Low IGF-1 levels are associated with cardiovascular risk factors in haemodialysis patients
Low IGF-1 levels are associated with cardiovascular risk factors in haemodialysis patients
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DOI：
10.1007/s11010-007-9441-6
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发表时间：
2007-08-01
影响因子：
4.3
通讯作者：
Singh, Jaipaul
中科院分区：
文献类型：
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作者：
Abdulle, Abdishakur M.;Gillett, Michael P. T.;Singh, Jaipaul
心血管疾病（CVD）是一种重大风险，可能部分解释血液透析（HD）患者的高发病率和死亡率。几项研究表明，胰岛素样生长因子（IGF-1）水平降低与CVD的发展有关。然而，目前尚不清楚IGF-1及其与其他激素如瘦素、胰岛素和生长激素（GH）的关系，以及人体测量变量是否可以解释慢性肾脏病（CKD）患者血管并发症的高发病率。本研究旨在测量CKD患者和年龄匹配的对照受试者的总血清IGF-1、瘦素、胰岛素和GH水平，并阐明IGF-1与GH、瘦素和胰岛素以及其他已知的CVD病因风险因素（包括血压、体重指数（BMI）和年龄）之间的关系。该研究包括50例接受维持性血液透析的CKD患者[36例男性和14例女性;平均年龄：41.8 ± 10.3岁]和50例年龄和性别匹配的健康对照受试者（36例男性和14例女性;平均年龄：41.6 ± 10.2岁）。患者和对照组中无受试者报告吸烟或糖尿病史。男性和女性患者的IGF-1水平均显著低于对照组（P < 0.001）。此外，IGF-1与收缩压（SBP）（r = -0.360; P < 0.01）与舒张压（DBP）两组合并SBP（r =-0.396; P < 0.001）、DBP（r =-0.296; P <0.01）时，CKD组SBP（r = -0.512; P < 0.001）、DBP（r = -0.296; P <0.001）明显高于CKD组。当调整年龄时，相关性更显着，然而，当调整BMI时，IGF-1和血压之间没有显着相关性。对照组IGF-1与年龄呈负相关（r = -0.367; P < 0.01），与BMI呈负相关（r = -0.310; P < 0.05），而患者组IGF-1与年龄无相关性。瘦素与BMI呈正相关（r = 0.358; P < 0.01; r = 0.640，P < 0.001）。结果显示，与健康正常受试者相比，CKD患者的IGF-1循环水平显著较低，并且与SBP和DBP呈负相关，与年龄无关，但与BMI无关，表明心血管风险因素与低IGF-1水平之间存在强相关性。尽管数据并未明确表明低IGF-1水平是这些心血管风险因素的原因或影响，但它们确实指出，与年龄匹配的健康对照受试者相比，CKD患者中低IGF-1水平与心血管风险因素增加之间存在有趣的关系。
Cardiovascular diseases (CVD) constitute a significant risk and may, in part, explain the high morbidity and mortality rates among haemodialysis (HD) patients. Several studies have implicated reduced insulin like growth factor (IGF-1) levels in the development of CVD. However, it is not clear whether IGF-1, and its relationship with other hormones such as leptin, insulin, and growth hormone (GH), as well as anthropometric variables may explain the high incidence of vascular complications in chronic kidney disease (CKD) patients. This study was designed to measure total serum IGF-1, leptin, insulin and GH levels in CKD patients and in age-matched control subjects and to elucidate the relationship between IGF-1 and GH, leptin, and insulin as well as other known aetiological risk factors for CVD including blood pressure, body mass index (BMI), and age. The study consisted of 50 CKD patients [36 M and 14 F; mean age; 41.8 +/- 10.3 years) on maintenance haemodialysis and 50 healthy control subjects (36 M and 14 F; mean age 41.6 +/- 10.2 years) matched for age and sex. None of the subject among patients and controls reported either smoking or history of diabetes mellitus. The circulating levels of IGF-1 were significantly lower (P < 0.001) in both male and female patients compared to the control subjects. Moreover, IGF-1 was strongly and inversely correlated with both systolic blood pressure (SBP) (r = -0.360; P < 0.01) and diastolic blood pressure (DBP) (r = -0.512; P < 0.001) in the CKD group, and when the two groups were combined SBP (r = -0.396; P < 0.001) and DBP (r = -0.296; P < 0.01). When adjusted for age, the correlation was more significant, however, when adjusted for BMI no significant correlation was observed between IGF-1 and blood pressure. IGF-1 was inversely correlated with age (r = -0.367; P < 0.01) and BMI (r = -0.310; P < 0.05) in the control group, but not the patient group. In controls and patients, respectively, a positive correlation between leptin and BMI (r = 0.358; P < 0.01; r = 0.640, P < 0.001) was observed. The results show that circulating levels of IGF-1 were significantly lower in CKD patients as compared to healthy normal subjects and were inversely correlated with SBP and DBP independent of age, but not BMI indicative of a strong relationship between cardiovascular risk factors and low IGF-1 levels. Although, the data do not clearly indicate low IGF-1 levels as a cause or an effect of these cardiovascular risk factors, they do point to an interesting relationship between low IGF-1 levels and increased cardiovascular risk factors among CKD patients as compared to age-matched healthy control subjects.