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Mortality and Serum Insulin-Like Growth Factor (IGF)-I and IGF Binding Protein 3 Concentrations

Institute for Community Medicine (N.F., R.H., H.V.), Institute of Clinical Chemistry and Laboratory Medicine (N.F., R.H., M.N., J.L., H.W.), Institute of Pharmacology (D.R.), and Departments of Internal Medicine A (E.S.-L.) and Internal Medicine B (S.B.F., M.D.), Ernst Moritz Arndt University, D-17487 Greifswald, Germany; and Department of Endocrinology (G.B.), Christie Hospital, M20 4BX Manchester, United Kingdom

Address all correspondence and requests for reprints to: Nele Friedrich, Ph.D., Institute for Community Medicine, Ernst Moritz Arndt University, Walther Rathenau Strasse 48, D-17487 Greifswald, Germany. E-mail: nele.friedrich{at}uni-greifswald.de.

Background: 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.

Methods: 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.

Results: 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)].

Conclusions: 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.

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