Ittermann Till, Noord Charlotte van, Friedrich Nele, Dörr Marcus, Felix Stephan B, Nauck Matthias, Völzke Henry, Hofman Albert, Witteman Jacqueline C M, Stricker Bruno Hch, Wallaschofski Henri
Institute of Clinical Chemistry and Laboratory Medicine, University of Greifswald, Germany.
Growth Horm IGF Res. 2012 Feb;22(1):1-5. doi: 10.1016/j.ghir.2011.11.001. Epub 2011 Dec 11.
Previous studies reported associations between insulin-like growth factor I (IGF-I) serum concentration and cardiac morbidity and mortality, but the association between IGF-I serum concentration and cardiac repolarization has not been investigated in a population-based study so far. Therefore, we analyzed the impact of IGF-I concentrations on QTc, QT and RR intervals in two population based studies, The Study of Health in Pomerania (SHIP) and the Rotterdam Study.
457 individuals from SHIP and 155 individuals from the Rotterdam Study older than 55 years and without cardiovascular diseases and a left ventricular hypertrophy were investigated. IGF-I was determined by automated two-site chemiluminescence immunoassays and electrocardiograms were recorded by an ACTA electrocardiograph at a sampling frequency of 500 Hz. The association of IGF-I with QTc, QT and RR intervals was investigated by multivariable linear regression analyses adjusted for age, gender, diabetes mellitus, myocardial infarction, hypertension, body mass index, serum potassium and calcium in both studies separately and in pooled analysis.
There were no significant associations between log-transformed IGF-I and QTc interval in the single populations, whereas a significant inverse association was detectable in the pooled population (β, -15.6; 95%-confidence interval, -25.7, -5.5). The QTc interval was significantly higher in the first tertile of IGF-I compared to the third tertile (β, 5.4; 95%-confidence interval, 9.5-1.3) in the pooled analysis.
The inverse association between IGF-I serum concentrations and QTc interval in our study is suggestive of a higher risk for cardiac arrhythmias and thus might provide additional evidence for increased cardiovascular mortality in subjects with low IGF-I secretion.
既往研究报道了胰岛素样生长因子I(IGF-I)血清浓度与心脏发病率和死亡率之间的关联,但迄今为止,尚未在基于人群的研究中探讨IGF-I血清浓度与心脏复极之间的关联。因此,我们在两项基于人群的研究——波美拉尼亚健康研究(SHIP)和鹿特丹研究中,分析了IGF-I浓度对QTc、QT和RR间期的影响。
对SHIP研究中的457名个体以及鹿特丹研究中155名年龄超过55岁、无心血管疾病且无左心室肥厚的个体进行了调查。采用自动双位点化学发光免疫分析法测定IGF-I,并使用ACTA心电图仪以500Hz的采样频率记录心电图。在两项研究中分别以及合并分析时,通过对年龄、性别、糖尿病、心肌梗死、高血压、体重指数、血清钾和钙进行校正的多变量线性回归分析,研究IGF-I与QTc、QT和RR间期之间的关联。
在单个研究人群中,经对数转换的IGF-I与QTc间期之间无显著关联,而在合并人群中可检测到显著的负相关(β,-15.6;95%置信区间,-25.7,-5.5)。在合并分析中,IGF-I第一三分位数组的QTc间期显著高于第三三分位数组(β,5.4;95%置信区间,9.5 - 1.3)。
我们的研究中IGF-I血清浓度与QTc间期之间的负相关提示心律失常风险较高,因此可能为IGF-I分泌低的受试者心血管死亡率增加提供额外证据。