title: Sleep and insulin-like growth factors in the Cardiovascular Health Study.
abstract: OBJECTIVE
  Sleep and sleep disordered breathing (obstructive sleep apnea [OSA]) are known to affect the growth hormone/insulin-like growth factor (GH/IGF) axis. There are few relevant population studies in this area, particularly in the elderly. We conducted this study to investigate the relationship between sleep (architecture and OSA) and circulating IGF-I (insulin-like growth factor-1), IGFBP-1 (insulin-like growth factor binding protein-1), and IGFBP-3 (insulin-like growth factor binding protein-3) levels in an elderly population.
  
  
  METHODS
  Cross-sectional analysis of participants from the year 9 visit of the Cardiovascular Health Study (CHS) who were enrolled in the Sleep Heart Health Study (SHHS).
  
  
  METHODS
  1,233 elderly participants from the CHS and SHHS.
  
  
  RESULTS
  The mean age of males (n = 526) and females (n = 697) was 77 years. The mean value of IGF-I (ng/mL) in males was 112.4 vs. 97.1 in females (p < 0.01). Mean IGFBP-1 and IGFBP-3 levels were higher in females than males (p < 0.01). As expected, slow wave sleep was better preserved in females compared to males (22% total sleep time vs. 9% total sleep time, p < 0.01). Furthermore, as expected, OSA (apneahypopnea index [AHI] ≥ 5/h) was more prevalent in males compared to females (60% vs. 46%, p < 0.01). Multivariable linear regression was used to determine the relationship between objective sleep parameters and circulating IGF-I, IGFBP-1, and IGFBP-3 levels, with adjustment for age, sex, race, BMI, diabetes, estrogen use, progestin use, and physical activity. We did not detect a significant association between slow wave sleep (SWS) (per 5 min) and IGF-I, IGFBP-1, and IGFBP-3 levels (ng/mL). We found no significant linear association between OSA (AHI ≥ 5/h) and IGF-I, IGFBP-1, and IGFBP-3 levels. Gender-stratification of the entire cohort did not alter these findings. Sensitivity analyses excluding diabetics revealed that moderate OSA (AHI ≥ 5 and < 15) is inversely associated with IGFBP-3 levels in women. Conclusions The relationship between SWS and GH/IGF system is not significant in the elderly. Furthermore, OSA does not appear to adversely influence the GH/IGF axis, as reported in younger individuals. Whether our study findings are due to diminished GH/IGF-I axis activity in elderly needs further investigation by replication in other large population based elderly cohorts.
authors: Albert Einstein College of Medicine, Bronx, NY ; Montefiore Medical Center, Bronx, NY.
authors: Neomi
authors: N
authors: Shah
authors: Tom
authors: T
authors: Rice
authors: Daniel
authors: D
authors: Tracy
authors: Thomas
authors: T
authors: Rohan
authors: Petra
authors: P
authors: Bůžková
authors: Anne
authors: A
authors: Newman
authors: Robert C
authors: RC
authors: Kaplan
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment / Q000379:methods* / Q000706:statistics & numerical data; D006306:Health Surveys / Q000379:methods* / Q000706:statistics & numerical data; 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; D008297:Male; D017678:Sex Distribution; D012890:Sleep / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000453:epidemiology; D013002:Somatomedins / Q000378:metabolism*; D014481:United States / Q000453:epidemiology
chemical_list: D018970:Insulin-Like Growth Factor Binding Protein 1; D018972:Insulin-Like Growth Factor Binding Protein 3; D013002:Somatomedins; D007334:Insulin-Like Growth Factor I
keywords: GH/IGF axis; IGF; IGFBP-3; Insulin-like growth factors; elderly; sleep; sleep apnea; slow wave sleep