro-inflammatory markers. Thus, there is a possibility of an inflammatory relationship existing between depression and PCOS. It is also possible that the inflammatory markers in PCOS can cross the blood-brain barrier (BBB) leading to the development of depression. Through the present review, we have attempted to shed light on common associations/shared links between depression and PCOS with respect to the levels of cortisol, androgen, vitamin D, neurotransmitters, monoaminoxidase (MAO), and insulin-like growth factor-1 (IGF-1). Tracking down common associations between depression and PCOS will help find potential drug therapies and improve the QOL of females with depression in PCOS.
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Castro-Diehl C, Ehrbar R, Obas V, Oh A, Vasan RS, Xanthakis V. Biomarkers representing key aging-related biological pathways are associated with subclinical atherosclerosis and all-cause mortality: The Framingham Study. PLoS One 2021; 16:e0251308. [PMID: 33989340 PMCID: PMC8121535 DOI: 10.1371/journal.pone.0251308] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 04/24/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Increased oxidative stress, leukocyte telomere length (LTL) shortening, endothelial dysfunction, and lower insulin-like growth factor (IGF)-1 concentrations reflect key molecular mechanisms of aging. We hypothesized that biomarkers representing these pathways are associated with measures of subclinical atherosclerosis and all-cause mortality. METHODS AND RESULTS We evaluated up to 2,314 Framingham Offspring Study participants (mean age 61 years, 55% women) with available biomarkers of aging: LTL, circulating concentrations of IGF-1, asymmetrical dimethylarginine (ADMA), and urinary F2-Isoprostanes indexed to urinary creatinine. We evaluated the association of each biomarker with coronary artery calcium [ln (CAC+1)] and carotid intima-media thickness (IMT). In multivariable-adjusted linear regression models, higher ADMA levels were associated with higher CAC values (βADMA per 1-SD increase 0.25; 95% confidence interval [CI] [0.11, 0.39]). Additionally, shorter LTL and lower IGF-1 values were associated with higher IMT values (βLTL -0.08, 95%CI -0.14, -0.02, and βIGF-1 -0.04, 95%CI -0.08, -0.01, respectively). During a median follow-up of 15.5 years, 593 subjects died. In multivariable-adjusted Cox regression models, LTL and IGF-1 values were inversely associated with all-cause mortality (hazard ratios [HR] per SD increase in biomarker, 0.85, 95% CI 0.74-0.99, and 0.90, 95% CI 0.82-0.98 for LTL and IGF-1, respectively). F2-Isoprostanes and ADMA values were positively associated with all-cause mortality (HR per SD increase in biomarker, 1.15, 95% CI, 1.10-1.22, and 1.10, 95% CI, 1.02-1.20, respectively). CONCLUSION In our prospective community-based study, aging-related biomarkers were associated with measures of subclinical atherosclerosis cross-sectionally and with all-cause mortality prospectively, supporting the concept that these biomarkers may reflect the aging process in community-dwelling adults.
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Affiliation(s)
- Cecilia Castro-Diehl
- Department of Medicine, Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Rachel Ehrbar
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Vanesa Obas
- Department of Medicine, Internal Medicine Residency Program, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Albin Oh
- Department of Medicine, Internal Medicine Residency Program, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Ramachandran S. Vasan
- Department of Medicine, Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, Massachusetts, United States of America
- Lung, and Blood Institute’s Framingham Heart Study, Boston University’s and National Heart, Framingham, Massachusetts, United States of America
- Department of Medicine, Section of Cardiology, Boston University School of Medicine, Boston, Massachusetts, United States of America
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Vanessa Xanthakis
- Department of Medicine, Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, Massachusetts, United States of America
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
- Lung, and Blood Institute’s Framingham Heart Study, Boston University’s and National Heart, Framingham, Massachusetts, United States of America
- * E-mail:
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Berben L, Floris G, Wildiers H, Hatse S. Cancer and Aging: Two Tightly Interconnected Biological Processes. Cancers (Basel) 2021; 13:1400. [PMID: 33808654 PMCID: PMC8003441 DOI: 10.3390/cancers13061400] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 02/07/2023] Open
Abstract
Age is one of the main risk factors of cancer; several biological changes linked with the aging process can explain this. As our population is progressively aging, the proportion of older patients with cancer is increasing significantly. Due to the heterogeneity of general health and functional status amongst older persons, treatment of cancer is a major challenge in this vulnerable population. Older patients often experience more side effects of anticancer treatments. Over-treatment should be avoided to ensure an optimal quality of life. On the other hand, under-treatment due to fear of toxicity is a frequent problem and can lead to an increased risk of relapse and worse survival. There is a delicate balance between benefits of therapy and risk of toxicity. Robust biomarkers that reflect the body's biological age may aid in outlining optimal individual treatment regimens for older patients with cancer. In particular, the impact of age on systemic immunity and the tumor immune infiltrate should be considered, given the expanding role of immunotherapy in cancer treatment. In this review, we summarize current knowledge concerning the mechanistic connections between aging and cancer, as well as aging biomarkers that could be helpful in the field of geriatric oncology.
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Affiliation(s)
- Lieze Berben
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, 3000 Leuven, Belgium;
| | - Giuseppe Floris
- Department of Pathology, University Hospitals Leuven, 3000 Leuven, Belgium;
- Laboratory of Translational Cell and Tissue Research, Department of Imaging and Pathology, KU Leuven, 3000 Leuven, Belgium
| | - Hans Wildiers
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, 3000 Leuven, Belgium;
- Department of General Medical Oncology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Sigrid Hatse
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, 3000 Leuven, Belgium;
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Investigation of brain damage mechanism in middle cerebral artery occlusion/reperfusion rats based on i-TRAQ quantitative proteomics. Exp Brain Res 2021; 239:1247-1260. [PMID: 33599834 DOI: 10.1007/s00221-021-06054-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 02/01/2021] [Indexed: 01/04/2023]
Abstract
The objective of this study is to analyze the differential protein expression profile in cerebral cortex of rats with middle cerebral ischemia/reperfusion (MCAO/R), explore the brain damage mechanism of MCAO/R at protein level, and provide experimental foundation for searching specific marker proteins of MCAO/R. Rat model of MCAO/R was established by modified suture-occluded method, and the model was evaluated by the results of brain 2,3,5-triphenyltetrazolium chloride (TTC) and hematoxylin-eosin (HE) staining. Cerebral cortex of rats from sham-operated group (Sham) and MCAO/R groups was used for FASP enzymatic hydrolysis, i-TRAQ quantitative labeling, and reverse-phase liquid chromatography purification and separation. Orbitrap Q Exactive mass spectrometry was used for qualitative and quantitative analyses of total differential protein expression profiles. MCAO/R rats had obvious cerebral infarction lesions, and the relative surface area of cerebral infarction was significantly different compared with sham rats, suggesting that MCAO/R rat model was successfully prepared. There were 199 significant difference proteins (MCAO/R vs Sham, p < 0.05, |fold change|> 1.2), including 104 up-regulated proteins and 95 down-regulated proteins. Gene ontology (GO) enrichment analysis showed that the up-regulated proteins were mainly concentrated in the biological processes of positive regulation of NF-κB transcription and I-κB kinase-NF-κB, etc. Down-regulated proteins were mainly concentrated in long-term synaptic potentiation, cellular response to DNA damage stimulus, etc. KEGG pathway analysis showed that the pathway involved in differential proteins includes oxidative phosphorylation, metabolic pathway, and Ras signaling pathway. Network analysis of differential proteins showed that Alb, ndufb5, ndufs7, ApoB, Cdc42, Ndufa3, Igf1r, P4hb, Mbp, Gc, Nme1, Akt2, and other proteins may play an important role in regulating oxidative stress, apoptosis, and inflammatory response in MCAO/R. Quantitative proteomics based on i-TRAQ labeling reveals the effect of inflammation and apoptosis in brain damage mechanism of MCAO/R. Besides, this research provide some experimental foundation for search and determination of potential therapeutic targets of MCAO/R.
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Cianfarani S. Safety of Pediatric rhGH Therapy: An Overview and the Need for Long-Term Surveillance. Front Endocrinol (Lausanne) 2021; 12:811846. [PMID: 35002983 PMCID: PMC8740026 DOI: 10.3389/fendo.2021.811846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/06/2021] [Indexed: 12/26/2022] Open
Abstract
Growth hormone (GH) therapy dates back to 1958 and, though has shown an excellent safety profile in the short-term, has never ceased to raise concern about potential long-term side effects. In the last decade, a number of observational studies in different cohorts of young adult patients treated with GH during childhood have yielded conflicting results. The attention has mainly focused on three major potential risks associated with GH therapy: cancer, cardio and cerebrovascular diseases and diabetes. This review intends to provide a detailed overview of the main studies reporting long-term safety in subjects treated with rhGH therapy during childhood, highlighting the evidence for or against the risk of cancer, cardio and cerebrovascular diseases and diabetes.
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Affiliation(s)
- Stefano Cianfarani
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Dipartimento Pediatrico Universitario Ospedaliero, IRCCS “Bambino Gesù” Children’s Hospital, Rome, Italy
- Department of Women’s and Children’s Health, Karolinska Institute and University Hospital, Stockholm, Sweden
- *Correspondence: Stefano Cianfarani,
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Ricci Bitti S, Franco M, Albertelli M, Gatto F, Vera L, Ferone D, Boschetti M. GH Replacement in the Elderly: Is It Worth It? Front Endocrinol (Lausanne) 2021; 12:680579. [PMID: 34211437 PMCID: PMC8239420 DOI: 10.3389/fendo.2021.680579] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 06/02/2021] [Indexed: 11/24/2022] Open
Abstract
Growth hormone (GH), once the age of linear growth is completed, continues to play a fundamental role for the human body. In adulthood, GH contributes to regulate muscle, cardiovascular and bone metabolism. The same happens in old age, although there is less data on the effect of GH in the elderly. Regardless the age of onset, a reduced quality of life (QoL), an increased cardiovascular risk and an accelerated age-related decline in physical strength have been demonstrated in the elderly with GH deficiency (EGHD). In adults with GH deficiency (AGHD), recent studies suggest a role of GH replacement therapy (GHrt) in improving lean/fat mass ratio, blood pressure, lipid profile, bone metabolism and QoL. Despite these recent studies, there is still a lack of randomized controlled trials proving these positive effects in EGHD. Moreover, the lack of a long-term positive outcome on mortality, and the cost of GHrt could often impact on treatment decision-making and lead to postpone or avoid the prescription. The aim of this mini-review is to summarize the available data on GHrt in EGHD, in order to highlight its weaknesses and strengths and to provide directions to clinicians that will help in the management of this specific set of patients.
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Affiliation(s)
- Silvia Ricci Bitti
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties, School of Medical and Pharmaceutical Sciences, University of Genova, Genova, Italy
| | - Marta Franco
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties, School of Medical and Pharmaceutical Sciences, University of Genova, Genova, Italy
| | - Manuela Albertelli
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties, School of Medical and Pharmaceutical Sciences, University of Genova, Genova, Italy
- Endocrinology Unit, IRCCS Policlinico San Martino, Genova, Italy
| | - Federico Gatto
- Endocrinology Unit, IRCCS Policlinico San Martino, Genova, Italy
| | - Lara Vera
- Endocrinology Unit, IRCCS Policlinico San Martino, Genova, Italy
| | - Diego Ferone
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties, School of Medical and Pharmaceutical Sciences, University of Genova, Genova, Italy
- Endocrinology Unit, IRCCS Policlinico San Martino, Genova, Italy
| | - Mara Boschetti
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties, School of Medical and Pharmaceutical Sciences, University of Genova, Genova, Italy
- Endocrinology Unit, IRCCS Policlinico San Martino, Genova, Italy
- *Correspondence: Mara Boschetti,
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Yang L, Liu Z, Ling W, Wang L, Wang C, Ma J, Peng X, Chen J. Effect of Anthocyanins Supplementation on Serum IGFBP-4 Fragments and Glycemic Control in Patients with Fasting Hyperglycemia: A Randomized Controlled Trial. Diabetes Metab Syndr Obes 2020; 13:3395-3404. [PMID: 33061500 PMCID: PMC7532046 DOI: 10.2147/dmso.s266751] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/19/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Insulin-like growth factor binding protein-4 (IGFBP-4) fragments have been shown to be associated with cardiometabolic diseases. Anthocyanins as a subgroup of natural polyphenols could have benefits on treating cardiometabolic diseases. The aim of this study was to examine the effects of purified anthocyanins on serum IGFBP-4 fragments and glycemic control in patients with fasting hyperglycemia. METHODS A set of 121 participants with elevated fasting glucose (≥5.6 mmol/L), who were originally randomly assigned to anthocyanins (320 mg/day) or placebo groups, were included in this study. Serum IGFBP-4 fragments, fasting and postload glucose, insulin, and C-peptide after a three-hour oral glucose tolerance test (OGTT) were measured at baseline and at the end of 12 weeks. RESULTS Compared with placebo, anthocyanins increased serum IGFBP-4 fragments (net change 8.33 ng/mL, 95% CI [1.2, 15.47], p=0.023) and decreased fasting glucose (-0.4 mmol/L [-0.71, -0.1], p=0.01), 2-hour C-peptide (-1.02 ng/mL [-1.99, -0.04], p=0.041) and the 3-hour area under the curve (AUC) of C-peptide (-2.19 [-4.11, -0.27], p=0.026). No other significant difference in parameters for glycemic control and insulin resistance was observed. CONCLUSION Anthocyanins supplementation for 12 weeks improved serum IGFBP-4 fragments and decreased fasting glucose and postload C-peptide in patients with fasting hyperglycemia. Further studies are needed to confirm our findings and clarify the potential mechanism. TRIAL REGISTRATION ClinicalTrials.gov, NCT02689765. Registered on 6 February 2016, https://clinicaltrials.gov/ct2/show/NCT02689765.
