Effects of exercise training on insulin-like growth factor-I expression in the skeletal muscle of non-cachectic patients with chronic heart failure.
BACKGROUND
Chronic heart failure (CHF) is associated with progressive muscle atrophy and reduced local expression of insulin-like growth factor I (IGF-I).


METHODS
The present study was designed to test the hypothesis that the local deficiency of IGF-I in the skeletal muscle of patients with CHF would respond to a 6-months aerobic training intervention. Therefore, 18 patients [mean age 52.4 (SD 4.8) years, left ventricular ejection function (LVEF) 27 (SD 6)%] were prospectively randomized to either 6 months of training or sedentary lifestyle.


METHODS
Serum levels of growth hormone (GH) were measured by immunofluorometric assay, IGF-I by competitive solid phase immunoassay. IGF-I expression was assessed in vastus lateralis biopsies by real-time PCR.


RESULTS
Exercise training led to a significant increase in peak oxygen uptake by 26% [from 20.3 (SD 3.3) ml/kg per min to 25.5 (SD 5.7) ml/kg per min, P=0.003 versus control]. Local expression of IGF-I increased significantly after exercise training by 81% [from 6.3 (SE 0.8) to 11.4 (SE 1.4) relative units, P=0.007 versus control] while IGF-I receptor expression was reduced by 33% [from 20.0 (SE 2.1) to 13.8 (SE 1.7) relative units, P=0.008 versus control]. Serum growth hormone (GH) rose modestly from 0.12 (SE 0.07) to 0.65 (SE 0.37) ng/ml in the training group (P=0.043 versus baseline), however, this change was not significant compared to the control group (P=0.848). IGF-I serum levels remained virtually unchanged.


CONCLUSIONS
Exercise training improves local IGF-I expression without significant changes of systemic parameters of the GH/IGF-I axis. These findings indicate that exercise training has the therapeutic potential to attenuate peripheral skeletal muscle alterations in particular with respect to local IGF-I expression in patients with moderate CHF.
Hambrecht
Rainer
R
Heart Center, Department of Cardiology, University of Leipzig, Germany. hamr@medizin.uni-leipzig.de
Schulze
Paul Christian
PC
Gielen
Stephan
S
Linke
Axel
A
Möbius-Winkler
Sven
S
Erbs
Sandra
S
Kratzsch
Jürgen
J
Schubert
Andreas
A
Adams
Volker
V
Schuler
Gerhard
G
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002100:Cachexia / Q000378:metabolism; D002352:Carrier Proteins / Q000378:metabolism; D002908:Chronic Disease; D015444:Exercise; D005080:Exercise Test; D013006:Growth Hormone / Q000378:metabolism; D006333:Heart Failure / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000378:metabolism; D007334:Insulin-Like Growth Factor I / Q000096:biosynthesis / Q000378:metabolism*; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000378:metabolism*; D010101:Oxygen Consumption; D011446:Prospective Studies; D017526:Receptor, IGF Type 1 / Q000378:metabolism; D013318:Stroke Volume; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D015415:Biomarkers; D002352:Carrier Proteins; D018972:Insulin-Like Growth Factor Binding Protein 3; D014409:Tumor Necrosis Factor-alpha; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D017526:Receptor, IGF Type 1; C051815:somatotropin-binding protein