Growth hormone and insulin-like growth factor-1 in prognosis coronary artery disease in patients with obesity

Abstract

Introduction. In patients with obesity coronary atherosclerosis and chronic heart failure (CHF) progress rapidly and have a worse long-term prognosis than those with normal weight.Objective: To investigate the prognostic significance of GH and IGF-1 in the evaluation of cardiovascular risk in patients with obesity.Materials and Methods. The study included 75 men (mean age 55.31±6.32 years), which are overweight or have mild obesity (body mass index (BMI) 28.69±3.6 kg/m2). Group 1 included 45 patients (age 56.4±6.29 years, BMI 28.69±3.69 kg/m2, blood pressure 124±10.18/80±4.59 mm Hg) who underwent coronary angiography. Group 2 included 30 patients (mean age 53.6 ± 6.1 years, BMI 28.68±3.52 kg/m2, blood pressure 128±9/83±6.81 mm Hg), CAD who are excluded by treadmill test. The coronary artery calcium score was assessed in group 2. All participants were evaluated impaired glucose tolerance (IGT), triglycerides (TG), IGF-1 and GH, LPHD, LPLD, geometry of the heart chambers was assessed by echocardiography.Results. Patients in both groups did not differ in age, BMI, blood pressure. IGF-1 levels were not significantly different among the study groups. High circulating IGF-1 levels were frequently observed in group 1 (р=0.018). A statistically significant association of high IGF-1 observed with obesity (p=0.033), smoking (p=0.049), hypertension (p=0.002), end-diastolic dimension (p=0.045). GH was lower in group 1 compared with group 2 (p=0.046). Serum levels of GH are positively associated with EF (p=0.023) and E/A (p=0.043) and negatively associated with left atrial wall thickness (p=0.025) and coronary artery calcium score (p=0.005).Conclusion: 1. IGF-1 may be a useful indicator to assess the prognosis of CAD and CHF in patients with obesity. 2. Relative GH deficiency was more often associated with severe CAD in patients with obesity.

Insulin-like growth factor-1 and myocardial remodeling in female patients with arterial hypertension and metabolic syndrome

“…Но, в отличие от инсулина, который не синтезируется в миокарде, локальная секреция ИФР-1 и его рецеп-торов происходит в кардиомиоцитах за счет его синтеза посредством аутокринных или паракринных механиз-мов [13,26]. Поэтому представляется вероятным, что развитие процессов ремоделирования миокарда, апоптоза и интерстициального фиброза при АГ и ожи-рении происходит через «посредничество» ИФР-1.…”

“…В ряде ис-следований показано, что увеличение уровня ИФР-1 ас-социируется с высоким риском развития ИБС [13,14], а в других работах зарегистрирована низкая активность ИФР-1, что, по мнению авторов, свидетельствовало о высоком риске развития ИБС и смертности [15]. Имеют-ся исследования, в которых продемонстрирована роль ИФР-1 как прогностически значимого биологического маркера развития сердечной недостаточности [16,17].…”