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Insulin-like Growth Factor-1 and IGF Binding Proteins Predict All-Cause Mortality and Morbidity in Older Adults

Zhang, William B., Aleksic, Sandra, Gao, Tina, Weiss, Erica F., Demetriou, Eleni, Verghese, Joe, Holtzer, Roee, Barzilai, Nir, Milman, Sofiya·2020·Cells

Abstract

While the growth hormone/insulin-like growth factor-1 (GH/IGF-1) pathway plays essential roles in growth and development, diminished signaling via this pathway in model organisms extends lifespan and health-span. In humans, circulating IGF-1 and IGF-binding proteins 3 and 1 (IGFBP-3 and 1), surrogate measures of GH/IGF-1 system activity, have not been consistently associated with morbidity and mortality. In a prospective cohort of independently-living older adults (n = 840, mean age 76.1 ± 6.8 years, 54.5% female, median follow-up 6.9 years), we evaluated the age- and sex-adjusted hazards for all-cause mortality and incident age-related diseases, including cardiovascular disease, diabetes, cancer, and multiple-domain cognitive impairment (MDCI), as predicted by baseline total serum IGF-1, IGF-1/IGFBP-3 molar ratio, IGFBP-3, and IGFBP-1 levels. All-cause mortality was positively associated with IGF-1/IGFBP-3 molar ratio (HR 1.28, 95% CI 1.05–1.57) and negatively with IGFBP-3 (HR 0.82, 95% CI 0.680–0.998). High serum IGF-1 predicted greater risk for MDCI (HR 1.56, 95% CI 1.08–2.26) and composite incident morbidity (HR 1.242, 95% CI 1.004–1.538), whereas high IGFBP-1 predicted lower risk for diabetes (HR 0.50, 95% CI 0.29–0.88). In conclusion, higher IGF-1 levels and bioavailability predicted mortality and morbidity risk, supporting the hypothesis that diminished GH/IGF-1 signaling may contribute to human longevity and health-span.

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Figure 1 Insulin-like growth factor (IGF)-associated proteins and mortality. Unadjusted survival curves for individuals with high and low levels of IGF-1 (a. combined cohort; b. males; c. females), IGFBP-1 (d–f), IGFBP-3 (g–i), and IGF-1/IGFBP-3 molar ratio (j–l).
Figure 1 Insulin-like growth factor (IGF)-associated proteins and mortality. Unadjusted survival curves for individuals with high and low levels of IGF-1 (a. combined cohort; b. males; c. females), IGFBP-1 (d–f), IGFBP-3 (g–i), and IGF-1/IGFBP-3 molar ratio (j–l).CC BY · PubMed Central
Figure 2 IGF-associated proteins and mortality hazard. Sex and age-adjusted survival hazards for combined cohort (a) and age-adjusted survival hazard for males (b) and females (c) with high levels of IGF-associated proteins as compared to individuals with low levels.
Figure 2 IGF-associated proteins and mortality hazard. Sex and age-adjusted survival hazards for combined cohort (a) and age-adjusted survival hazard for males (b) and females (c) with high levels of IGF-associated proteins as compared to individuals with low levels.CC BY · PubMed Central
Figure 3 IGF-1 levels and morbidity. Unadjusted survival curves for multiple-domain cognitive impairment (MDCI) (a. combined cohort; b. males; c. females), diabetes (d–f), cardiovascular disease (g–i), cancer (j–l), and composite incident morbidity (m–o) in individuals with high and low levels of IGF-1.
Figure 3 IGF-1 levels and morbidity. Unadjusted survival curves for multiple-domain cognitive impairment (MDCI) (a. combined cohort; b. males; c. females), diabetes (d–f), cardiovascular disease (g–i), cancer (j–l), and composite incident morbidity (m–o) in individuals with high and low levels of IGF-1.CC BY · PubMed Central
Figure 4 IGF-1 and morbidity hazard. Sex and age-adjusted morbidity hazards for all individuals in cohort (a), and age-adjusted morbidity hazards for males (b) and females (c) with high levels of IGF-1 as compared to individuals with low levels.
Figure 4 IGF-1 and morbidity hazard. Sex and age-adjusted morbidity hazards for all individuals in cohort (a), and age-adjusted morbidity hazards for males (b) and females (c) with high levels of IGF-1 as compared to individuals with low levels.CC BY · PubMed Central
Figure 5 IGFBP-1 levels and morbidity. Unadjusted survival curves for MDCI (a. combined cohort; b. males; c. females), diabetes (d–f), cardiovascular disease (g–i), cancer (j–l), and composite incident morbidity (m–o) in individuals with high and low levels of IGFBP-1.
Figure 5 IGFBP-1 levels and morbidity. Unadjusted survival curves for MDCI (a. combined cohort; b. males; c. females), diabetes (d–f), cardiovascular disease (g–i), cancer (j–l), and composite incident morbidity (m–o) in individuals with high and low levels of IGFBP-1.CC BY · PubMed Central
Figure 6 IGFBP-1 and morbidity hazard. Sex and age-adjusted morbidity hazards for all individuals (a), and age-adjusted morbidity hazard for males (b) and females (c) with high levels of IGFBP-1 as compared to individuals with low levels.
Figure 6 IGFBP-1 and morbidity hazard. Sex and age-adjusted morbidity hazards for all individuals (a), and age-adjusted morbidity hazard for males (b) and females (c) with high levels of IGFBP-1 as compared to individuals with low levels.CC BY · PubMed Central

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Metadata

Authors
Zhang, W. B., Aleksic, S., Gao, T., Weiss, E. F., Demetriou, E., Verghese, J., Holtzer, R., Barzilai, N., & Milman, S.
Affiliations
  • Department of Medicine, Division of Endocrinology, Institute for Aging Research, Albert Einstein College of Medicine, Bronx, NY 10461, USA
  • Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
  • Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY 10033, USA
Venue
Cells
Publisher
MDPI AG
Published
2020-06-01
Volume
9
Issue
6
Pages
1368
ISSN
2073-4409
Cited by
64
References
7
Language
en
Funders
  • National Institute on Aging (K23AG051148, R01AG061155, P30AG038072, R01AG057909, R01AG044829-01A1, R01AG050448, T32AG023475-18)
  • National Institute of Neurological Disorders and Stroke (2R37NS43209, 1UG3NS105565–01, R01NS109023)
  • National Center for Advancing Translational Sciences (Einstein/Montefiore CTSA UL1TR002556)

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