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Affiliation(s)
- Liping Yang
- Center for Chronic Disease Control, Nanshan, Shenzhen, People’s Republic of China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Zhaomin Liu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Wenhua Ling
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Li Wang
- Center for Chronic Disease Control, Nanshan, Shenzhen, People’s Republic of China
| | - Changyi Wang
- Center for Chronic Disease Control, Nanshan, Shenzhen, People’s Republic of China
| | - Jianping Ma
- Center for Chronic Disease Control, Nanshan, Shenzhen, People’s Republic of China
| | - Xiaolin Peng
- Center for Chronic Disease Control, Nanshan, Shenzhen, People’s Republic of China
| | - Jianying Chen
- Internal Medicine Department, BaiYun Hospital, GuangZhou, GuangDong Province, People’s Republic of China
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Hong YA, Han KD, Yun JS, Sil ES, Ko SH, Chung S. Short adult height increases the risk of end-stage renal disease in type 2 diabetes. Endocr Connect 2020; 9:912-921. [PMID: 33069158 PMCID: PMC7583136 DOI: 10.1530/ec-20-0319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/02/2020] [Indexed: 12/05/2022]
Abstract
OBJECTIVE Although short adult height has been associated with an increasing variety of diseases and all-cause death, no reliable data exist on the association between adult height and end-stage renal disease (ESRD) in diabetic patients. We investigated the relationship between short adult height, development of ESRD, and mortality in type 2 diabetes mellitus (DM). METHODS This nationwide population-based cohort study analyzed clinical data from a total of 2,621,907 subjects aged ≥30 years with type 2 DM between January 1, 2009 and December 31, 2012, using the National Health Insurance Database in Korea. RESULTS During a 6.9-year follow-up period, 220,457 subjects (8.4%) died, and 28,704 subjects (1.1%) started dialysis. Short adult height significantly increased the incidence of ESRD and all-cause mortality in the overall cohort analysis. In multivariable Cox models, hazard ratios (HR) for the development of ESRD comparing the highest and lowest quartiles of adult height were 0.86 (95% CI 0.83-0.89). All-cause mortality also decreased with the highest height compared to patients with the lowest height, after fully adjusting for confounding variables (HR 0.79, 95% CI 0.78-0.81). Adult height had an inverse relationship to newly diagnosed ESRD (male: HR 0.86, 95% CI 0.83-0.90, female: HR 0.84, 95% CI 0.79-0.90) and all-cause mortality (male: HR 0.81, 95% CI 0.79-0.82, female: HR 0.80, 95% CI 0.78-0.82). CONCLUSIONS Short adult height is strongly associated with the increased risk of ESRD development and all-cause mortality in type 2 DM.
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Affiliation(s)
- Yu Ah Hong
- Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Jae-Seung Yun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Eun Sil Sil
- Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Correspondence should be addressed to S-H Ko or S Chung: or
| | - Sungjin Chung
- Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Correspondence should be addressed to S-H Ko or S Chung: or
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11
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Liu J, Wang S, Hou J, Cai H, Pan W, Dong H, Sun R, Dong H, Fang S, Yu B. Proteomics Profiling Reveals Insulin-Like Growth Factor 1, Collagen Type VI α-2 Chain, and Fermitin Family Homolog 3 as Potential Biomarkers of Plaque Erosion in ST-Segment Elevated Myocardial Infarction. Circ J 2020; 84:985-993. [PMID: 32350230 DOI: 10.1253/circj.cj-19-1206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Plaque erosion (PE) has been considered a secondary pathogenesis of ST-segment elevated myocardial infarction (STEMI) following plaque rupture (PR). Previous studies demonstrated that they had different demographic and histology characteristics and need different treatment strategy. But there are few non-invasive plasma biomarkers for distinguishing them. The present study aimed to identify non-invasive predictive biomarkers for PE and PR in patients with STEMI.Methods and Results:A total 108 patients were recruited and grouped into a PE group (n=36), a PR group (n=36), and an unstable angina pectoris (UAP) (n=36) group for analysis. A 9-plex tandem mass tag (TMT)-based proteomics was used to compare plasma protein profiles of PE, PR, and UAP. In total, 36 significant differential proteins (DPs) were identified among groups, 10 of which were screened out using bio-information analysis and validated with enzyme-linked immunosorbent assay (ELISA). The relationship of angiography and optical coherence tomography (OCT) imaging data and the 10 target DPs was analyzed statistically. Logistic regression showed elevated collagen type VI α-2 chain (COL6A2) and insulin-like growth factor 1 (IGF1), and decreased fermitin family homolog 3 (FERMT3), were positively associated with PE. Multivariate analysis indicated IGF1, FERMT3, and COL6A2 had independent predictive ability for PE. IGF1 was inversely correlated with lumen stenosis and the lipid arc of the plaque. CONCLUSIONS IGF1, COL6A2, and FERMT3 are potential predictive biomarkers of PE in STEMI patients. And IGF1 was negatively correlated with the developing of culprit plaque.
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Affiliation(s)
- Jinxin Liu
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University.,The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry Education
| | - Shanjie Wang
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University.,The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry Education
| | - Jingbo Hou
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University.,The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry Education
| | - Hengxuan Cai
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University.,The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry Education
| | - Weili Pan
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University.,The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry Education
| | - Haimeng Dong
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University
| | - Rong Sun
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University.,The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry Education
| | - Hui Dong
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University.,The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry Education
| | - Shaohong Fang
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University.,The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry Education
| | - Bo Yu
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University.,The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry Education
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12
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van Bunderen CC, Meijer RI, Lips P, Kramer MH, Serné EH, Drent ML. Titrating Growth Hormone Dose to High-Normal IGF-1 Levels Has Beneficial Effects on Body Fat Distribution and Microcirculatory Function Despite Causing Insulin Resistance. Front Endocrinol (Lausanne) 2020; 11:619173. [PMID: 33633687 PMCID: PMC7899963 DOI: 10.3389/fendo.2020.619173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 12/18/2020] [Indexed: 11/29/2022] Open
Abstract
UNLABELLED To clarify the mechanism underlying the described U-shaped relation of both low and high levels of IGF-1 with cardiovascular disease this study explores the effect of decreasing and increasing growth hormone dose in GH deficient adults on (micro)vascular function, body composition and insulin resistance. In this randomized clinical trial, thirty-two subjects receiving GH therapy with an IGF-1 concentration between -1 and 1 SD score (SDS) for at least one year were randomized to receive either a decrease (IGF-1 target level of -2 to -1 SDS) or an increase of their daily GH dose (IGF-1 target level of 1 to 2 SDS) for a period of 24 weeks. Microvascular endothelium (in)dependent vasodilatation and vasomotion, vascular stiffness by pulse wave analysis, and HOMA-IR were measured. At the end of the study 30 subjects (65.6% men, mean age 46.6 (SD 9.9) years) were analyzed. There was a favorable effect of increasing the IGF-1 level on waist circumference compared to decreasing the IGF-1 level (p=0.05), but a detrimental effect on insulin resistance (p=0.03). Decreasing IGF-1 level significantly lowered the endothelial domain of vasomotion (p=0.03), whereas increasing IGF-1 level increased the contribution of the neurogenic domain (p=0.05). This change was related to the favorable change in waist circumference. In conclusion, increasing IGF-1 levels was beneficial for body composition but detrimental with respect to insulin resistance. The contribution of the neurogenic vasomotion domain increased in parallel, and could be explained by the favorable change in waist circumference. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, identifier NCT01877512.
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Affiliation(s)
- Christa C. van Bunderen
- Section of Endocrinology, Neuroscience Campus Amsterdam, Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
- *Correspondence: Christa C. van Bunderen,
| | - Rick I. Meijer
- Section of Vascular Medicine, Department of Internal Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Paul Lips
- Section of Endocrinology, Neuroscience Campus Amsterdam, Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Mark H. Kramer
- Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Erik H. Serné
- Section of Vascular Medicine, Department of Internal Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Madeleine L. Drent
- Section of Endocrinology, Neuroscience Campus Amsterdam, Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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13
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Galerneau LM, Borel AL, Chabre O, Sapene M, Stach B, Girey-Rannaud J, Tamisier R, Pépin JL, Caron P. The Somatotropic Axis in the Sleep Apnea-Obesity Comorbid Duo. Front Endocrinol (Lausanne) 2020; 11:376. [PMID: 32655494 PMCID: PMC7325876 DOI: 10.3389/fendo.2020.00376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 05/12/2020] [Indexed: 11/21/2022] Open
Abstract
Background: Growth hormone (GH) stimulates the production of insulin-like growth factor 1 (IGF-1) in most tissues and together GH and IGF-1 profoundly impact adipose tissue deposition, glucose metabolism and cardiovascular function. A low serum IGF-I level has been reported as being associated with obstructive sleep apnea (OSA) and might be one of the mechanisms underlying cardio-metabolic risk in OSA patients. Methods: In a multicenter national study, 817 patients consulting for suspicion of OSA (OSA confirmed for 567 patients) underwent serum IGF-1 measurements. We analyzed the association between an IGF-1 level below the median value of the population and variables related to cardio-metabolic risk: body mass index (BMI) and waist circumference, apnea hypopnea index (AHI), cholesterol and triglycerides (expressed as median and divided into quartiles for continuous variables). Results: After adjustment for age and gender, low IGF-1 levels were associated with increased BMI and AHI (Odds ratios (OR) = 2.83; p < 0.0001 and OR = 3.03, p < 0.0001 for Quartile 4 vs. Quartile1, respectively), with elevated cholesterol levels (OR = 1.36, p = 0.0444), and elevated triglyceride levels (OR = 1.36; p = 0.0008). Conclusions: Both adiposity and sleep apnea synergistically predict low levels of IGF-1 and thus could together contribute toward cardio-metabolic risk. Further work are needed to confirm whether IGF-1 levels allow grading severity and predicting response to treatments to aim at a personalized medicine for patients suffering from OSA.
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Affiliation(s)
- Louis-Marie Galerneau
- Hypoxia PathoPhysiology (HP2) Laboratory, University Grenoble Alpes, Grenoble, France
- *Correspondence: Louis-Marie Galerneau
| | - Anne-Laure Borel
- Hypoxia PathoPhysiology (HP2) Laboratory, University Grenoble Alpes, Grenoble, France
| | - Olivier Chabre
- Endocrinology Department, Pole Digidune, Grenoble Alpes University Hospital, Grenoble, France
| | | | | | | | - Renaud Tamisier
- Hypoxia PathoPhysiology (HP2) Laboratory, University Grenoble Alpes, Grenoble, France
| | - Jean-Louis Pépin
- Hypoxia PathoPhysiology (HP2) Laboratory, University Grenoble Alpes, Grenoble, France
| | - Philippe Caron
- Department of Endocrinology and Metabolic diseases, Pôle Cardiovascular and Metabolic, Larrey University Hospital, Toulouse, France
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14
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Gaddas M, Périn L, Le Bouc Y. Evaluation of IGF1/IGFBP3 Molar Ratio as an Effective Tool for Assessing the Safety of Growth Hormone Therapy in Small-for-gestational-age, Growth Hormone-Deficient and Prader-Willi Children. J Clin Res Pediatr Endocrinol 2019; 11:253-261. [PMID: 30759961 PMCID: PMC6745465 DOI: 10.4274/jcrpe.galenos.2019.2018.0277] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE IGF1 concentration is the most widely used parameter for the monitoring and therapeutic adaptation of recombinant human growth hormone (rGH) treatment. However, more than half the variation of the therapeutic response is accounted for by variability in the serum concentrations of IGF1 and IGFBP3. We therefore compared the use of IGF1/IGFBP3 molar ratio with that of IGF1 concentration alone. METHODS We selected 92 children on rGH for this study and assigned them to three groups on the basis of growth deficiency etiology: small for gestational age (SGA), GH deficiency (GHD) and Prader-Willi syndrome (PWS). Plasma IGF1 and IGFBP3 concentrations and their molar ratio were determined. RESULTS Before rGH treatment, mean IGF1/IGFBP3 molar ratio in the SGA, GHD and PWS groups was 0.14±0.04, 0.07±0.01 and 0.12±0.02, respectively. After the initiation of rGH treatment, these averages were 0.19±0.07, 0.20±0.08 and 0.19±0.09, within the normal range for most children, even at puberty and despite some significant increases in serum IGF1 levels. CONCLUSION We consider IGF1/IGFBP3 molar ratio to be a useful additional parameter for assessing therapeutic safety in patients on rGH, and for maintaning the values within the normal range for age and pubertal stage.
