title: Serum IGF1, metabolic syndrome, and incident cardiovascular disease in older people: a population-based study.
abstract: OBJECTIVE
  High as well as low levels of IGF1 have been associated with cardiovascular diseases (CVD). The relationship of IGF1 with (components of) the metabolic syndrome could help to clarify this controversy. The aims of this study were: i) to investigate the association of IGF1 concentration with prevalent (components of) the metabolic syndrome; and ii) to examine the role of (components of) the metabolic syndrome in the relationship between IGF1 and incident CVD during 11 years of follow-up.
  
  
  METHODS
  Data were used from the Longitudinal Aging Study Amsterdam, a cohort study in a representative sample of the Dutch older population (≥65 years). Data were available in 1258 subjects. Metabolic syndrome was determined using the definition of the US National Cholesterol Education Program Adult Treatment Panel III. CVD were ascertained by self-reports and mortality data.
  
  
  RESULTS
  Levels of IGF1 in the fourth quintile were associated with prevalent metabolic syndrome compared with the lowest quintile (odds ratio: 1.59, 95% confidence interval (CI) 1.09-2.33). The middle up to the highest quintile of IGF1 was positively associated with high triglycerides in women. Metabolic syndrome was not a mediator in the U-shaped relationship of IGF1 with CVD. Both subjects without the metabolic syndrome and low IGF1 levels (hazard ratio (HR) 1.75, 95% CI 1.12-2.71) and subjects with the metabolic syndrome and high IGF1 levels (HR 2.28, 95% CI 1.21-4.28) demonstrated increased risks of CVD.
  
  
  CONCLUSIONS
  In older people, high-normal IGF1 levels are associated with prevalent metabolic syndrome and high triglycerides. Furthermore, this study suggests the presence of different pathomechanisms for both low and high IGF1 levels and incident CVD.
authors.affiliation: Departments of Internal Medicine, section Endocrinology ZH 4A62, Amsterdam, The Netherlands. c.vanbunderen@vumc.nl
authors.forename: Christa C
authors.initials: CC
authors.lastname: van Bunderen
authors.forename: Mirjam M
authors.initials: MM
authors.lastname: Oosterwerff
authors.forename: Natasja M
authors.initials: NM
authors.lastname: van Schoor
authors.forename: Dorly J H
authors.initials: DJ
authors.lastname: Deeg
authors.forename: Paul
authors.initials: P
authors.lastname: Lips
authors.forename: Madeleine L
authors.initials: ML
authors.lastname: Drent
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015228:Hypertriglyceridemia / Q000453:epidemiology / Q000209:etiology; D015994:Incidence; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000503:physiopathology*; D009426:Netherlands / Q000453:epidemiology; D016016:Proportional Hazards Models; D057566:Self Report; D012727:Sex Characteristics; D014280:Triglycerides / Q000097:blood
chemical_list: D014280:Triglycerides; D007334:Insulin-Like Growth Factor I