title: Both low and high serum IGF-1 levels associate with increased risk of cardiovascular events in elderly men.
abstract: BACKGROUND
  Most previous prospective studies suggest that low serum IGF-1 associates with increased risk of cardiovascular disease (CVD) events whereas other studies suggest that high serum IGF-1 associates with increased risk of CVD events.
  
  
  OBJECTIVE
  We tested the hypothesis that not only low, but also high serum IGF-1 levels associate with increased risk of CVD events in elderly men.
  
  
  METHODS
  Serum IGF-1 levels were measured in 2901 elderly men (age 69-81 years) included in the Swedish cohort of the prospective, population-based Osteoporotic Fractures in Men Study (MrOS), Sweden cohort. Data for CVD events were obtained from national Swedish registers with no loss of followup.
  
  
  RESULTS
  During followup (median, 5.1 y) 589 participants experienced a CVD event. The association between serum IGF-1 and risk of CVD events was nonlinear, and restricted cubic spline Cox regression analysis revealed a U-shaped association between serum IGF-1 levels and CVD events (P < .01 for nonlinearity). Low as well as high serum IGF-1 (quintile 1 or 5 vs quintiles 2-4) significantly associated with increased risk for CVD events (hazard ratio [HR] = 1.25, 95% confidence interval, [CI], 1.02-1.54; and HR = 1.35, 95% CI 1.10-1.66, respectively). These associations remained after adjustment for prevalent CVD and multiple risk factors. High serum IGF-1 associated with increased risk of coronary heart disease (CHD) events but not with risk of cerebrovascular events.
  
  
  CONCLUSIONS
  Both low and high serum IGF-1 levels are risk markers for CVD events in elderly men. The association between high serum IGF-1 and CVD events is mainly driven by CHD events.
authors: Center for Bone and Arthritis Research (D.C., J.S., D.M., C.O.), Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Center for Applied Biostatistics (M.P.), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Clinical and Molecular Osteoporosis Research Unit (M.K.K.), Department of Orthopaedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Medical Sciences (Ö.L.), University of Uppsala, Uppsala, Sweden; and Wallenberg Laboratory for Cardiovascular Research (Å.T.), Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: Daniel
authors: D
authors: Carlzon
authors: Johan
authors: J
authors: Svensson
authors: Max
authors: M
authors: Petzold
authors: Magnus K
authors: MK
authors: Karlsson
authors: Östen
authors: Ö
authors: Ljunggren
authors: Åsa
authors: Å
authors: Tivesten
authors: Dan
authors: D
authors: Mellström
authors: Claes
authors: C
authors: Ohlsson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012042:Registries; D012306:Risk; D013548:Sweden
chemical_list: D007334:Insulin-Like Growth Factor I