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Affiliation(s)
- Meriem Gaddas
- University of Sousse, Faculty of Medicine ‘Ibn el Jazzar’, Department of Physiology and Functional Explorations, Sousse, Tunisia,* Address for Correspondence: University of Sousse, Faculty of Medicine ‘Ibn el Jazzar’, Department of Physiology and Functional Explorations, Sousse, Tunisia Phone: +21698569921 E-mail:
| | - Laurence Périn
- Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Department of Pediatric Endocrinology, Paris, France
| | - Yves Le Bouc
- Sorbonne Université, INSERM, Centre de Recherche St-Antoine UMR S938, Assistance Publique-Hôpitaux de Paris, Trousseau Hospital, Department of Pediatric Endocrinology, Paris, France
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15
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Praksch D, Sandor B, Kovacs D, Petrovics P, Kovacs K, Toth K, Szabados E. Impact of home- and center- based physical training program on cardio-metabolic health and IGF-1 level in elderly women. Eur Rev Aging Phys Act 2019; 16:13. [PMID: 31417661 PMCID: PMC6688290 DOI: 10.1186/s11556-019-0220-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 07/30/2019] [Indexed: 12/22/2022] Open
Abstract
Background Data in the literature concerning the effects of physical activity on lipid and IGF-1levels are controversial in postmenopausal women. The aim of the present study was to determine the combined effects of a 12 weeks home-based walking program aiming to achieve 10,000 steps daily and a center- based aerobic exercise training on functional capacity, some important cardio-metabolic parameters, IGF-1 level and psychological items among elderly female patients. Sixty female patients (67.4 ± 5 years) with moderate to high cardiovascular risk were randomly assigned either to an exercise training program for 12 weeks or to the control group. Results Our organized training program resulted in a significantly improved daily physical activity (4232 [IQR: 3162–7219] to 8455 [IQR: 6757–11,488]; p < 0.001 ft-steps), functional capacity (MET) (8.17 ± 1.57 to 8.87 ± 1.76) (p = 0.002), metabolic status including total cholesterol (5.17 ± 1.13 to 4.77 ± 1.12 mmol/l), LDL cholesterol (3.37 ± 1.05 to 2.81 ± 0.98 mmol/l), triglyceride (1.68 ± 0.71 to 1.28 ± 0.71 mmol/l) and HgbA1c (6.24 ± 0.67 to 6.06 ± 0.58 mmol/l), as well as IGF-1 (59.68 ± 27.37 to 66.79 ± 22.74 ng/ml) levels (p < 0.05) in the training group. From psychological tests only physical functionality improved significantly (p = 0.03) in the training group. The training group significantly differed from the control group in four parameters including MET (p = 0.003), LDL-cholesterol (p = 0.046), triglyceride (p = 0.001) and IGF-1 levels (p < 0.001) after the intervention. Conclusion The applied home-, and- center based training program effectively increased the daily physical activity of the elderly female patients and improved several cardio-metabolic parameters. Further investigations are needed on larger patient population to establish our findings and examine how these positive changes may decrease CV events and mortality.
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Affiliation(s)
- Dora Praksch
- 1First Department of Medicine, Division of Cardiology and Angiology, University of Pécs, Medical School, Pécs, Hungary
| | - Barbara Sandor
- 1First Department of Medicine, Division of Cardiology and Angiology, University of Pécs, Medical School, Pécs, Hungary
| | - David Kovacs
- 1First Department of Medicine, Division of Cardiology and Angiology, University of Pécs, Medical School, Pécs, Hungary
| | - Peter Petrovics
- 2First Department of Medicine, Division of Preventive Cardiology and Rehabilitation, University of Pécs, Medical School, Rákóczi Street 2, Pécs, H-7624 Hungary
| | - Krisztina Kovacs
- 3Department of Biochemistry and Medical Chemistry, University of Pécs, Medical School, Pécs, Hungary
| | - Kalman Toth
- 1First Department of Medicine, Division of Cardiology and Angiology, University of Pécs, Medical School, Pécs, Hungary
| | - Eszter Szabados
- 2First Department of Medicine, Division of Preventive Cardiology and Rehabilitation, University of Pécs, Medical School, Rákóczi Street 2, Pécs, H-7624 Hungary
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16
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Filion KB, Douros A, Azoulay L, Yin H, Yu OH, Suissa S. Sulfonylureas as initial treatment for type 2 diabetes and the risk of adverse cardiovascular events: A population-based cohort study. Br J Clin Pharmacol 2019; 85:2378-2389. [PMID: 31276600 DOI: 10.1111/bcp.14056] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 06/07/2019] [Accepted: 06/17/2019] [Indexed: 12/13/2022] Open
Abstract
AIMS Sulfonylureas are recommended as second-line treatment in the management of type 2 diabetes. However, they are still commonly used also as first-line treatment instead of metformin. Given the controversial cardiovascular safety of sulfonylureas, we aimed to determine if their use as first-line treatment is associated with adverse cardiovascular events among patients with newly treated type 2 diabetes compared with metformin. METHODS We conducted a population-based cohort study of patients with newly treated type 2 diabetes using the UK's Clinical Practice Research Datalink. Initiators of metformin and sulfonylurea monotherapy were matched on high-dimensional propensity score, and Cox proportional hazards models were used to compare the rate of cardiovascular events (myocardial infarction, ischaemic stroke, cardiovascular death, and all-cause mortality) with sulfonylureas vs metformin. RESULTS Our cohort included 94 750 patients initiating treatment for type 2 diabetes, 17 612 on a sulfonylurea and 77 138 on metformin. After matching, sulfonylurea monotherapy, compared with metformin monotherapy, was not associated with an increased risk of myocardial infarction (hazard ratio [HR]: 1.04, 95% confidence interval [CI]: 0.85-1.25) but was associated with increased risks of ischaemic stroke (HR: 1.25, 95% CI: 1.002-1.56), cardiovascular death (HR: 1.25, 95% CI: 1.06-1.47), and all-cause mortality (HR: 1.60, 95% CI: 1.45-1.76). This represents an additional 2.0 ischaemic strokes, 3.5 cardiovascular deaths, and 21.4 all-cause deaths per 1,000 patients per year with sulfonylureas. CONCLUSIONS Initiating treatment of type 2 diabetes with a sulfonylurea rather than metformin is associated with higher rates of ischaemic stroke, cardiovascular death, and all-cause mortality.
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Affiliation(s)
- Kristian B Filion
- Department of Medicine, McGill University, Montreal, Quebec, Canada.,Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Antonios Douros
- Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.,Institute of Clinical Pharmacology and Toxicology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Laurent Azoulay
- Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.,Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada
| | - Hui Yin
- Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
| | - Oriana H Yu
- Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.,Division of Endocrinology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Samy Suissa
- Department of Medicine, McGill University, Montreal, Quebec, Canada.,Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
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17
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Abstract
Non-communicable diseases, such as cardiovascular diseases, are the leading cause of mortality worldwide. For this reason, a tremendous effort is being made worldwide to effectively circumvent these afflictions, where insulin-like growth factor 1 (IGF1) is being proposed both as a marker and as a central cornerstone in these diseases, making it an interesting molecule to focus on. Firstly, at the initiation of metabolic deregulation by overfeeding, IGF1 is decreased/inhibited. Secondly, such deficiency seems to be intimately related to the onset of MetS and establishment of vascular derangements leading to atherosclerosis and finally playing a definitive part in cerebrovascular and myocardial accidents, where IGF1 deficiency seems to render these organs vulnerable to oxidative and apoptotic/necrotic damage. Several human cohort correlations together with basic/translational experimental data seem to confirm deep IGF1 implication, albeit with controversy, which might, in part, be given by experimental design leading to blurred result interpretation.
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18
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Whey protein in cancer therapy: A narrative review. Pharmacol Res 2019; 144:245-256. [PMID: 31005617 DOI: 10.1016/j.phrs.2019.04.019] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 04/16/2019] [Accepted: 04/17/2019] [Indexed: 02/07/2023]
Abstract
Cancer remains a public health challenge in the identification and development of ideal pharmacological therapies and dietary strategies. The use of whey protein as a dietary strategy is widespread in the field of oncology. The two types of whey protein, sweet or acid, result from several processing techniques and possess distinct protein subfraction compositions. Mechanistically, whey protein subfractions have specific anti-cancer effects. Alpha-lactalbumin, human α-lactalbumin made lethal to tumor cell, bovine α-lactalbumin made lethal to tumor cell, bovine serum albumin, and lactoferrin are whey protein subfractions with potential to hinder tumor pathways. Such effects, however, are principally supported by studies performed in vitro and/or in vivo. In clinical practice, whey protein intake-induced anti-cancer effects are indiscernible. However, whey protein supplementation represents a practical, feasible, and cost-effective approach to mitigate cancer cachexia syndrome. The usefulness of whey protein is evidenced by a greater leucine content and the potential to modulate IGF-1 concentrations, representing important factors towards musculoskeletal hypertrophy. Further clinical trials are warranted and needed to establish the effects of whey protein supplementation as an adjuvant to cancer therapy.
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19
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Shaheen H, Sobhy S, El Mously S, Niazi M, Gomaa M. Insulin-Like Growth Factor-1 in Acute Ischemic Stroke. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2018; 54:42. [PMID: 30595648 PMCID: PMC6290716 DOI: 10.1186/s41983-018-0042-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 11/18/2018] [Indexed: 01/14/2023] Open
Abstract
Background Cerebrovascular ischemic stroke is highly prevalent in the general population and is considered one of the frequent causes of mortality and disability. Insulin-like growth factor-1 (IGF-1) is recognized as an important neuro-protective factor against cerebral vascular ischemic insult. Aim of the work To study the relationship between serum IGF-1 levels and acute ischemic stroke (AIS) in the Egyptian population. Patients and methods Two hundred patients with AIS (within the first 24 h) were subjected to full neurological examination, assessment of stroke severity using National Institute of Health Stroke Scale (NIHSS) and measurement of serum IGF-1 levels. The control group included 100 subjects matched for age, gender, and conventional vascular risk factors. Results Serum IGF-1 levels were significantly reduced in cases of first AIS compared to control group. A reduced serum IGF-1 level was an independent risk factor for ischemic stroke with cut off value less than 148.3 ng/ml associated with increased AIS risk. Conclusion Lower IGF-1 levels are significantly related to risk of ischemic stroke occurrence, independent from other conventional risk factors in the Egyptian population.
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Affiliation(s)
- Hala Shaheen
- Faculty of Medicine, Fayoum University, Keman Fares area, Fayoum City, 63611 Egypt
| | - Sayed Sobhy
- Faculty of Medicine, Fayoum University, Keman Fares area, Fayoum City, 63611 Egypt
| | - Sherine El Mously
- Faculty of Medicine, Fayoum University, Keman Fares area, Fayoum City, 63611 Egypt
| | - Manal Niazi
- Faculty of Medicine, Fayoum University, Keman Fares area, Fayoum City, 63611 Egypt
| | - Mohammed Gomaa
- Faculty of Medicine, Fayoum University, Keman Fares area, Fayoum City, 63611 Egypt
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20
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Kenchegowda D, Legesse B, Hritzo B, Olsen C, Aghdam S, Kaur A, Culp W, Derrien-Colemyn A, Severson G, Moroni M. Selective Insulin-like Growth Factor Resistance Associated with Heart Hemorrhages and Poor Prognosis in a Novel Preclinical Model of the Hematopoietic Acute Radiation Syndrome. Radiat Res 2018; 190:164-175. [PMID: 29809108 PMCID: PMC6118398 DOI: 10.1667/rr14993.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Although bone marrow aplasia has been considered for the past decades as the major contributor of radiation-induced blood disorders, cytopenias alone are insufficient to explain differences in the prevalence of bleeding. In this study, the minipig was used as a novel preclinical model of hematopoietic acute radiation syndrome to assess if factors other than platelet counts correlated with bleeding and survival. We sought to determine whether radiation affected the insulin-like growth factor-1 (IGF-1) pathway, a growth hormone with cardiovascular and radioprotective features. Gottingen and Sinclair minipigs were exposed to ionizing radiation at hematopoietic doses. The smaller Gottingen minipig strain was more sensitive to radiation; differences in IGF-1 levels were minimal, suggesting that increased sensitivity could depend on weak response to the hormone. Radiation caused IGF-1 selective resistance by inhibiting the anti-inflammatory anti-oxidative stress IRS/PI3K/Akt but not the pro-inflammatory MAPK kinase pathway, shifting IGF-1 signaling towards a pro-oxidant, pro-inflammatory environment. Selective IGF-1 resistance associated with hemorrhages in the heart, poor prognosis, increase in C-reactive protein and NADPH oxidase 2, uncoupling of endothelial nitric oxide synthase, inhibition of nitric oxide (NO) synthesis and imbalance between the vasodilator NO and the vasoconstrictor endothelin-1 molecules. Selective IGF-1 resistance is a novel mechanism of radiation injury, associated with a vicious cycle amplifying reactive oxygen species-induced damage, inflammation and endothelial dysfunction. In the presence of thrombocytopenia, selective inhibition of IGF-1 cardioprotective function may contribute to the development of hemostatic disorders. This finding may be particularly relevant for individuals with low IGF-1 activity, such as the elderly or those with cardiometabolic dysfunctions.
