title: Serum insulin-like growth factor-I level is independently associated with coronary artery disease progression in young male survivors of myocardial infarction: beneficial effects of bezafibrate treatment.
abstract: OBJECTIVE
  We investigated whether the effect of bezafibrate on progression of coronary atherosclerosis in the BEzafibrate Coronary Atherosclerosis Intervention Trial (BECAIT) was related to insulin-like growth factor (IGF)-I and glucose-insulin homeostasis.
  
  
  BACKGROUND
  BECAIT, the first double-blind, placebo-controlled, randomized, serial angiographic trial of a fibrate compound, demonstrated that progression of focal coronary atherosclerosis in young patients after infarction could be retarded by bezafibrate treatment.
  
  
  METHODS
  The treatment effects on serum concentrations of IGF-I and insulin-like growth factor binding protein (IGFBP)-1, as well as on basal and postload glucose and insulin levels, were examined, and on-trial determinations were related to the angiographic outcome measurements.
  
  
  RESULTS
  Bezafibrate treatment resulted in a significant reduction of serum IGF-I levels, both at two and five years, and on-trial serum IGF-I levels were directly related to changes in both minimal lumen diameter (r = 0.25, p < 0.05) and mean segment diameter (r = 0.29, p < 0.05). In contrast, none of the available indexes of insulin resistance (homeostasis model assessment estimate, basal and postload plasma insulin concentrations and serum IGFBP-1 levels) were related to the angiographic changes, nor were they significantly affected by bezafibrate treatment. Multiple stepwise regression analysis showed that the relation between on-trial serum IGF-I level and coronary artery disease (CAD) progression was independent of baseline angiographic score, age, body mass index, serum lipoprotein and plasma fibrinogen concentrations and measures of glucose-insulin homeostasis.
  
  
  CONCLUSIONS
  IGF-I could be implicated in the progression of premature CAD, and a reduction of serum IGF-I concentration could account partly for the effect of bezafibrate on progression of focal coronary atherosclerosis.
authors.affiliation: Atherosclerosis Research Unit, King Gustaf V Research Institute, Karolinska Hospital, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Ruotolo
authors.forename: P
authors.initials: P
authors.lastname: Båvenholm
authors.forename: K
authors.initials: K
authors.lastname: Brismar
authors.forename: S
authors.initials: S
authors.lastname: Eféndic
authors.forename: C G
authors.initials: CG
authors.lastname: Ericsson
authors.forename: U
authors.initials: U
authors.lastname: de Faire
authors.forename: J
authors.initials: J
authors.lastname: Nilsson
authors.forename: A
authors.initials: A
authors.lastname: Hamsten
mesh_terms: D000328:Adult; D001629:Bezafibrate / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology; D018450:Disease Progression; D004311:Double-Blind Method; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008074:Lipoproteins / Q000097:blood; D008297:Male; D009203:Myocardial Infarction / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D000960:Hypolipidemic Agents; D018970:Insulin-Like Growth Factor Binding Protein 1; D008074:Lipoproteins; D007334:Insulin-Like Growth Factor I; D001629:Bezafibrate