TY - JOUR
T1 - Serum Insulin-Like Growth Factor 1 and the Risk of Ischemic Stroke
AU - Saber, Hamidreza
AU - Himali, Jayandra J.
AU - Beiser, Alexa S.
AU - Shoamanesh, Ashkan
AU - Pikula, Aleksandra
AU - Roubenoff, Ronenn
AU - Romero, Jose R.
AU - Kase, Carlos S.
AU - Vasan, Ramachandran S.
AU - Seshadri, Sudha
N1 - Funding Information:
This study was supported by the Framingham Heart Study-s National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute (NHLBI) contract (N01 HC25195 and N01 HHSN-268201500001) and by grants from the National Institute of Neurological Disorders and Stroke (NINDS; R01 NS017950), the National Institute on Aging (R01 AG16495, AG 033040, AG008122, AG033193, AG031287, and K23 AG038444), and the American Heart Association (11CRP4930020).
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Background and Purpose - Low insulin-like growth factor 1 (IGF-1) has been associated with increased risk of atherosclerosis and atrial fibrillation in cross-sectional studies. Yet, prospective data linking IGF-1 levels to the development of ischemic stroke remain inconclusive. We examined prospectively the association between serum IGF-1 levels and incident ischemic stroke. Methods - We measured serum IGF-1 levels in 757 elderly individuals (mean age 79±5, 62% women), free of prevalent stroke, from the Framingham original cohort participants at the 22nd examination cycle (1990-1994) and were followed up for the development of ischemic stroke. Cox models were used to relate IGF-1 levels to the risk for incident ischemic stroke, adjusted for potential confounders. Results - During a mean follow-up of 10.2 years, 99 individuals developed ischemic stroke. After adjustment for age, sex, and potential confounders, higher IGF-1 levels were associated with a lower risk of incident ischemic stroke, with subjects in the lowest quintile of IGF-1 levels having a 2.3-fold higher risk of incident ischemic stroke (95% confidence interval, 1.09-5.06; P=0.03) as compared with those in the top quintile. We observed an effect modification by diabetes mellitus and waist-hip ratio for the association between IGF-1 and ischemic stroke (P<0.1). In subgroup analyses, the effects were restricted to subjects with diabetics and those in top waist-hip ratio quartile, in whom each standard deviation increase in IGF-1 was associated with a 61% (hazard ratio, 0.39; 95% confidence interval, 0.20-0.78; P=0.007) and 41% (hazard ratio, 0.59; 95% confidence interval, 0.37-0.95; P=0.031) lower risk of incident ischemic stroke, respectively. Conclusions - IGF-1 levels were inversely associated with ischemic stroke, especially among persons with insulin resistance.
AB - Background and Purpose - Low insulin-like growth factor 1 (IGF-1) has been associated with increased risk of atherosclerosis and atrial fibrillation in cross-sectional studies. Yet, prospective data linking IGF-1 levels to the development of ischemic stroke remain inconclusive. We examined prospectively the association between serum IGF-1 levels and incident ischemic stroke. Methods - We measured serum IGF-1 levels in 757 elderly individuals (mean age 79±5, 62% women), free of prevalent stroke, from the Framingham original cohort participants at the 22nd examination cycle (1990-1994) and were followed up for the development of ischemic stroke. Cox models were used to relate IGF-1 levels to the risk for incident ischemic stroke, adjusted for potential confounders. Results - During a mean follow-up of 10.2 years, 99 individuals developed ischemic stroke. After adjustment for age, sex, and potential confounders, higher IGF-1 levels were associated with a lower risk of incident ischemic stroke, with subjects in the lowest quintile of IGF-1 levels having a 2.3-fold higher risk of incident ischemic stroke (95% confidence interval, 1.09-5.06; P=0.03) as compared with those in the top quintile. We observed an effect modification by diabetes mellitus and waist-hip ratio for the association between IGF-1 and ischemic stroke (P<0.1). In subgroup analyses, the effects were restricted to subjects with diabetics and those in top waist-hip ratio quartile, in whom each standard deviation increase in IGF-1 was associated with a 61% (hazard ratio, 0.39; 95% confidence interval, 0.20-0.78; P=0.007) and 41% (hazard ratio, 0.59; 95% confidence interval, 0.37-0.95; P=0.031) lower risk of incident ischemic stroke, respectively. Conclusions - IGF-1 levels were inversely associated with ischemic stroke, especially among persons with insulin resistance.
KW - IGF-1
KW - atrial fibrillation
KW - insulin resistance
KW - ischemic stroke
KW - risk
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U2 - 10.1161/STROKEAHA.116.016563
DO - 10.1161/STROKEAHA.116.016563
M3 - Article
C2 - 28596451
AN - SCOPUS:85020628937
VL - 48
SP - 1760
EP - 1765
JO - Stroke
JF - Stroke
SN - 0039-2499
IS - 7
ER -