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Affiliation(s)
- Doreswamy Kenchegowda
- Scientific Research Department, Armed Forces Radiobiology Research Institute, Bethesda, Maryland
| | - Betre Legesse
- Scientific Research Department, Armed Forces Radiobiology Research Institute, Bethesda, Maryland
| | - Bernadette Hritzo
- Scientific Research Department, Armed Forces Radiobiology Research Institute, Bethesda, Maryland
| | - Cara Olsen
- Biostatistics Consulting Center, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Saeed Aghdam
- Scientific Research Department, Armed Forces Radiobiology Research Institute, Bethesda, Maryland
| | - Amandeep Kaur
- Scientific Research Department, Armed Forces Radiobiology Research Institute, Bethesda, Maryland
| | - William Culp
- Office of the Vice President for Research, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | - Grant Severson
- Scientific Research Department, Armed Forces Radiobiology Research Institute, Bethesda, Maryland
| | - Maria Moroni
- Scientific Research Department, Armed Forces Radiobiology Research Institute, Bethesda, Maryland
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van Nieuwpoort IC, Vlot MC, Schaap LA, Lips P, Drent ML. The relationship between serum IGF-1, handgrip strength, physical performance and falls in elderly men and women. Eur J Endocrinol 2018; 179:73-84. [PMID: 29789408 DOI: 10.1530/eje-18-0076] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 05/22/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Human aging is accompanied by a decrease in growth hormone secretion and serum insulin-like growth factor (IGF)-1 levels. Also, loss of muscle mass and strength and impairment of physical performance, ending in a state of frailty, are seen in elderly. We aimed to investigate whether handgrip strength, physical performance and recurrent falls are related to serum IGF-1 levels in community-dwelling elderly. DESIGN Observational cohort study (cross-sectional and prospective). METHODS We studied the association between IGF-1 and handgrip strength, physical performance and falls in participants of the Longitudinal Aging Study Amsterdam. A total of 1292 participants were included (633 men, 659 women). Serum IGF-1 levels were divided into quartiles (IGF-1-Q1 to IGF-1-Q4). Data on falls were collected prospectively for a period of 3 years. All analyses were stratified for age and physical activity and adjusted for relevant confounders. RESULTS Men with a low physical activity score in IGF-1-Q1 and IGF-1-Q2 of the younger age group had a lower handgrip strength compared to IGF-1-Q4. In younger more active males in IGF-1-Q2 physical performance was worse. Recurrent fallers were less prevalent in older, low active males with low IGF-1 levels. In females, recurrent fallers were more prevalent in older, more active females in IGF-1-Q2. IGF-1 quartile may predict changes in handgrip strength and physical performance in men and women. CONCLUSIONS Our results indicate that lower IGF-1 levels are associated with lower handgrip strength and worse physical performance, but less recurrent fallers especially in men. Associations were often more robust in IGF-1-Q2. Future studies on this topic are desirable.
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Affiliation(s)
- I C van Nieuwpoort
- Department of Internal Medicine, Section Endocrinology, VU University Medical Center, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - M C Vlot
- Department of Internal Medicine, Section Endocrinology, VU University Medical Center, Amsterdam, The Netherlands
| | - L A Schaap
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - P Lips
- Department of Internal Medicine, Section Endocrinology, VU University Medical Center, Amsterdam, The Netherlands
- Institute for Research in Extramural Medicine (EMGO Institute), VU University Medical Center, Amsterdam, The Netherlands
| | - M L Drent
- Department of Internal Medicine, Section Endocrinology, VU University Medical Center, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
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22
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Barnard SA, Smith W, Mels CMC, Botha S, Schutte AE. Bioavailable IGF-1 is beneficially associated with biomarkers of endothelial function in young healthy adults: The African-PREDICT study. Growth Horm IGF Res 2018; 41:28-33. [PMID: 29936324 DOI: 10.1016/j.ghir.2018.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 06/01/2018] [Accepted: 06/10/2018] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Low circulating levels of insulin-like growth factor-1 (IGF-1) are associated with endothelial dysfunction, subsequently leading to the development of cardiovascular disease. OBJECTIVE To better understand the early phases of vascular deterioration in a young, healthy population, we investigated, cross-sectionally, whether biomarkers of endothelial function (intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and von Willebrand factor antigen (vWFag)) are associated with IGF-1 in a healthy study population forming part of the larger African Prospective study on the Early Detection and Identification of Cardiovascular diseases and Hypertension (African-PREDICT). METHOD We included 825 black and white men and women (aged 20-30 years) and determined IGF-1, IGF binding protein-3 (IGFBP-3), ICAM-1, VCAM-1 and vWFag from blood samples. We also measured 24-h blood pressure and health behaviours namely waist circumference, accelerometery, cotinine and gamma glutamyl transferase. We used the IGF-1/IGFBP-3 M ratio as an estimate of bioavailable IGF-1. RESULTS In multivariable-adjusted regression analyses performed in the total group, VCAM-1 associated positively with IGFBP-3 (β = 0.21; p < .001) and negatively with IGF-1/IGFBP-3 (β = -0.18; p < .001). ICAM-1 showed a borderline negative association with IGF-1 (β = -0.09; p = .054) and IGF-1/IGFBP-3 (β = -0.08; p = .057). vWFag was not associated with IGF-1, IGFBP-3 or bioavailable IGF-1. CONCLUSION VCAM-1 is beneficially associated with IGF-1 in a young healthy cohort, independent of sex, ethnicity, blood pressure and health behaviours - thereby confirming the potential importance of bioavailable IGF-1 in early vascular endothelial protection.
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Affiliation(s)
- Sunelle A Barnard
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
| | - Wayne Smith
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Research Unit for Hypertension and Cardiovascular disease, North-West University, Potchefstroom, South Africa.
| | - Catharina M C Mels
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Research Unit for Hypertension and Cardiovascular disease, North-West University, Potchefstroom, South Africa.
| | - Shani Botha
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Research Unit for Hypertension and Cardiovascular disease, North-West University, Potchefstroom, South Africa.
| | - Aletta E Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Research Unit for Hypertension and Cardiovascular disease, North-West University, Potchefstroom, South Africa.
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23
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Lin JG, Lin SZ, Lin LH, Wu CC, Tsai WT, Harn HJ, Su LH, Ho WY, Hsieh CJ, Ho TJ. Effects of Moxibustion on the Levels of Insulin-Like Growth Factor 1: A Pilot Study. Cell Transplant 2018; 27:551-556. [PMID: 29692183 PMCID: PMC6038048 DOI: 10.1177/0963689717724795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Moxibustion (艾灸) is a traditional Chinese medicine therapy performed using Artemisia argyii. Zusanli (足三里, ST36) is an acupoint in the stomach meridian, long associated in ancient Chinese medical practices with the extension of life span when moxibustion is applied to it. The aim of this study was to investigate changes in insulin-like growth factor 1 (IGF-1) levels after application of moxibustion to ST36. Four healthy men and women participated in this 28-day trial and were randomly divided into 2 groups. Group A received moxibustion treatment from days 1 to 14, while group B received moxibustion treatment from days 15 to 28. Blood samples were taken 5 times during this study to measure serum IGF-1 (s-IGF-1) levels. The s-IGF-1 levels increased in both groups after 7 and 14 d of moxibustion therapy (group A: 11.02% [7 d] and 29.65% [14 d]; group B: 169.12% [7 d] and 274.85% [14 d]). After moxibustion therapy had been completed (day 14), s-IGF-1 levels continued to increase in group A (increases on day 21 and day 28 were 53.19% and 61.45%, respectively). There were no adverse events in either group. The s-IGF-1 levels were significantly raised in both groups after 7 and 14 d of moxibustion therapy. Moreover, once therapy had been completed, s-IGF-1 levels continued to increase in group A up to 14 d after the treatment.
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Affiliation(s)
- Jaung-Geng Lin
- 1 School of Chinese Medicine, China Medical University, Shenyang Shi, Taichung, Taiwan
| | - Shinn-Zong Lin
- 2 Bioinnovation Center, Tzu Chi Foundation, Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan
| | - Lih-Hwa Lin
- 3 Division of Chinese Medicine, An Nan Hospital, China Medical University, Liaoning Sheng, Tainan, Taiwan.,4 Graduate Institute of Chinese Medicine, School of Chinese Medicine, China Medical University, Liaoning Sheng, Taichung, Taiwan
| | - Chun-Chang Wu
- 5 Division of Chinese Medicine, China Medical University Beigang Hospital, Yunlin County, Taiwan
| | - Wan-Ting Tsai
- 5 Division of Chinese Medicine, China Medical University Beigang Hospital, Yunlin County, Taiwan
| | - Horng-Jyh Harn
- 6 Bioinnovation Center, Tzu Chi Foundation, Department of Pathology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan
| | - Li-Hui Su
- 7 Department of Nursing, China Medical University Beigang Hospital, Yunlin County, Taiwan
| | - Wen-Yu Ho
- 8 Department of Laboratory Medicine, China Medical University Beigang Hospital, Yunlin County, Taiwan.,9 Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli County, Taiwan
| | - Che-Jui Hsieh
- 1 School of Chinese Medicine, China Medical University, Shenyang Shi, Taichung, Taiwan
| | - Tsung-Jung Ho
- 1 School of Chinese Medicine, China Medical University, Shenyang Shi, Taichung, Taiwan.,3 Division of Chinese Medicine, An Nan Hospital, China Medical University, Liaoning Sheng, Tainan, Taiwan.,5 Division of Chinese Medicine, China Medical University Beigang Hospital, Yunlin County, Taiwan
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24
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Markers of arterial health could serve as accurate non-invasive predictors of human biological and chronological age. Aging (Albany NY) 2018; 9:1280-1292. [PMID: 28455973 PMCID: PMC5425127 DOI: 10.18632/aging.101227] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 04/17/2017] [Indexed: 12/23/2022]
Abstract
The decline in functional capacity is unavoidable consequence of the process of aging. While many anti-aging interventions have been proposed, clinical investigations into anti-aging medicine are limited by lack of reliable techniques for evaluating the rate of ageing. Here we present simple, accurate and cost-efficient techniques for estimation of human biological age, Male and Female Arterial Indices. We started with developing a model which accurately predicts chronological age. Using machine learning, we arrived on a set of four predictors, all of which reflect the functioning of the cardiovascular system. In Arterial Indices models, results of carotid artery duplex scan that show the thickness of the intima media complex and quantitatively describe the degree of stenosis are combined with pulse wave velocity and augmentation index measurements performed by applanation tonometry. In our cohort, the age of men was determined with MAE = 6.91 years (adjusted R-squared = 0.55), and the age of women with MAE = 5.87 years (adjusted R2 = 0.69). The Epsilon-accuracies of age-predicting models were at 86.5% and 80% for women and men, respectively. Substantially higher differences between the predicted age and the calendar age were noted for patients with Type 2 Diabetes Mellitus (T2D) as compared to non-T2D controls, indicating that the model could serve as a good approximation for an elusive biological age. Notably, in females with chronological and biological ages mismatching by 5 or more years, significant increases in in Framingham CVD scores and lower levels of IGF-1 were observed. Proposed Male and Female Arterial Indices derive biological age from the results of functional tests which do not require specialized laboratory equipment and, therefore, could be performed in hospitals and community health clinics.
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25
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Jensen RB, Thankamony A, Holst KK, Janssen JAMJL, Juul A, Dunger D, Poulsen P, Scheike T. Genetic influence on the associations between IGF-I and glucose metabolism in a cohort of elderly twins. Eur J Endocrinol 2018; 178:153-161. [PMID: 29208737 DOI: 10.1530/eje-17-0754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/14/2017] [Accepted: 11/20/2017] [Indexed: 11/08/2022]
Abstract
OBJECTIVE IGF-I may be a marker of later metabolic and cardiovascular disease. The interactions between IGF-I and glucose metabolism are multifactorial, and there is potential confounding from several secondary effects. In this study, we examined the interaction between IGF-I and glucose metabolism in a large cohort of clinically well-characterized elderly twins. DESIGN A total of 303 twin pairs of the same gender (606 twins) were included in the study; 125 monozygotic and 178 dizygotic twin pairs. METHODS A clinical examination including a standard oral glucose tolerance test (OGTT) and anthropometric measurements was performed. RESULTS The heritability estimates were high for IGF-I and IGFBP-3 (h2: 0.65 (95% CI: 0.55-0.74) and 0.71 (0.48-0.94), respectively) and for insulin secretion (h2 = 0.56, P < 0.0001), whereas the heritability estimates for insulin sensitivity were low (h2 = 0.14, P = 0.11). In a multiple regression analysis (adjusting for age, gender and twin status), there was a negative association between IGF-I and insulin sensitivity (B: -0.13, SE 0.03, P < 0.0001) and IGF-I and disposition index (B: -0.05, SE 0.02, P < 0.001) in the entire cohort of 606 twins. The associations between IGF-I and both DI and HOMA-S did not differ between the DZ and MZ twins. Forty-five twin pairs were discordant for T2D, but the discordant twins had similar concentrations of IGF-I or IGFBP-3. CONCLUSIONS There was a high heritability for IGF-I and IGFBP-3, but a low heritability for insulin secretion and insulin sensitivity in a group of elderly twins. In addition, we found a strong negative relationship between IGF-I and insulin sensitivity, which did not seem to be strongly genetically determined.
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Affiliation(s)
- Rikke Beck Jensen
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ajay Thankamony
- Department of Pediatrics, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Klaus K Holst
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Joseph A M J L Janssen
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, Rotterdam, The Netherlands
| | - Anders Juul
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - David Dunger
- Department of Pediatrics, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | | | - Thomas Scheike
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
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Chan YX, Alfonso H, Paul Chubb SA, Ho KKY, Gerard Fegan P, Hankey GJ, Golledge J, Flicker L, Yeap BB. Higher IGFBP3 is associated with increased incidence of colorectal cancer in older men independently of IGF1. Clin Endocrinol (Oxf) 2018; 88:333-340. [PMID: 29044573 DOI: 10.1111/cen.13499] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 10/02/2017] [Accepted: 10/11/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Insulin-like growth factor 1 (IGF1) has anabolic and growth-promoting effects, raising concerns regarding its potential to promote tumour growth. Circulating IGF1 is bound to binding proteins, which modulate bioavailability of IGF1. This study assessed the associations of IGF1 and its binding proteins 1 (IGFBP1) and 3 (IGFBP3) with cancer risk. DESIGN A prospective cohort study of 4042 men aged ≥70 years. METHODS Plasma total IGF1, IGFBP1 and IGFBP3 were measured between 2001 and 2004. Cancer-related outcomes were assessed until 20 June 2013 using data linkage. Analyses were performed using proportional hazards models with death as a competing risk, and adjustments were made for potential confounders. Results are expressed as subhazard ratios (SHR). RESULTS There were 907 men who were diagnosed with cancer during a median of 9-year follow-up. Of these, there were 359, 139 and 125 prostate, colorectal and lung cancers, respectively. After adjustments, total IGF1 was not associated with the incidence of any cancer, prostate, lung or colorectal cancer. In the fully-adjusted model, higher IGFBP3 was associated with increased incidence of colorectal cancer (SHR = 1.20, 95% CI 1.01-1.43; P = .041 for every 1 standard deviation increase in IGFBP3) but not other cancers. This effect was not attenuated by inclusion of total IGF1 into the multivariate model (SHR = 1.28, 95% CI 1.03-1.58; P = .025). Neither total IGF1, IGFBP1 nor IGFBP3 were associated with cancer-related deaths. CONCLUSION Higher IGFBP3 predicted increased incidence of colorectal cancer in older men independent of conventional risk factors and total IGF1. Further studies are warranted to explore potential underlying mechanisms.
