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Association between insulin-like growth factor-1 and cardiovascular events: a systematic review and dose–response meta-analysis of cohort studies

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Abstract

Background

Insulin-like growth factor-1 (IGF-1) has increasingly been reported as linked to cardiovascular (CV) events; however, reported results have been inconsistent, and no meta-analysis has been undertaken to quantitatively assess this association.

Methods

We searched PubMed, Embase, and Web of Science databases for cohort articles published up to December 1, 2020. Fixed or random-effects models were used to estimate the summary relative risks (RRs) and 95% confidence intervals (CIs) of CV events in relation to IGF-1. Restricted cubic splines were used to model the dose–response association.

Results

We identified 11 articles (thirteen cohort studies) covering a total of 22,995 participants and 3040 CV events in this meta-analysis. The risk of overall CV events reduced by 16% from the highest to the lowest IGF-1 levels (RR 0.83, 95% CI 0.72–0.95), while the occurrence of CV events reduced by 28% (RR 0.72, 95% CI 0.56–0.92), but not for CV deaths, however (RR 1.00, 95% CI 0.65–1.55). We also found linear associations between IGF-1 levels and CV events. With each per 45 μg/mL IGF-1 increase, the pooled RRs were 0.91 (95% CI 0.86–0.96), 0.91 (95% CI 0.85–0.97) and 0.91 (95% CI 0.84–0.98) for overall CV events, for the occurrence of CV events, and for CV deaths, respectively.

Conclusions

Our findings based on cohort studies support the contention that any increase in IGF-1 is helpful in reducing the overall risk of CV events. As an important biomarker for assessing the likelihood of CV events, IGF-1 appears to offer a promising prognostic approach for aiding prevention.

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Data availability

The raw data required to reproduce these findings cannot be shared at this time as the data also forms part of an ongoing study.

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Acknowledgements

We acknowledge all the authors and Prof. Dongsheng Hu for methodological advice and help to modify the meta-analysis. All authors have read and approved the submission of the manuscript.

Funding

This study was supported by the National Natural Science Foundation of China (Grant nos. 81402752 and 81673260), the Natural Science Foundation of Guangdong Province (Grant no. 2019A1515011183), the Science and Technology Development Foundation of Shenzhen (Grant no. JCYJ20190808145805515), and the SZU medical young scientists’ program (Grant no. 71201-000001). The investigators are grateful to the dedicated participants and all research staff involved in the study.

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People’s Republic of China

    T. Li, Y. Zhao, X. Yang, Y. Feng, X. Li, H. Hu, J. Zhang, L. Yuan & D. Hu

  2. Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People’s Republic of China

    Y. Li, Y. Wu & M. Zhang

  3. Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, 518001, Guangdong, People’s Republic of China

    Y. Liu & X. Sun

  4. Department of Endocrinology, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, People’s Republic of China

    P. Qin

  5. Department of Medical Record Management, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, People’s Republic of China

    C. Chen

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  1. T. Li
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Contributions

TL substantially contributed to the design and drafting of the study and the analysis and interpretation of the data. TL wrote the manuscript.  YZ, XY, YF, YL, YW, MZ, XL, HH, JZ, LY, YL, XS, PQ, CC, and DH revised the manuscript.

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Correspondence to D. Hu.

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Tianze Li, Yang Zhao, Xingjin Yang, Yifei Feng, Yang Li, Yuying Wu, Ming Zhang, Xi Li, Huifang Hu, Jinli Zhang, Lijun Yuan, Yu Liu, Xizhuo Sun, Pei Qin, Chuanqi Chen, and Dongsheng Hu declare that they have no conflicts of interest relevant to the content of this review.

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Li, T., Zhao, Y., Yang, X. et al. Association between insulin-like growth factor-1 and cardiovascular events: a systematic review and dose–response meta-analysis of cohort studies. J Endocrinol Invest 45, 2221–2231 (2022). https://doi.org/10.1007/s40618-022-01819-1

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