Associations of insulin-like growth factor-I and its binding proteins and testosterone with frailty in older men

作者：Yeap B B^*; Chubb S A Paul; Lopez Derrick; Ho K K Y; Hankey Graeme J; Flicker Leon

来源：Clinical Endocrinology, 2013, 78(5): 752-759.

DOI：10.1111/cen.12052

Objective Ageing is associated with frailty and decreased anabolic hormones, insulin-like growth factor-I (IGF-I) and testo;?%26gt;sterone. We hypothesized that components of the IGF-I system, in conjunction with testosterone, modulate frailty risk in the elderly. We examined associations between IGF-I, its binding proteins IGFBP1 and IGFBP3 and testosterone with frailty in men. Design Observational study of 3 447 community-dwelling men aged 7089years assessed in 200104, with 1 654 reassessed in 200809. Methods Baseline total IGF-I, IGFBP1, IGFBP3 and testosterone were assayed. Frailty was assessed using the FRAIL scale, comprising 5 domains: fatigue; difficulty climbing stairs; difficulty walking %26gt;100m; %26gt;5 illnesses; weight loss %26gt;5%. Men with3 domains were considered frail. Results At baseline, 527 men (15 center dot 3%) were frail. Frail men had lower IGFBP3 (3 630ng/ml vs not frail: 3 800ng/ml, P%26lt;0 center dot 001) and comparable IGFBP1 (23 center dot 5 vs 21 center dot 5ng/ml, P=0 center dot 09). In multivariate analyses, higher IGFBP1 was associated with increased prevalence of frailty (highest vs lowest quartile Q4:Q1, adjusted odds ratio [OR]=1 center dot 39, 95% CI=1 center dot 031 center dot 88). New-onset frailty arose in 260 (17 center dot 5%) of 1484 men. Lower baseline IGF-I predicted new-onset frailty (Q1:Q4 OR=1 center dot 48, 95% CI=1 center dot 002 center dot 20) as did higher IGFBP1 (Q4:Q1 OR=1 center dot 59, 95% CI=1 center dot 012 center dot 50). Men with both IGF-I and free testosterone in Q1 had greater odds of prevalent frailty (OR=2 center dot 13, 95% CI=1 center dot 542 center dot 95). Conclusions Older men with higher IGFBP1 level, or both lower IGF-I and testosterone, are more likely to be frail, while those with lower IGF-I and higher IGFBP1 are more likely to become frail. Components of the IGF-I system may be biomarkers or independent predictors of frailty.

• 出版日期2013-5