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Affiliation(s)
- Yi X Chan
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, WA, Australia
| | - Helman Alfonso
- School of Public Health, Department of Epidemiology and Biostatistics, Curtin University, Perth, WA, Australia
| | - Stephen Anthony Paul Chubb
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Pathwest Laboratory Medicine, Fiona Stanley Hospital, Perth, WA, Australia
| | - Ken K Y Ho
- Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Peter Gerard Fegan
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, WA, Australia
| | - Graeme J Hankey
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Department of Neurology, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
- Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, QLD, Australia
| | - Leon Flicker
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Western Australian Centre for Health and Ageing, Centre for Medical Research, University of Western Australia, Perth, WA, Australia
| | - Bu B Yeap
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, WA, Australia
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Toriola AT, Ziegler M, Li Y, Pollak M, Stolzenberg-Solomon R. Prediagnosis Circulating Insulin-Like Growth Factors and Pancreatic Cancer Survival. Ann Surg Oncol 2017; 24:3212-3219. [PMID: 28681154 DOI: 10.1245/s10434-017-5988-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND Prediagnosis obesity and diabetes are associated with survival from pancreatic cancer, but the underlying mechanisms have not been characterized. Because both are associated with dysregulation in circulating insulin-like growth factor (IGF) levels, we evaluated the associations of prediagnosis IGF levels (IGF-I, IGF-II) and IGF binding protein 3 (IGFBP-3) with pancreatic cancer survival. METHODS Participants were subjects enrolled in the intervention arm of the PLCO Cancer Screening Trial who developed exocrine pancreatic cancer during follow-up (N = 178, 116 men and 67 women). Participants provided blood samples at enrollment, before cancer diagnosis. Cox proportional hazards regression model, adjusted for confounders was used to investigate associations of IGF biomarkers with pancreatic cancer survival. Because of the well-documented, gender-specific differences in circulating IGF biomarkers, and differential associations of IGF biomarkers with mortality, we evaluated associations separately among males and females. RESULTS Median survival was 172 days. Higher IGF-II and IGFBP-3 levels were associated with pancreatic cancer survival among males but not among females. The hazard ratios (HR) of death among men in the highest tertiles of IGF-II and IGFBP-3 compared with men in the lowest tertiles were 0.40 (95% confidence interval (CI) 0.23-0.71, p < 0.01) and 0.59 (95% CI 0.35-0.97, p = 0.10), respectively. There were no statistically significant associations between IGF-I concentrations, IGF-I/IGFBP-3, and pancreatic cancer survival. CONCLUSIONS Higher prediagnosis circulating IGF-II and IGFBP-3 levels are associated with better pancreatic cancer survival among men but not women. A greater understanding of how IGF signaling is related to pancreatic cancer survival could have utility in improving pancreatic cancer prognosis.
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Affiliation(s)
- Adetunji T Toriola
- Department of Surgery, Division of Public Health Sciences, and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA.
| | - Mark Ziegler
- Department of Surgery, Division of Public Health Sciences, and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Yize Li
- Department of Surgery, Division of Public Health Sciences, and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Michael Pollak
- Department of Oncology, McGill University, Montreal, Canada
| | - Rachael Stolzenberg-Solomon
- Branch of Nutritional Epidemiology, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
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Bucci L, Ostan R, Cevenini E, Pini E, Scurti M, Vitale G, Mari D, Caruso C, Sansoni P, Fanelli F, Pasquali R, Gueresi P, Franceschi C, Monti D. Centenarians' offspring as a model of healthy aging: a reappraisal of the data on Italian subjects and a comprehensive overview. Aging (Albany NY) 2017; 8:510-9. [PMID: 26979133 PMCID: PMC4833142 DOI: 10.18632/aging.100912] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Within the scenario of an increasing life expectancy worldwide it is mandatory to identify determinants of healthy aging. Centenarian offspring (CO) is one of the most informative model to identify trajectories of healthy aging and their determinants (genetic and environmental), being representative of elderly in their 70th whose lifestyle can be still modified to attain a better health. This study is the first comprehensive investigation of the health status of 267 CO (mean age: 70.2 years) and adopts the innovative approach of comparing CO with 107 age-matched offspring of non-long-lived parents (hereafter indicated as NCO controls), recruited according to strict inclusion demographic criteria of Italian population. We adopted a multidimensional approach which integrates functional and cognitive assessment together with epidemiological and clinical data, including pro- and anti-inflammatory cytokines and adipokines, lipid profile, and insulin resistance. CO have a lower prevalence of stroke, cerebral thrombosis-hemorrhage, hypertension, hypercholesterolemia, and other minor diseases, lower BMI and waist circumference, a better functional and cognitive status and lower plasma level of FT4 compared to NCO controls. We conclude that a multidimensional approach is a reliable strategy to identify the health status of elderly at an age when interventions to modify their health trajectory are feasible.
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Affiliation(s)
- Laura Bucci
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES) and Interdepartmental Centre "L. Galvani" (CIG), University of Bologna, 40126 Bologna, Italy
| | - Rita Ostan
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES) and Interdepartmental Centre "L. Galvani" (CIG), University of Bologna, 40126 Bologna, Italy
| | - Elisa Cevenini
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES) and Interdepartmental Centre "L. Galvani" (CIG), University of Bologna, 40126 Bologna, Italy
| | - Elisa Pini
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES) and Interdepartmental Centre "L. Galvani" (CIG), University of Bologna, 40126 Bologna, Italy
| | - Maria Scurti
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES) and Interdepartmental Centre "L. Galvani" (CIG), University of Bologna, 40126 Bologna, Italy
| | - Giovanni Vitale
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, 20122 Milan, Italy.,Laboratory of Endocrine and Metabolic Research, IRCCS Istituto Auxologico Italiano, Cusano Milanino (MI) 20095, Italy
| | - Daniela Mari
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, 20122 Milan, Italy.,Laboratory of Endocrine and Metabolic Research, IRCCS Istituto Auxologico Italiano, Cusano Milanino (MI) 20095, Italy.,Geriatric Unit, Fondazione Ca' Granda, IRCCS Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Calogero Caruso
- Department of Pathobiology and Medical and Forensic Biotechnologies, University of Palermo, 90134 Palermo, Italy
| | - Paolo Sansoni
- Department of Clinical and Experimental Medicine, University of Parma, 43126 Parma, Italy
| | - Flaminia Fanelli
- Endocrinology Unit, and Department of Medical and Surgical Sciences and Center for Applied Biomedical Sciences, St Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy
| | - Renato Pasquali
- Endocrinology Unit, and Department of Medical and Surgical Sciences and Center for Applied Biomedical Sciences, St Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy
| | - Paola Gueresi
- Department of Statistical Sciences "Paolo Fortunati", University of Bologna, 40126 Bologna, Italy
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES) and Interdepartmental Centre "L. Galvani" (CIG), University of Bologna, 40126 Bologna, Italy
| | - Daniela Monti
- Department of Clinical, Experimental and Biomedical Sciences, University of Florence, 50134 Florence, Italy
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Conover CA. Discrepancies in insulin-like growth factor signaling? No, not really. Growth Horm IGF Res 2016; 30-31:42-44. [PMID: 27792888 DOI: 10.1016/j.ghir.2016.10.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 10/03/2016] [Accepted: 10/21/2016] [Indexed: 01/03/2023]
Abstract
Why do studies on insulin-like growth factors (IGFs) and IGF signaling seem so contradictory? The answer is "It depends". This mini- review will explore a few of the factors that are likely to contribute to a seemingly confusing message. Most of the evidence comes from experimental animal models.
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Affiliation(s)
- Cheryl A Conover
- Endocrine Research Unit, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States.
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Miyake H, Kanazawa I, Sugimoto T. Decreased serum insulin-like growth factor-I level is associated with the increased mortality in type 2 diabetes mellitus. Endocr J 2016; 63:811-818. [PMID: 27349183 DOI: 10.1507/endocrj.ej16-0076] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Mortality is increased in type 2 diabetes mellitus (T2DM). Although previous studies showed that decreased serum insulin-like growth factor-I (IGF-I) levels are associated with diabetic complications, little is known about the association between serum IGF-I level and the mortality in patients with T2DM. This is a historical cohort study with end-point of all-cause mortality in 234 men and 191 women with T2DM. Standard deviation of serum IGF-I [IGF-I (SD)] was calculated by adjusting for age and gender. Of 234 male and 191 female, 46 and 25 patients died, respectively, for the follow-up period of almost 7 years. Unadjusted survival analyses showed that lower IGF-I was associated with higher mortality in men and women (p<0.001 and p=0.004, respectively). In Cox regression analyses adjusted for age, duration of diabetes, body mass index, HbA1c, and serum creatinine, serum IGF-I was inversely associated with the mortality [men, hazard ratio (HR)=0.40, 95% confidence interval (CI)=0.25-0.64 per SD increase, p<0.001; women, HR=0.28, 95%CI 0.08-0.96, p=0.043]. When IGF-I was replaced to IGF-I (SD), the relationships are still significant. After additional adjustments for serum albumin, systolic blood pressure, ALT, LDL-cholesterol, smoking, and past history of cardiovascular disease, the association between serum IGF-I and the mortality in men remained significant (HR=0.31, 95%CI 0.15-0.65, p=0.002), but not in women. The present study showed that lower serum IGF-I levels were associated with the increased all-cause mortality in patients with T2DM, suggesting that serum IGF-I could be clinically useful for assessing the risk of mortality in the population.
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Affiliation(s)
- Hitomi Miyake
- Department of Internal Medicine 1, Shimane University Faculty of Medicine, Izumo 693-8501, Japan
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Schutte AE, Conti E, Mels CM, Smith W, Kruger R, Botha S, Gnessi L, Volpe M, Huisman HW. Attenuated IGF-1 predicts all-cause and cardiovascular mortality in a Black population: A five-year prospective study. Eur J Prev Cardiol 2016; 23:1690-1699. [PMID: 27450159 DOI: 10.1177/2047487316661436] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 07/07/2016] [Indexed: 11/15/2022]
Abstract
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.
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Affiliation(s)
- Aletta E Schutte
- Hypertension 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
| | - Elena Conti
- Department of Clinical and Molecular Medicine, University of Rome, Sapienza, Italy
| | - Catharina Mc Mels
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Wayne Smith
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Ruan Kruger
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Shani Botha
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Lucio Gnessi
- Department of Experimental Medicine, Pathophysiology and Endocrinology Unit, University of Rome, Sapienza, Italy
| | - Massimo Volpe
- Department of Clinical and Molecular Medicine, University of Rome, Sapienza, Italy IRCCS Neuromed, Pozzilli, Italy
| | - Hugo W Huisman
- Hypertension 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
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Milman S, Huffman DM, Barzilai N. The Somatotropic Axis in Human Aging: Framework for the Current State of Knowledge and Future Research. Cell Metab 2016; 23:980-989. [PMID: 27304500 PMCID: PMC4919980 DOI: 10.1016/j.cmet.2016.05.014] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 05/24/2016] [Accepted: 05/26/2016] [Indexed: 12/19/2022]
Abstract
Mutations resulting in reduced signaling of the growth hormone/insulin-like growth factor-1 (GH/IGF-1) axis are associated with increased life- and healthspan across model organisms. Similar findings have been noted in human cohorts with functional mutations in the somatotropic axis, suggesting that this pathway may also be relevant to human aging and protection from age-related diseases. While epidemiological data indicate that low circulating IGF-1 level may protect aging populations from cancer, results remain inconclusive regarding most other diseases. We propose that studies in humans and animals need to consider differences in sex, pathway function, organs, and time-specific effects of GH/IGF-1 signaling in order to better define the role of the somatotropic axis in aging. Agents that modulate signaling of the GH/IGF-1 pathway are available for human use, but before they can be implemented in clinical studies that target aging and age-related diseases, researchers need to address the challenges discussed in this Review.
