title: Attenuated IGF-1 predicts all-cause and cardiovascular mortality in a Black population: A five-year prospective study.
abstract: Inconsistent findings are reported on whether insulin-like growth factor-1 (IGF-1) is protective or harmful in predicting hypertension, carotid wall thickness and mortality. We determined the five-year prognostic value of IGF-1 for these outcomes in a large Black population prone to hypertension and cardiovascular disease.
  
  
  
  A longitudinal study as part of the PURE (Prospective Urban and Rural Epidemiology) study, North West Province, South Africa.
  
  
  
  We measured IGF-1 and IGF binding protein-3 (IGFBP-3) in 1038 HIV-uninfected participants (age range 32-94 years) and assessed blood pressure, carotid intima-media thickness and mortality.
  
  
  
  Over five years 116 deaths occurred. Baseline IGF-1 was similar in survivors and non-survivors (p = 0.50), but tended to be higher in survivors upon adjustment for IGFBP-3 and covariates (p = 0.061). Normotensives and hypertensives (p = 0.072), and those with carotid intima-media thickness < 0.9 mm and ≥ 0.9 mm also displayed similar baseline IGF-1 (p = 0.55). Multivariable-adjusted Cox-regression indicated high IGF-1 predicting lower risk for all-cause mortality (hazard ratio 0.45; 0.23-0.88) and cardiovascular mortality (hazard ratio 0.26; 0.08-0.83) when also adjusting for IGFBP-3. When including normo- and hypertensives at baseline, high IGF-1 was related to normotension at follow-up (hazard ratio 0.68; 0.49-0.95). We found no association with carotid intima-media thickness (hazard ratio 0.59; 0.31-1.14).
  
  
  
  In a Black South African population with low socio-economic status and harmful health behaviours, we found a protective independent association between IGF-1 and hypertension, cardiovascular and all-cause mortality, with no association with carotid wall thickness.
authors.affiliation: Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa Medical Research Council, Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa alta.schutte@nwu.ac.za.
authors.forename: Aletta E
authors.initials: AE
authors.lastname: Schutte
authors.affiliation: Department of Clinical and Molecular Medicine, University of Rome, Sapienza, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Conti
authors.affiliation: Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
authors.forename: Catharina Mc
authors.initials: CM
authors.lastname: Mels
authors.affiliation: Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
authors.forename: Wayne
authors.initials: W
authors.lastname: Smith
authors.affiliation: Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
authors.forename: Ruan
authors.initials: R
authors.lastname: Kruger
authors.affiliation: Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
authors.forename: Shani
authors.initials: S
authors.lastname: Botha
authors.affiliation: Department of Experimental Medicine, Pathophysiology and Endocrinology Unit, University of Rome, Sapienza, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Gnessi
authors.affiliation: Department of Clinical and Molecular Medicine, University of Rome, Sapienza, Italy IRCCS Neuromed, Pozzilli, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Volpe
authors.affiliation: Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa Medical Research Council, Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
authors.forename: Hugo W
authors.initials: HW
authors.lastname: Huisman
mesh_terms: D015415:Biomarkers / Q000097:blood; D044383:Black People / Q000208:ethnology*; D002318:Cardiovascular Diseases / Q000097:blood / Q000401:mortality*; D002423:Cause of Death / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012424:Rural Population; D013019:South Africa / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014505:Urban Population
chemical_list: D015415:Biomarkers; D007334:Insulin-Like Growth Factor I
keywords: African; Insulin-like growth factor-1; atherosclerosis; carotid intima-media thickness; death; hypertension; insulin-like growth factor binding protein-3; longitudinal