title: Decline in circulating insulin-like growth factors and mortality in older adults: cardiovascular health study all-stars study.
abstract: BACKGROUND
  The association between changes in IGF-I and IGF binding protein (IGFBP) levels and mortality in older adults is unknown.
  
  
  METHODS
  Participants were 997 persons 77 to 100 yr old enrolled in the Cardiovascular Health Study All Stars Study. Plasma levels of IGF-I, IGFBP-1, and IGFBP-3 were assessed at two study examinations (1996-1997 and 2005-2006). Mortality was assessed between 2006 and 2010.
  
  
  RESULTS
  Cumulative mortality (CM) was similar among individuals who had at least 10% decreases over time in IGF-I levels (CM = 29.6%), individuals who had at least 10% increases over time in IGF-I levels (CM = 24.7%), and individuals who had IGF-I levels remaining within ±10% over time (CM = 23.5%). Adjusted for age, sex, race, diabetes, body mass index, creatinine, albumin, and C-reactive protein, decreasing IGF-I level had no significant association with overall cancer mortality or noncancer mortality. Levels of IGFBP-1 increased markedly over time by 38% (median). Individuals with the largest increases in IGFBP-1 level over time had significantly increased risk of mortality. The adjusted hazard ratio per sd of IGFBP-1 change was 1.40 for overall cancer mortality (95% confidence interval = 1.10, 1.77; P = 0.01) and 1.14 for noncancer mortality (95% confidence interval = 1.02, 1.27; P = 0.02). Changes in IGFBP-3 levels were not significantly associated with mortality.
  
  
  CONCLUSIONS
  Among older adults, decreasing IGF-I level over time does not predict subsequent all-cause mortality, whereas increasing IGFBP-1 predicts increased risk of mortality.
authors.affiliation: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York 10461, USA. robert.kaplan@einstein.yu.edu
authors.forename: Robert C
authors.initials: RC
authors.lastname: Kaplan
authors.forename: Petra
authors.initials: P
authors.lastname: Bùzková
authors.forename: Anne R
authors.initials: AR
authors.lastname: Cappola
authors.forename: Howard D
authors.initials: HD
authors.lastname: Strickler
authors.forename: Aileen P
authors.initials: AP
authors.lastname: McGinn
authors.forename: Laina D
authors.initials: LD
authors.lastname: Mercer
authors.forename: Alice M
authors.initials: AM
authors.lastname: Arnold
authors.forename: Michael N
authors.initials: MN
authors.lastname: Pollak
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044383:Black People / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000097:blood* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood*; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality / Q000639:trends; D011237:Predictive Value of Tests; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data
chemical_list: C032231:IGFBP1 protein, human; C515497:IGFBP3 protein, human; D018970:Insulin-Like Growth Factor Binding Protein 1; D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I