Insulin-like growth factor axis (insulin-like growth factor-I/insulin-like growth factor-binding protein-3) as a prognostic predictor of heart failure: association with adiponectin

• Published in: European journal of heart failure Vol. 12; no. 11; pp. 1214 - 1222
• Main Authors: Watanabe, Shin, Tamura, Toshihiro, Ono, Koh, Horiuchi, Hisanori, Kimura, Takeshi, Kita, Toru, Furukawa, Yutaka
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.11.2010
• Subjects: Adiponectin; Adiponectin - physiology; Aged; Aged, 80 and over; Cardiac metabolism; Female; Heart failure; Heart Failure - blood; Heart Failure - mortality; Heart Failure - physiopathology; Humans; Insulin-Like Growth Factor Binding Protein 3 - analysis; Insulin-Like Growth Factor Binding Protein 3 - physiology; Insulin-Like Growth Factor I - analysis; Insulin-Like Growth Factor I - physiology; Insulin-like growth factor-I; Male; Middle Aged; Multivariate Analysis; Natriuretic Peptide, Brain - blood; Outcomes; Prognosis; Proportional Hazards Models
• ISSN: 1388-9842; 1879-0844; 1879-0844
• DOI: 10.1093/eurjhf/hfq166

Aims Insulin‐like growth factor (IGF)‐I is a regulator of glucose/fatty acid metabolism and may be involved in the pathophysiology of cardiovascular disease, but it remains unclear whether endogenous IGF‐I is associated with the prognosis of heart failure (HF). We investigated whether the IGF axis, the ratio of IGF‐I to IGF‐binding protein‐3 (IGFBP‐3), was a predictor of clinical outcomes in HF. The association of IGF axis with serum adiponectin level, a prognostic marker of HF as well as a regulator of glucose/fatty acid metabolism, was also analysed. Methods and results We measured serum IGF‐I and IGFBP‐3 in 142 HF patients with left ventricular systolic dysfunction and 63 control subjects. Patients with HF underwent clinical assessment and measurement of adiponectin and B‐type natriuretic peptide (BNP). Compared with controls, HF patients showed significantly decreased serum IGF axis values [median (inter‐quartile ranges), 0.114 (0.063–0.150) vs. 0.099 (0.052–0.158), P = 0.042]. In HF patients, the log‐transformed IGF axis values were inversely correlated with the log‐transformed serum adiponectin levels (r = −0.35, P < 0.0001) and plasma BNP levels (r = −0.25, P = 0.0028). The IGF axis was lower in patients with New York Heart Association (NYHA) functional class III/IV than those with class I/II [0.071 (0.044–0.145) vs. 0.107 (0.068–0.161), P = 0.022]. Furthermore, a decrease in IGF axis was associated with increased rates of all‐cause mortality (P = 0.013), cardiac death (P = 0.035), and a composite of cardiac death and re‐hospitalization (P = 0.0085). Conclusion Insulin‐like growth factor axis is a significant predictor of clinical outcomes in HF and is significantly associated with serum adiponectin levels.