title: IGF-I gene promoter polymorphism is a predictor of survival after myocardial infarction in patients with type 2 diabetes.
abstract: OBJECTIVE
  Previously we observed that non-carriers of the most common alleles of an IGF-I promoter polymorphism have low circulating IGF-I levels and an increased risk of developing myocardial infarction (MI), particularly in patients with type 2 diabetes.
  
  
  METHODS
  We investigated whether this IGF-I promoter polymorphism is associated with survival of type 2 diabetes in a Caucasian population aged 55 years and older.
  
  
  METHODS
  The study was embedded in the Rotterdam Study, a prospective population-based cohort study. At baseline, 668 patients with type 2 diabetes were diagnosed, among which, 55 incident MI were ascertained during follow-up. For the present study, we used two genotype groups: non-variant carriers (homozygous for 192, 194, or 192/194 bp genotypes), and variant carriers.
  
  
  RESULTS
  During a median follow-up of 8.8 years, 396 out of the 668 patients with type 2 diabetes (59.3%) died of various causes. The frequency of type 2 diabetes variant carrier and non-variant carriers was 28.7 and 71.3% respectively. The survival in patients with type 2 diabetes without an MI did not differ between the IGF-I genotype groups (hazard ratio (HR) = 0.8, 95% confidence interval (CI): 0.7-1.1, P = 0.1). In contrast, in those who developed an MI, variant carriers had a 2.4 times higher risk of mortality than non-variant carriers (95% CI: 1.2-4.8, P = 0.01).
  
  
  CONCLUSIONS
  Our study suggests that genetically determined low IGF-I activity is an important determinant of survival in patients with type 2 diabetes who developed an MI. The IGF-I promoter polymorphism, therefore, may help to predict the future mortality risk in this group of patients.
authors.affiliation: Department of Epidemiology and Biostatistics, Erasmus Medical Centre, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
authors.forename: Mojgan
authors.initials: M
authors.lastname: Yazdanpanah
authors.forename: Fakhredin A
authors.initials: FA
authors.lastname: Sayed-Tabatabaei
authors.forename: Joop A M J L
authors.initials: JA
authors.lastname: Janssen
authors.forename: Ingrid
authors.initials: I
authors.lastname: Rietveld
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Theo
authors.initials: T
authors.lastname: Stijnen
authors.forename: Huibert A P
authors.initials: HA
authors.lastname: Pols
authors.forename: Steven W J
authors.initials: SW
authors.lastname: Lamberts
authors.forename: Jacqueline C M
authors.initials: JC
authors.lastname: Witteman
authors.forename: Cornelia M
authors.initials: CM
authors.lastname: van Duijn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000235:genetics* / Q000401:mortality; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000235:genetics* / Q000401:mortality; D009426:Netherlands / Q000453:epidemiology; D011110:Polymorphism, Genetic / Q000235:genetics*; D011401:Promoter Regions, Genetic / Q000235:genetics*; D011446:Prospective Studies; D016019:Survival Analysis
chemical_list: D007334:Insulin-Like Growth Factor I