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Affiliation(s)
- Sofiya Milman
- Department of Medicine, Division of Endocrinology, Institute for Aging Research, Albert Einstein College of Medicine, Bronx, NY 10461, USA; Department of Medicine, Division of Geriatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
| | - Derek M Huffman
- Department of Medicine, Division of Endocrinology, Institute for Aging Research, Albert Einstein College of Medicine, Bronx, NY 10461, USA; Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Nir Barzilai
- Department of Medicine, Division of Endocrinology, Institute for Aging Research, Albert Einstein College of Medicine, Bronx, NY 10461, USA; Department of Medicine, Division of Geriatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA; Department of Genetics, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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van Bunderen CC, Lips P, Kramer MH, Drent ML. Comparison of low-normal and high-normal IGF-1 target levels during growth hormone replacement therapy: A randomized clinical trial in adult growth hormone deficiency. Eur J Intern Med 2016; 31:88-93. [PMID: 27118206 DOI: 10.1016/j.ejim.2016.03.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 03/12/2016] [Accepted: 03/26/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Current guidelines state that the goals of growth hormone (GH) therapy in adults should be an appropriate clinical response, avoidance of side effects, and an IGF-1 value within the age-adjusted reference range. There are no published studies on the target level for IGF-1 that offer specific guidance in this regard. OBJECTIVES To compare low-normal and high-normal target levels of IGF-1 on efficacy and safety of GH treatment. METHODS A randomized, open-label, clinical trial including thirty-two adults from one university hospital receiving GH therapy for at least one year with a stable IGF-1 concentration between -1 and 1 SD score (SDS). Subjects were randomized to receive either a decrease (IGF-1 target level of -2 to -1 SDS) or an increase of their daily GH dose (IGF-1 target level of 1 to 2 SDS) for a period of 24weeks. The effect on cardiovascular risk factors and physical performance, next to tolerability, was compared. RESULTS Thirty subjects (65.6% men, mean age 46.6 (SD 9.9) years) could be analyzed. In subjects with a high-normal IGF-1 target level, waist circumference decreased (p=0.05), and overall they felt better (p=0.04), compared to subjects with a low-normal IGF-1 target level. However, increasing IGF-1 levels led to more myalgia, and decreasing IGF-1 levels to more fatigue. There was a gender-dependent difference in effect on HDL cholesterol. CONCLUSION Although increasing GH dose to IGF-1 levels between 1 and 2 SDS improved waist circumference and well-being, safety was not guaranteed with the demonstrated effect on HDL cholesterol in men, and reported myalgia.
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Affiliation(s)
- Christa C van Bunderen
- Department of Internal Medicine, Section of Endocrinology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
| | - Paul Lips
- Department of Internal Medicine, Section of Endocrinology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Mark H Kramer
- Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Madeleine L Drent
- Department of Internal Medicine, Section of Endocrinology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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Carlzon D, Svensson J, Petzold M, Karlsson MK, Ljunggren Ö, Haghsheno MA, Damber JE, Mellström D, Ohlsson C. Insulin-like growth factor I and risk of incident cancer in elderly men - results from MrOS (Osteoporotic Fractures in Men) in Sweden. Clin Endocrinol (Oxf) 2016; 84:764-70. [PMID: 26440042 DOI: 10.1111/cen.12962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 07/04/2015] [Accepted: 09/30/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Studies of the association between circulating IGF-I and cancer risk have shown conflicting results. We have previously observed a U-shaped association between IGF-I and cancer mortality. This study test the hypotheses of a U-shaped association between IGF-I and incident cancer. DESIGN Elderly men (2368), randomly recruited from the general community. METHODS IGF-I was measured in a cohort of elderly men. Complete data for incident cancer were obtained from the Swedish Cancer Registry. Statistical analyses included Cox proportional hazards regressions with or without a spline approach. RESULTS Three hundred and sixty-nine participants had incident cancer after baseline. Prostate cancer was most frequent (n = 140). There was no association between serum IGF-I and all cancer or prostate cancer incidence. However, there was a nonlinear association between IGF-I and nonprostate cancer incidence (P = <0·05). Exploratory analyses were performed for low and high serum IGF-I (quintiles 1 and 5) vs intermediate (quintiles 2-4, referent). There was a tendency of increased nonprostate cancer risk in men with high IGF-I (HR = 1·26, 95% confidence interval (CI): 0·92-1·71, P = 0·15). After excluding participants with follow-up of less than 2·6 years (half median follow-up time), to control for potential diagnostic delay, the association was statistically significant (HR = 1·55, CI: 1·03-2·35). CONCLUSION There was a significant nonlinear association between IGF-I and nonprostate cancer. No association between IGF-I and prostate cancer was observed. Future studies are warranted to further investigate this nonlinear association, including whether IGF-I concentration is a reproducible, and useful, risk marker of nonprostate cancer.
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Affiliation(s)
- Daniel Carlzon
- Center for Bone and Arthritis Research at the Sahlgrenska Academy (CBAR), Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Johan Svensson
- Center for Bone and Arthritis Research at the Sahlgrenska Academy (CBAR), Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Max Petzold
- Center for Applied Biostatistics at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus K Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Orthopaedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Östen Ljunggren
- Department of Medical Sciences, University of Uppsala, Uppsala, Sweden
| | - Mohammad-Ali Haghsheno
- Department of Urology, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Jan-Erik Damber
- Department of Urology, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Dan Mellström
- Center for Bone and Arthritis Research at the Sahlgrenska Academy (CBAR), Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Claes Ohlsson
- Center for Bone and Arthritis Research at the Sahlgrenska Academy (CBAR), Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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Cubbon RM, Kearney MT, Wheatcroft SB. Endothelial IGF-1 Receptor Signalling in Diabetes and Insulin Resistance. Trends Endocrinol Metab 2016; 27:96-104. [PMID: 26712712 DOI: 10.1016/j.tem.2015.11.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 11/22/2015] [Accepted: 11/24/2015] [Indexed: 01/19/2023]
Abstract
Despite contemporary medical therapy, people with diabetes and insulin resistance experience substantially increased risk of cardiovascular events caused by atherosclerosis. Dysfunction of the endothelium is a key phase in early atherogenesis and represents a promising therapeutic target. The evolutionarily related insulin and insulin-like growth factor-1 (IGF-1) axes are implicated in the development of vascular disease. In this review, we summarise recent developments in our understanding of how modulating the IGF-1 axis influences vascular disease in the setting of insulin resistance. By contrasting data from models of altered insulin and/or IGF-1 signalling, we emphasise the complex spatiotemporal interplay of these systems in health and disease. We then discuss therapeutic opportunities, before detailing important gaps in our knowledge relevant to therapeutic translation.
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Affiliation(s)
- Richard M Cubbon
- Leeds Institute for Cardiovascular and Metabolic Medicine, LIGHT laboratories, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK
| | - Mark T Kearney
- Leeds Institute for Cardiovascular and Metabolic Medicine, LIGHT laboratories, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK.
| | - Stephen B Wheatcroft
- Leeds Institute for Cardiovascular and Metabolic Medicine, LIGHT laboratories, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK
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36
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Harmatina OY. [INSULIN-LIKE GROWTH FACTOR 1 UNDER CONDITIONS OF THE BRAIN VASCULAR DISEASES.]. ACTA ACUST UNITED AC 2016; 62:95-102. [PMID: 29975480 DOI: 10.15407/fz62.04.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The system insulin-like growth factors (IGF) occupies an important place in the development and growth of the central nervous system (CNS). Gene expression of insulin-like growth factor I (IGF-1) and IGF-1 receptor are represented in all parts of the brain and are heavily concentrated in the cerebral vessels. IGF-1 is involved in neuro-, angiogenesis, in the stimulation of cell proliferation, and repair responses to damage for both the central and peripheral nervous system. IGF- 1 exerts antioxidant, anti-inflammatory and protective effects on the CNS. The review discusses the importance and the role of IGF-I in vascular diseases of the brain, in particular, aneurysms, the ischemic stroke, the aneurysmal subarachnoid hemorrhage, as well as neuroprotection.
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Ock S, Lee WS, Ahn J, Kim HM, Kang H, Kim HS, Jo D, Abel ED, Lee TJ, Kim J. Deletion of IGF-1 Receptors in Cardiomyocytes Attenuates Cardiac Aging in Male Mice. Endocrinology 2016; 157:336-45. [PMID: 26469138 PMCID: PMC4701888 DOI: 10.1210/en.2015-1709] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
IGF-1 receptor (IGF-1R) signaling is implicated in cardiac hypertrophy and longevity. However, the role of IGF-1R in age-related cardiac remodeling is only partially understood. We therefore sought to determine whether the deletion of the IGF-1R in cardiomyocytes might delay the development of aging-associated myocardial pathologies by examining 2-year-old male cardiomyocyte-specific IGF-1R knockout (CIGF1RKO) mice. Aging was associated with the induction of IGF-1R expression in hearts. Cardiomyocytes hypertrophied with age in wild-type (WT) mice. In contrast, the cardiac hypertrophic response associated with aging was blunted in CIGF1RKO mice. Concomitantly, fibrosis was reduced in aged CIGF1RKO compared with aged WT hearts. Expression of proinflammatory cytokines such as IL-1α, IL-1β, IL-6, and receptor activator of nuclear factor-κB ligand was increased in aged WT hearts, but this increase was attenuated in aged CIGF1RKO hearts. Phosphorylation of Akt was increased in aged WT, but not in aged CIGF1RKO, hearts. In cultured cardiomyocytes, IGF-1 induced senescence as demonstrated by increased senescence-associated β-galactosidase staining, and a phosphoinositide 3-kinase inhibitor inhibited this effect. Furthermore, inhibition of phosphoinositide 3-kinase significantly prevented the increase in IL-1α, IL-1β, receptor activator of nuclear factor-κB ligand, and p21 protein expression by IGF-1. These data reveal an essential role for the IGF-1-IGF-1R-Akt pathway in mediating cardiomyocyte senescence.
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MESH Headings
- Aging
- Animals
- Biomarkers/metabolism
- Cardiomegaly/immunology
- Cardiomegaly/metabolism
- Cardiomegaly/pathology
- Cardiomegaly/prevention & control
- Cells, Cultured
- Cellular Senescence/drug effects
- Cytokines/antagonists & inhibitors
- Cytokines/genetics
- Cytokines/metabolism
- Enzyme Inhibitors/pharmacology
- Fibrosis
- Gene Expression Regulation, Developmental/drug effects
- Heart Ventricles/drug effects
- Heart Ventricles/immunology
- Heart Ventricles/metabolism
- Heart Ventricles/pathology
- Insulin-Like Growth Factor I/metabolism
- Male
- Mice, Inbred C57BL
- Mice, Knockout
- Myocytes, Cardiac/drug effects
- Myocytes, Cardiac/immunology
- Myocytes, Cardiac/metabolism
- Myocytes, Cardiac/pathology
- Phosphatidylinositol 3-Kinase/metabolism
- Phosphoinositide-3 Kinase Inhibitors
- Phosphorylation/drug effects
- Protein Processing, Post-Translational/drug effects
- Proto-Oncogene Proteins c-akt/metabolism
- Receptor, IGF Type 1/agonists
- Receptor, IGF Type 1/genetics
- Receptor, IGF Type 1/metabolism
- Signal Transduction/drug effects
- Ventricular Remodeling/drug effects
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Affiliation(s)
- Sangmi Ock
- Division of Endocrinology and Metabolism (S.O., J.A., H.M.K., J.K.), Department of Internal Medicine, Division of Cardiology (W.S.L.), Department of Internal Medicine, and Departments of Anesthesiology (H.K.) and Pathology (T.J.L.), College of Medicine, Chung-Ang University, Seoul, 156-755, Korea; Department of Biochemistry (H.-S.K.), College of Medicine, The Catholic University of Korea, Seoul, 110-758, Korea; Department of Surgery (D.J.), Vanderbilt University School of Medicine, Nashville, Tennessee 37232; and Fraternal Order of Eagles Diabetes Research Center and Division of Endocrinology and Metabolism (D.A.), University of Iowa Carver College of Medicine, Iowa City, Iowa 52242
| | - Wang Soo Lee
- Division of Endocrinology and Metabolism (S.O., J.A., H.M.K., J.K.), Department of Internal Medicine, Division of Cardiology (W.S.L.), Department of Internal Medicine, and Departments of Anesthesiology (H.K.) and Pathology (T.J.L.), College of Medicine, Chung-Ang University, Seoul, 156-755, Korea; Department of Biochemistry (H.-S.K.), College of Medicine, The Catholic University of Korea, Seoul, 110-758, Korea; Department of Surgery (D.J.), Vanderbilt University School of Medicine, Nashville, Tennessee 37232; and Fraternal Order of Eagles Diabetes Research Center and Division of Endocrinology and Metabolism (D.A.), University of Iowa Carver College of Medicine, Iowa City, Iowa 52242
| | - Jihyun Ahn
- Division of Endocrinology and Metabolism (S.O., J.A., H.M.K., J.K.), Department of Internal Medicine, Division of Cardiology (W.S.L.), Department of Internal Medicine, and Departments of Anesthesiology (H.K.) and Pathology (T.J.L.), College of Medicine, Chung-Ang University, Seoul, 156-755, Korea; Department of Biochemistry (H.-S.K.), College of Medicine, The Catholic University of Korea, Seoul, 110-758, Korea; Department of Surgery (D.J.), Vanderbilt University School of Medicine, Nashville, Tennessee 37232; and Fraternal Order of Eagles Diabetes Research Center and Division of Endocrinology and Metabolism (D.A.), University of Iowa Carver College of Medicine, Iowa City, Iowa 52242
| | - Hyun Min Kim
