Kaplan Robert C, Strizich Garrett, Aneke-Nash Chino, Dominguez-Islas Clara, Bužková Petra, Strickler Howard, Rohan Thomas, Pollak Michael, Kuller Lewis, Kizer Jorge R, Cappola Anne, Li Christopher I, Psaty Bruce M, Newman Anne
Department of Epidemiology and Population Health and.
Department of Biostatistics and.
J Clin Endocrinol Metab. 2017 Jan 1;102(1):267-278. doi: 10.1210/jc.2016-2779.
Multiple diseases may explain the association of the growth hormone/insulinlike growth factor-I (GH/IGF-I) axis with longevity.
To relate circulating GH/IGF-I system protein levels with major health events.
This is a cohort study set in 4 US communities.
Adults (N = 2268) 65 years and older free of diabetes and cardiovascular disease.
We assessed insulinlike growth factor binding protein-1 (IGFBP-1) and ghrelin in fasting and 2-hour oral glucose tolerance test (OGTT) blood samples, as well as fasting IGF-I and IGFBP-3. Hazard ratios for mortality and a composite outcome for first incident myocardial infarction, stroke, heart failure, hip fracture, or death were adjusted for sociodemographic, behavioral, and physiological covariates.
During 13,930 person-years of follow-up, 48.1% of individuals sustained one or more components of the composite outcome and 31.8% died. Versus the lowest quartiles, the highest quartiles of fasting and 2-hour ghrelin were associated with 27% higher (95% confidence interval [CI]: 6%, 53%) and 39% higher (95% CI: 14%, 71%) risks of the composite outcome, respectively. The highest quartile of 2-hour IGFBP-1 was associated with 35% higher (95% CI: 1%, 52%) risk of the composite end point. Similarly, higher mortality was significantly associated with higher fasting and 2-hour ghrelin levels and with 2-hour IGFBP-1 level. When examined together, 2-hour post-OGTT levels of IGFBP-1 and ghrelin tended to predict outcomes better than fasting levels.
Circulating IGFBP-1 and ghrelin measured during an OGTT predicted major health events and death in older adults, which may explain the influence of the GH/IGF-I axis on lifespan and health.
多种疾病可能解释生长激素/胰岛素样生长因子-I（GH/IGF-I）轴与长寿之间的关联。
将循环中的GH/IGF-I系统蛋白水平与主要健康事件联系起来。
这是一项在美国4个社区开展的队列研究。
年龄在65岁及以上、无糖尿病和心血管疾病的成年人（N = 2268）。
我们在空腹和口服葡萄糖耐量试验（OGTT）2小时的血样中评估胰岛素样生长因子结合蛋白-1（IGFBP-1）和胃饥饿素，以及空腹IGF-I和IGFBP-3。对死亡率以及首次发生心肌梗死、中风、心力衰竭、髋部骨折或死亡的复合结局的风险比，根据社会人口统计学、行为和生理协变量进行了调整。
在13930人年的随访期间，48.1%的个体出现了复合结局的一个或多个组成部分，31.8%的个体死亡。与最低四分位数相比，空腹和OGTT 试验2小时时胃饥饿素的最高四分位数分别与复合结局风险高27%（95%置信区间[CI]：6%，53%）和高39%（95%CI：14%，71%）相关。OGTT试验2小时时IGFBP-1的最高四分位数与复合终点风险高35%（95%CI：1%，52%）相关。同样，较高的死亡率与较高的空腹和OGTT试验2小时时胃饥饿素水平以及OGTT试验2小时时IGFBP-1水平显著相关。综合来看，OGTT试验2小时后的IGFBP-1和胃饥饿素水平预测结局的能力往往优于空腹水平。
在OGTT试验期间测量循环中的IGFBP-1和胃饥饿素可预测老年人发生的主要健康事件和死亡，这可能解释了GH/IGF-I轴对寿命和健康的影响。
