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.
OBJECTIVE
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.


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).


CONCLUSIONS
Insulin-like growth factor axis is a significant predictor of clinical outcomes in HF and is significantly associated with serum adiponectin levels.
Watanabe
Shin
S
Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Japan.
Tamura
Toshihiro
T
Ono
Koh
K
Horiuchi
Hisanori
H
Kimura
Takeshi
T
Kita
Toru
T
Furukawa
Yutaka
Y
D052242:Adiponectin / Q000502:physiology*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000032:analysis / Q000502:physiology*; D007334:Insulin-Like Growth Factor I / Q000032:analysis / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011379:Prognosis; D016016:Proportional Hazards Models
D052242:Adiponectin; D018972:Insulin-Like Growth Factor Binding Protein 3; D020097:Natriuretic Peptide, Brain; D007334:Insulin-Like Growth Factor I