- Division of Endocrinology and Metabolism (S.O., J.A., H.M.K., J.K.), Department of Internal Medicine, Division of Cardiology (W.S.L.), Department of Internal Medicine, and Departments of Anesthesiology (H.K.) and Pathology (T.J.L.), College of Medicine, Chung-Ang University, Seoul, 156-755, Korea; Department of Biochemistry (H.-S.K.), College of Medicine, The Catholic University of Korea, Seoul, 110-758, Korea; Department of Surgery (D.J.), Vanderbilt University School of Medicine, Nashville, Tennessee 37232; and Fraternal Order of Eagles Diabetes Research Center and Division of Endocrinology and Metabolism (D.A.), University of Iowa Carver College of Medicine, Iowa City, Iowa 52242
| | - Hyun Kang
- Division of Endocrinology and Metabolism (S.O., J.A., H.M.K., J.K.), Department of Internal Medicine, Division of Cardiology (W.S.L.), Department of Internal Medicine, and Departments of Anesthesiology (H.K.) and Pathology (T.J.L.), College of Medicine, Chung-Ang University, Seoul, 156-755, Korea; Department of Biochemistry (H.-S.K.), College of Medicine, The Catholic University of Korea, Seoul, 110-758, Korea; Department of Surgery (D.J.), Vanderbilt University School of Medicine, Nashville, Tennessee 37232; and Fraternal Order of Eagles Diabetes Research Center and Division of Endocrinology and Metabolism (D.A.), University of Iowa Carver College of Medicine, Iowa City, Iowa 52242
| | - Ho-Shik Kim
- Division of Endocrinology and Metabolism (S.O., J.A., H.M.K., J.K.), Department of Internal Medicine, Division of Cardiology (W.S.L.), Department of Internal Medicine, and Departments of Anesthesiology (H.K.) and Pathology (T.J.L.), College of Medicine, Chung-Ang University, Seoul, 156-755, Korea; Department of Biochemistry (H.-S.K.), College of Medicine, The Catholic University of Korea, Seoul, 110-758, Korea; Department of Surgery (D.J.), Vanderbilt University School of Medicine, Nashville, Tennessee 37232; and Fraternal Order of Eagles Diabetes Research Center and Division of Endocrinology and Metabolism (D.A.), University of Iowa Carver College of Medicine, Iowa City, Iowa 52242
| | - Daewoong Jo
- Division of Endocrinology and Metabolism (S.O., J.A., H.M.K., J.K.), Department of Internal Medicine, Division of Cardiology (W.S.L.), Department of Internal Medicine, and Departments of Anesthesiology (H.K.) and Pathology (T.J.L.), College of Medicine, Chung-Ang University, Seoul, 156-755, Korea; Department of Biochemistry (H.-S.K.), College of Medicine, The Catholic University of Korea, Seoul, 110-758, Korea; Department of Surgery (D.J.), Vanderbilt University School of Medicine, Nashville, Tennessee 37232; and Fraternal Order of Eagles Diabetes Research Center and Division of Endocrinology and Metabolism (D.A.), University of Iowa Carver College of Medicine, Iowa City, Iowa 52242
| | - E Dale Abel
- Division of Endocrinology and Metabolism (S.O., J.A., H.M.K., J.K.), Department of Internal Medicine, Division of Cardiology (W.S.L.), Department of Internal Medicine, and Departments of Anesthesiology (H.K.) and Pathology (T.J.L.), College of Medicine, Chung-Ang University, Seoul, 156-755, Korea; Department of Biochemistry (H.-S.K.), College of Medicine, The Catholic University of Korea, Seoul, 110-758, Korea; Department of Surgery (D.J.), Vanderbilt University School of Medicine, Nashville, Tennessee 37232; and Fraternal Order of Eagles Diabetes Research Center and Division of Endocrinology and Metabolism (D.A.), University of Iowa Carver College of Medicine, Iowa City, Iowa 52242
| | - Tae Jin Lee
- Division of Endocrinology and Metabolism (S.O., J.A., H.M.K., J.K.), Department of Internal Medicine, Division of Cardiology (W.S.L.), Department of Internal Medicine, and Departments of Anesthesiology (H.K.) and Pathology (T.J.L.), College of Medicine, Chung-Ang University, Seoul, 156-755, Korea; Department of Biochemistry (H.-S.K.), College of Medicine, The Catholic University of Korea, Seoul, 110-758, Korea; Department of Surgery (D.J.), Vanderbilt University School of Medicine, Nashville, Tennessee 37232; and Fraternal Order of Eagles Diabetes Research Center and Division of Endocrinology and Metabolism (D.A.), University of Iowa Carver College of Medicine, Iowa City, Iowa 52242
| | - Jaetaek Kim
- Division of Endocrinology and Metabolism (S.O., J.A., H.M.K., J.K.), Department of Internal Medicine, Division of Cardiology (W.S.L.), Department of Internal Medicine, and Departments of Anesthesiology (H.K.) and Pathology (T.J.L.), College of Medicine, Chung-Ang University, Seoul, 156-755, Korea; Department of Biochemistry (H.-S.K.), College of Medicine, The Catholic University of Korea, Seoul, 110-758, Korea; Department of Surgery (D.J.), Vanderbilt University School of Medicine, Nashville, Tennessee 37232; and Fraternal Order of Eagles Diabetes Research Center and Division of Endocrinology and Metabolism (D.A.), University of Iowa Carver College of Medicine, Iowa City, Iowa 52242
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38
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Córdova C, Boullosa DA, Custódio MR, Quaglia LA, Santos SN, Freitas WM, Sposito AC, Nóbrega OT. Atheroprotective Properties of Serum IGF-1 in the Carotid and Coronary Territories and Beneficial Role on the Physical Fitness of the Oldest Old. J Gerontol A Biol Sci Med Sci 2015; 71:1281-8. [DOI: 10.1093/gerona/glv216] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 11/09/2015] [Indexed: 12/21/2022] Open
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Desai NA, Patel SS. Increased insulin-like growth factor-1 in relation to cardiovascular function in polycystic ovary syndrome: friend or foe? Gynecol Endocrinol 2015; 31:801-7. [PMID: 26288196 DOI: 10.3109/09513590.2015.1075497] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The incidence of cardiovascular disease (CVD) in patients with polycystic ovary syndrome (PCOS) is very high and conventional risk factors only partially explain excessive risk of developing CVD in patients of PCOS. The pathophysiology of PCOS is very unique, and several hormonal and metabolic changes occur. Several observations suggest that serum IGF-1 levels decrease in insulin resistance, which results in IGF-1 deficiency. In patient of PCOS, close relationships have been demonstrated between insulin resistance and serum IGF-1 levels. Hyperinsulinemic insulin resistance results in a general augmentation of steroidogenesis and LH release in PCOS. The action of IGF-1 varies in different tissues possibly via autocrine or paracrine mechanisms. The increase or decrease in IGF-1 in different tissues results in differential outcomes. Several studies suggest that lowered circulating IGF-1 levels play important role in the initiation of the cardiac hypertrophic response which results in the risk of cardiovascular disease. While recent results suggests that individual with elevated IGF-1 is protected against cardiovascular disease. Thus IGF-1 shows versatile pleiotropic actions. This review provides a current perspective on increased level of IGF-1 in PCOS and also adds to the current controversy regarding the roles of IGF-1 in cardiovascular disease.
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Affiliation(s)
- Namrata Ajaykumar Desai
- a Department of Pharmacology , Institute of Pharmacy, Nirma University , Ahmedabad , Gujarat , India
| | - Snehal S Patel
- a Department of Pharmacology , Institute of Pharmacy, Nirma University , Ahmedabad , Gujarat , India
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Frysak Z, Schovanek J, Iacobone M, Karasek D. Insulin-like Growth Factors in a clinical setting: Review of IGF-I. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2015; 159:347-51. [PMID: 26365932 DOI: 10.5507/bp.2015.041] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 07/28/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND AIMS Interest in growth hormone (GH) is inextricably linked to the need for in depth understanding of the somatomedins (insulin-like growth factors) which are polypeptides structurally similar to insulin and with broad physiological activity. To date, the most commonly known is Insulin-Like Growth Factor I (IGF-I). Despite considerable current knowledge of IGF-I, however, its bioactivity is incompletely understood. Measurement of IGF-I is of the utmost importance in the diagnosis and treatment of, for example acromegaly and growth hormone deficiency. The development of recombinant IGF-I, has allowed its use in such cases. Clinical practice, however, shows that few young/adult patients will benefit from treatment with the rIGF-I, mecasermin, given the number of adverse effects found. This review focuses on current knowledge mainly related to IGF-I and the use of its recombinant form (rIGF-I) in clinical practice. Several functions of IGI-II have been elucidated but their clinical significance is unclear.
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Affiliation(s)
- Zdenek Frysak
- Department of Internal Medicine III-Nephrology, Rheumatology and Endocrinology, University Hospital and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic, I.P.Pavlova 6 - 779 00, - Olomouc, Czech Republic
| | - Jan Schovanek
- Department of Internal Medicine III-Nephrology, Rheumatology and Endocrinology, University Hospital and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic, I.P.Pavlova 6 - 779 00, - Olomouc, Czech Republic
| | - Maurizio Iacobone
- Minimally Invasive Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy, Via Giustiniani 2 - 35128 - Padova, Italy
| | - David Karasek
- Department of Internal Medicine III-Nephrology, Rheumatology and Endocrinology, University Hospital and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic, I.P.Pavlova 6 - 779 00, - Olomouc, Czech Republic
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van Varsseveld NC, van Bunderen CC, Sohl E, Comijs HC, Penninx BWJH, Lips P, Drent ML. Serum insulin-like growth factor 1 and late-life depression: a population-based study. Psychoneuroendocrinology 2015; 54:31-40. [PMID: 25678185 DOI: 10.1016/j.psyneuen.2015.01.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 12/22/2014] [Accepted: 01/20/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Serum insulin-like growth factor 1 (IGF-1) concentration decreases, while the prevalence of depressive symptoms increases with advancing age. Although basic research indicates a link between low IGF-1 concentration and depression, this has scarcely been investigated in humans. This study investigates whether lower IGF-1 concentrations are associated with prevalent and incident late-life depression over a 3-year period. METHODS The study included 1188 participants, aged ≥ 65 years, from the Longitudinal Aging Study Amsterdam (LASA), an ongoing, population-based cohort study. Depression was assessed at baseline and after three years using the Center for Epidemiological Studies-Depression Scale (CES-D) and the Diagnostic Interview Schedule (DIS), and categorized into minor depression and major depression (MDD). Serum IGF-1 concentration was determined at baseline. Associations were adjusted for relevant confounders. RESULTS Serum IGF-1 concentrations were within the normal range (mean 13.9 nmol/l, standard deviation 5.3 nmol/l). At baseline, in men, as compared to high concentrations, mid concentrations decreased the probability of prevalent minor depression (odds ratio [OR] = 0.35, 95% confidence interval [CI] = 0.15-0.82). In women, as compared to high concentrations, low concentrations tended to increase the probability of prevalent MDD (OR = 2.66, 95% CI = 0.89-7.89). At three-year follow-up, in men, no significant prospective associations were detected. In women, as compared to high concentrations, mid concentrations decreased the probability of incident minor depression (OR = 0.43, 95% CI = 0.19-0.95). CONCLUSIONS Several associations, which differed across the genders, were observed between IGF-1 and depression. Cross-sectional findings were not supported by longitudinal findings, which suggest that IGF-1 may not play an important predictive role in the development of depression in older persons over time. However, a more acute role of IGF-1 in current depression, as indicated by the cross-sectional results, may be possible. Further studies are needed to elucidate the complex relation between IGF-1 and late-life depression.
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Affiliation(s)
- N C van Varsseveld
- Department of Internal Medicine, Endocrine Section, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - C C van Bunderen
- Department of Internal Medicine, Endocrine Section, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - E Sohl
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - H C Comijs
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, The Netherlands
| | - B W J H Penninx
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, The Netherlands
| | - P Lips
- Department of Internal Medicine, Endocrine Section, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - M L Drent
- Department of Internal Medicine, Endocrine Section, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
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Ren J, Anversa P. The insulin-like growth factor I system: physiological and pathophysiological implication in cardiovascular diseases associated with metabolic syndrome. Biochem Pharmacol 2014; 93:409-17. [PMID: 25541285 DOI: 10.1016/j.bcp.2014.12.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 12/11/2014] [Accepted: 12/11/2014] [Indexed: 12/31/2022]
Abstract
Metabolic syndrome is a cluster of risk factors including obesity, dyslipidemia, hypertension, and insulin resistance. A number of theories have been speculated for the pathogenesis of metabolic syndrome including impaired glucose and lipid metabolism, lipotoxicity, oxidative stress, interrupted neurohormonal regulation and compromised intracellular Ca(2+) handling. Recent evidence has revealed that adults with severe growth hormone (GH) and insulin-like growth factor I (IGF-1) deficiency such as Laron syndrome display increased risk of stroke and cardiovascular diseases. IGF-1 signaling may regulate contractility, metabolism, hypertrophy, apoptosis, autophagy, stem cell regeneration and senescence in the heart to maintain cardiac homeostasis. An inverse relationship between plasma IGF-1 levels and prevalence of metabolic syndrome as well as associated cardiovascular complications has been identified, suggesting the clinical promises of IGF-1 analogues or IGF-1 receptor activation in the management of metabolic and cardiovascular diseases. However, the underlying pathophysiological mechanisms between IGF-1 and metabolic syndrome are still poorly understood. This mini-review will discuss the role of IGF-1 signaling cascade in the prevalence of metabolic syndrome in particular the susceptibility to overnutrition and sedentary life style-induced obesity, dyslipidemia, insulin resistance and other features of metabolic syndrome. Special attention will be dedicated in IGF-1-associated changes in cardiac responses in various metabolic syndrome components such as insulin resistance, obesity, hypertension and dyslipidemia. The potential risk of IGF-1 and IGF-1R stimulation such as tumorigenesis is discussed. Therapeutic promises of IGF-1 and IGF-1 analogues including mecasermin, mecasermin rinfabate and PEGylated IGF-1 will be discussed.
