Friedrich Nele, Haring Robin, Nauck Matthias, Lüdemann Jan, Rosskopf Dieter, Spilcke-Liss Elisabeth, Felix Stephan B, Dörr Marcus, Brabant Georg, Völzke Henry, Wallaschofski Henri
Institute for Community Medicine, Ernst Moritz Arndt University, D-17487 Greifswald, Germany.
J Clin Endocrinol Metab. 2009 May;94(5):1732-9. doi: 10.1210/jc.2008-2138. Epub 2009 Feb 17.
Previous studies provided conflicting results regarding the association of serum IGF-I or IGF-binding protein-3 (IGFBP-3) and mortality. The aim of this study was to assess the relation of IGF-I and IGFBP-3 levels with mortality from all causes, cardiovascular disease (CVD), and cancer in a prospective population-based study.
From the Study of Health in Pomerania (SHIP) 1988 men and 2069 women aged 20-79 yr were followed up on average 8.5 yr. Causes of deaths were coded according to the International Classification of Diseases, 10th revision. Serum IGF-I and IGFBP-3 levels were determined by chemiluminescence immunoassays and categorized into three groups (low, normal, high) according to the sex- and age-specific 10th and 90th percentiles.
Adjusted analyses revealed that men with low but not high IGF-I levels had an almost 2-fold higher risk of all-cause mortality [hazard ratio (HR) 1.92 (95% confidence interval [CI] 1.35; 2.73)], CVD mortality [HR 1.92 (95% CI 1.00; 3.71)], and cancer mortality [HR 1.85 (95% CI 1.00; 3.45)] compared with men with normal IGF-I levels. In women, no association between IGF-I and mortality was found. Moreover, low IGFBP-3 levels were associated with higher all-cause mortality in men [HR 1.87 (95% CI 1.31; 2.64)] and women [HR 1.63 (95% CI 0.96; 2.76)].
The present study found inverse associations between IGF-I or IGFBP-3 levels and mortality from all causes, CVD, or cancer in men and between IGFBP-3 and all-cause mortality in women.
既往研究关于血清胰岛素样生长因子-I(IGF-I)或胰岛素样生长因子结合蛋白-3(IGFBP-3)与死亡率之间的关联得出了相互矛盾的结果。本研究的目的是在一项基于人群的前瞻性研究中评估IGF-I和IGFBP-3水平与全因死亡率、心血管疾病(CVD)死亡率及癌症死亡率之间的关系。
对波美拉尼亚健康研究(SHIP)中1988名年龄在20至79岁的男性和2069名女性进行了平均8.5年的随访。死亡原因根据《国际疾病分类》第十版进行编码。通过化学发光免疫分析法测定血清IGF-I和IGFBP-3水平,并根据性别和年龄特异性的第十和第九十百分位数分为三组(低、正常、高)。
校正分析显示,与IGF-I水平正常的男性相比,IGF-I水平低而非高的男性全因死亡率风险几乎高出2倍[风险比(HR)1.92(95%置信区间[CI] 1.35;2.73)]、CVD死亡率[HR 1.92(95% CI 1.00;3.71)]和癌症死亡率[HR 1.85(95% CI 1.00;3.45)]。在女性中,未发现IGF-I与死亡率之间存在关联。此外,低IGFBP-3水平与男性[HR 1.87(95% CI 1.31;2.64)]和女性[HR 1.63(95% CI 0.96;2.76)]的全因死亡率较高相关。
本研究发现IGF-I或IGFBP-3水平与男性全因、CVD或癌症死亡率之间以及IGFBP-3与女性全因死亡率之间存在负相关。