Attenuated IGF-1 predicts all-cause and cardiovascular mortality in a Black population: a five-year prospective study
Date
2016Author
Schutte, Aletta E.
Conti, Elena
Mels, Catharina M.C.
Smith, Wayne
Kruger, Ruan
Botha, Shani
Huisman, Hugo W.
Metadata
Show full item recordAbstract
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
¼
0.50), but
tended to be higher in survivors upon adjustment for IGFBP-3 and covariates (
p
¼
0.061). Normotensives and hyper-
tensives (
p
¼
0.072), and those with carotid intima-media thickness
<
0.9 mm and
0.9 mm also displayed similar baseline
IGF-1 (
p
¼
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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- Faculty of Health Sciences [2404]