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Affiliation(s)
- Jun Ren
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Center for Cardiovascular Research and Alternative Medicine, University of Wyoming College of Health Sciences, Laramie, WY 82071, USA.
| | - Piero Anversa
- Departments of Anesthesia and Medicine and Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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Carlzon D, Svensson J, Petzold M, Karlsson MK, Ljunggren Ö, Tivesten Å, Mellström D, Ohlsson C. Both low and high serum IGF-1 levels associate with increased risk of cardiovascular events in elderly men. J Clin Endocrinol Metab 2014; 99:E2308-16. [PMID: 25057875 PMCID: PMC4258605 DOI: 10.1210/jc.2014-1575] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Most previous prospective studies suggest that low serum IGF-1 associates with increased risk of cardiovascular disease (CVD) events whereas other studies suggest that high serum IGF-1 associates with increased risk of CVD events. OBJECTIVE We tested the hypothesis that not only low, but also high serum IGF-1 levels associate with increased risk of CVD events in elderly men. SETTING AND DESIGN Serum IGF-1 levels were measured in 2901 elderly men (age 69-81 years) included in the Swedish cohort of the prospective, population-based Osteoporotic Fractures in Men Study (MrOS), Sweden cohort. Data for CVD events were obtained from national Swedish registers with no loss of followup. RESULTS During followup (median, 5.1 y) 589 participants experienced a CVD event. The association between serum IGF-1 and risk of CVD events was nonlinear, and restricted cubic spline Cox regression analysis revealed a U-shaped association between serum IGF-1 levels and CVD events (P < .01 for nonlinearity). Low as well as high serum IGF-1 (quintile 1 or 5 vs quintiles 2-4) significantly associated with increased risk for CVD events (hazard ratio [HR] = 1.25, 95% confidence interval, [CI], 1.02-1.54; and HR = 1.35, 95% CI 1.10-1.66, respectively). These associations remained after adjustment for prevalent CVD and multiple risk factors. High serum IGF-1 associated with increased risk of coronary heart disease (CHD) events but not with risk of cerebrovascular events. CONCLUSIONS Both low and high serum IGF-1 levels are risk markers for CVD events in elderly men. The association between high serum IGF-1 and CVD events is mainly driven by CHD events.
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Affiliation(s)
- Daniel Carlzon
- Center for Bone and Arthritis Research (D.C., J.S., D.M., C.O.), Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Center for Applied Biostatistics (M.P.), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Clinical and Molecular Osteoporosis Research Unit (M.K.K.), Department of Orthopaedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Medical Sciences (Ö.L.), University of Uppsala, Uppsala, Sweden; and Wallenberg Laboratory for Cardiovascular Research (Å.T.), Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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ω-3 fatty acid differentially modulated serum levels of IGF1 and IGFBP3 in men with CVD: a randomized, double-blind placebo-controlled study. Nutrition 2014; 31:480-4. [PMID: 25701338 DOI: 10.1016/j.nut.2014.09.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 09/05/2014] [Accepted: 09/11/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Studies have reported elevated serum insulin-like growth factor (IGF)-1 levels followed by ω-3 supplementation in various groups. Considering decreased level of IGF1 in patients with cardiovascular disease (CVD) and protective effects of IGF1 against CVD progression and myocardial infarctions mortality, this study was performed with the aim of determining effects of ω-3 supplementation on serum levels and gene expression of IGF1 and IGF binding protein-3 (IGFBP3) in men with CVD. METHODS Sixty-two middle-aged (55.9 ± 6.5 y) non-obese men with CVD followed the study protocol in two groups of ω-3 (n = 31) or placebo (n = 31) supplementation. Participants took ω-3 supplement or placebo (edible paraffin) for 8 wk and were asked not to change their diet or physical activity plan. Anthropometric and lipid profile characteristics, serum IGF1, serum IGFBP3 and also IGF1 and IGFBP3 gene expression in peripheral blood mononuclear cells (PBMCs) were measured in all participants before and after the intervention. Statistical analyses were performed using SPSS software. RESULTS There were no significant differences between the two study groups in age and body mass index at baseline. The groups also had no difference in baseline serum low-density lipoprotein, high-density lipoprotein, very low-density lipoprotein, triacylglycerols, and IGF1. Compared with placebo, ω-3 supplementation increased serum IGF1 levels (P = 0.01), and decreased serum level of IGFBP3 (P = 0.02). There was a trending toward an increase in IGF1 expression and nonsignificant decrease in IGFBP3 expression. CONCLUSIONS ω-3 supplementation in patients with CVD increases serum IGF1 levels and decreases serum IGFBP3. Further research is warranted to investigate the underlying mechanisms.
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Holvik K, van Schoor NM, Eekhoff EMW, den Heijer M, Deeg DJH, Lips P, de Jongh R. Plasma osteocalcin levels as a predictor of cardiovascular disease in older men and women: a population-based cohort study. Eur J Endocrinol 2014; 171:161-70. [PMID: 24801588 DOI: 10.1530/eje-13-1044] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The role of osteocalcin (OC) in cardiovascular disease (CVD) is unresolved. We aimed to study the association between plasma OC concentrations and the risk of non-fatal and fatal CVDs. We also aimed to investigate whether such an association, if present, would be mediated by established metabolic risk factors. DESIGN A population-based longitudinal cohort study. METHODS In 1995/1996, OC was determined in blood samples drawn from 1319 subjects aged 65-88 years participating in the Longitudinal Aging Study Amsterdam in 1995/1996. The self-reported CVD events were collected every 3 years until 2005/2006, and CVD deaths until 1st January 2007. Cox proportional hazards regression was performed, considering potential confounders (smoking, physical activity, and BMI) and mediators (blood pressure, plasma triglycerides, total and HDL cholesterol, fructosamine, and aortic calcification). RESULTS During the median 4.1 years follow-up, 709 subjects (53.8%) suffered a CVD event. There was no overall association between OC and CVD: hazard ratio (HR) was 0.97 (95% CI 0.90-1.04) per nmol/l higher plasma OC, adjusted for age and sex. There was a statistical interaction between plasma OC, age, and sex on CVD (P=0.014). In those subjects aged ≥75 years, age-adjusted HRs (95% CI) were 0.86 (0.75-0.99) in men and 1.16 (1.03-1.31) in women per nmol/l higher plasma OC. Adjustment for covariates only slightly attenuated the association in older-old men, but did not affect the association in older-old women. CONCLUSION A higher plasma OC concentration was associated with a reduced risk of CVD in older-old men and with an increased risk of CVD in older-old women. We found no evidence that this was mediated by arterial calcification or metabolic risk factors.
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Affiliation(s)
- Kristin Holvik
- Division of EpidemiologyNorwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, NorwayDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care ResearchEndocrine SectionDepartment of Internal Medicine, VU University Medical Center, Amsterdam, The NetherlandsDivision of EpidemiologyNorwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, NorwayDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care ResearchEndocrine SectionDepartment of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Natasja M van Schoor
- Division of EpidemiologyNorwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, NorwayDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care ResearchEndocrine SectionDepartment of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Elisabeth M W Eekhoff
- Division of EpidemiologyNorwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, NorwayDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care ResearchEndocrine SectionDepartment of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Martin den Heijer
- Division of EpidemiologyNorwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, NorwayDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care ResearchEndocrine SectionDepartment of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Dorly J H Deeg
- Division of EpidemiologyNorwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, NorwayDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care ResearchEndocrine SectionDepartment of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Paul Lips
- Division of EpidemiologyNorwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, NorwayDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care ResearchEndocrine SectionDepartment of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Renate de Jongh
- Division of EpidemiologyNorwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, NorwayDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care ResearchEndocrine SectionDepartment of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
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van Bunderen CC, van Varsseveld NC, Erfurth EM, Ket JCF, Drent ML. Efficacy and safety of growth hormone treatment in adults with growth hormone deficiency: a systematic review of studies on morbidity. Clin Endocrinol (Oxf) 2014; 81:1-14. [PMID: 24750271 DOI: 10.1111/cen.12477] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 03/19/2014] [Accepted: 04/15/2014] [Indexed: 11/27/2022]
Abstract
Due to the positive effects demonstrated in randomized clinical trials on cardiovascular surrogate markers and bone metabolism, a positive effect of growth hormone (GH) treatment on clinically relevant end-points seems feasible. In this review, we discuss the long-term efficacy and safety of GH treatment in adult patients with growth hormone deficiency (GHD) with emphasis on morbidity: fatal and nonfatal cardiovascular disease (CVD) and stroke, fractures, fatal and nonfatal malignancies and recurrences, and diabetes mellitus. A positive effect of GH treatment on CVD and fracture risk could be concluded, but study design limitations have to be considered. Stroke and secondary brain tumours remained more prevalent. However, other contributing factors have to be taken into account. Regrowth and recurrences of (peri)pituitary tumours were not increased in patients with GH treatment compared to similar patients without GH treatment. All fatal and nonfatal malignancies were not more prevalent in GH-treated adults compared to the general population. However, follow-up time is still relatively short. The studies on diabetes are difficult to interpret, and more evidence is awaited. In clinical practice, a more individualized assessment seems appropriate, taking into consideration the underlying diagnosis of GHD, other treatment regimens, metabolic profile and the additional beneficial effects of GH set against the possible risks. Large and thoroughly conducted observational studies are needed and seem the only feasible way to inform the ongoing debate on health care costs, drug safety and clinical outcomes.
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Affiliation(s)
- Christa C van Bunderen
- Section of Endocrinology, Department of Internal Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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Yeap BB, Flicker L. Hormones and Cardiovascular Disease in Older Men. J Am Med Dir Assoc 2014; 15:326-33. [DOI: 10.1016/j.jamda.2013.12.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 12/03/2013] [Indexed: 12/29/2022]
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Dong X, Chang G, Ji XF, Tao DB, Wang YX. The relationship between serum insulin-like growth factor I levels and ischemic stroke risk. PLoS One 2014; 9:e94845. [PMID: 24728374 PMCID: PMC3984250 DOI: 10.1371/journal.pone.0094845] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 03/20/2014] [Indexed: 12/17/2022] Open
Abstract
Objective The aim of the study was to assess the relationship between insulin-like growth factor I (IGF-I) serum levels and acute ischemic stroke (AIS) in a Chinese population. Methods All consecutive patients with first-ever AIS from August 1, 2011 to July 31, 2013 were recruited to participate in the study. The control group comprised 200 subjects matched for age, gender, and conventional vascular risk factors. IGF-I serum levels were determined by chemiluminescence immunoassay. The National Institutes of Health Stroke Scale (NIHSS) score was assessed on admission blinded to serum IGF-I levels. Results The median serum IGF-1 levels were significantly (P = 0.011) lower in AIS patients (129; IQR, 109–153 ng/mL) compared with control cases (140; IQR, 125–159 ng/mL). We found that an increased risk of AIS was associated with IGF-I levels ≤135 ng/mL (unadjusted OR: 4.17; 95% CI: 2.52–6.89; P = 0.000). This relationship was confirmed in the dose-response model. In multivariate analysis, there was still an increased risk of AIS associated with IGF-I levels ≤135 ng/mL (OR: 2.16; 95% CI:1.33–3.52; P = 0.002) after adjusting for possible confounders. Conclusion Lower IGF-I levels are significantly related to risk of stroke, independent from other traditional and emerging risk factors, suggesting that they may play a role in the pathogenesis of AIS. Thus, strokes were more likely to occur in patients with low serum IGF-I levels in the Chinese population; further, post-ischemic IGF-I therapy may be beneficial for stroke.
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Affiliation(s)
- Xiang Dong
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, P.R. China
- * E-mail:
| | - Geng Chang
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, P.R. China
| | - Xiao-Fei Ji
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, P.R. China
| | - Ding-Bo Tao
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, P.R. China
| | - Ying-Xin Wang
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, P.R. China
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Proinsulin and IGFBP-1 predicts mortality in an elderly population. Int J Cardiol 2014; 174:260-7. [PMID: 24794551 DOI: 10.1016/j.ijcard.2014.03.171] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 02/26/2014] [Accepted: 03/26/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND High IGFBP-1 in elderly subjects is related to all-cause and cardiovascular (CV) mortality. We studied the relation of IGFBP-1 to cardiometabolic risk factors and cardiovascular and all-cause mortality, and also the impact of proinsulin and insulin on this association in an unselected elderly primary health care population. HYPOTHESIS Our hypothesis was that proinsulin and insulin may have an impact on the association of high IGFBP-1 levels with all-cause and CV-mortality in elderly. DESIGN, SETTING AND PARTICIPANTS A cross-sectional and prospective study was carried out in a rural Swedish population. 851 persons aged 66-81 years were evaluated by medical history, clinical examination, electrocardiography, echocardiography, and fasting plasma samples, and were followed prospectively for up to 12 years. RESULTS At baseline, in a multivariate analysis, IGFBP-1 was associated with gender, N-terminal proBNP (NT pro-BNP), blood glucose, body mass index (BMI), insulin and proinsulin, estimated glomerular filtration rate (eGFR) and haemoglobin (Hb). During the follow-up period there were 230 deaths (27%), of which 134 (16%) were due to CV mortality. When divided into tertiles there was a significant difference for CV mortality and all-cause mortality between tertiles of IGFBP-1 and proinsulin. For insulin there was a significant difference only for all-cause mortality. After adjustment for well-known risks factors, proinsulin and IGFBP-1 had significant impact on all-cause mortality but only proinsulin on CV mortality. CONCLUSION Only proinsulin is an independent predictor for both all-cause mortality and CV mortality when comparing IGFBP-1, insulin, and proinsulin as prognostic biomarkers for CV and all-cause mortality in an elderly population.
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