Decline in Circulating Insulin-Like Growth Factors and Mortality in Older Adults: Cardiovascular Health Study All-Stars Study

作者：Kaplan Robert C^*; Buzkova Petra; Cappola Anne R; Strickler Howard D; McGinn Aileen P; Mercer Laina D; Arnold Alice M; Pollak Michael N; Newman Anne B

来源：Journal of Clinical Endocrinology & Metabolism, 2012, 97(6): 1970-1976.

DOI：10.1210/jc.2011-2967

Background: The association between changes in IGF-I and IGF binding protein (IGFBP) levels and mortality in older adults is unknown.
Study Design: Participants were 997 persons 77 to 100 yr old enrolled in the Cardiovascular Health Study All Stars Study. Plasma levels of IGF-I, IGFBP-1, and IGFBP-3 were assessed at two study examinations (1996-1997 and 2005-2006). Mortality was assessed between 2006 and 2010.
Results: Cumulative mortality (CM) was similar among individuals who had at least 10% decreases over time in IGF-I levels (CM = 29.6%), individuals who had at least 10% increases over time in IGF-I levels (CM = 24.7%), and individuals who had IGF-I levels remaining within +/- 10% over time (CM = 23.5%). Adjusted for age, sex, race, diabetes, body mass index, creatinine, albumin, and C-reactive protein, decreasing IGF-I level had no significant association with overall cancer mortality or non-cancer mortality. Levels of IGFBP-1 increased markedly over time by 38%(median). Individuals with the largest increases in IGFBP-1 level over time had significantly increased risk of mortality. The adjusted hazard ratio per SD of IGFBP-1 change was 1.40 for overall cancer mortality (95% confidence interval = 1.10, 1.77; P = 0.01) and 1.14 for noncancer mortality (95% confidence interval = 1.02, 1.27; P = 0.02). Changes in IGFBP-3 levels were not significantly associated with mortality.
Conclusion: Among older adults, decreasing IGF-I level over time does not predict subsequent all-cause mortality, whereas increasing IGFBP-1 predicts increased risk of mortality. (J Clin Endocrinol Metab 97: 1970-1976, 2012)

• 出版日期2012-6