Insulinlike growth factor binding protein-1 and ghrelin predict health outcomes among older adults: Cardiovascular health study cohort

Robert C. Kaplan, Garrett Strizich, Chino Aneke-Nash, Clara Dominguez-Islas, Petra Bužková, Howard Strickler, Thomas Rohan, Michael Pollak, Lewis Kuller, Jorge R. Kizer, Anne Cappola, Christopher I. Li, Bruce M. Psaty, Anne Newman

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Context: Multiple diseases may explain the association of the growth hormone/insulinlike growth factor-I (GH/IGF-I) axis with longevity. Objective: To relate circulating GH/IGF-I system protein levels with major health events Design and Setting: This is a cohort study set in 4 US communities. Participants: Adults (N = 2268) 65 years and older free of diabetes and cardiovascular disease Measurements: We assessed insulinlike growth factor binding protein-1 (IGFBP-1) and ghrelin in fasting and 2-hour oral glucose tolerance test (OGTT) blood samples, as well as fasting IGF-I and IGFBP-3. Hazard ratios for mortality and a composite outcome for first incident myocardial infarction, stroke, heart failure, hip fracture, or death were adjusted for sociodemographic, behavioral, and physiological covariates. Results: During 13,930 person-years of follow-up, 48.1% of individuals sustained one or more components of the composite outcome and 31.8% died. Versus the lowest quartiles, the highest quartiles of fasting and 2-hour ghrelin were associated with 27% higher (95% confidence interval [CI]: 6%, 53%) and39% higher (95% CI: 14%, 71%) risks of the composite outcome, respectively. The highest quartile of 2-hour IGFBP-1 was associated with 35% higher (95% CI: 1%, 52%) risk of the composite end point. Similarly, higher mortality was significantly associated with higher fasting and 2-hour ghrelin levels and with 2-hour IGFBP-1 level. When examined together, 2-hour post-OGTT levels of IGFBP-1 and ghrelin tended to predict outcomes better than fasting levels. Conclusions: Circulating IGFBP-1 and ghrelin measured during an OGTT predicted major health events and death in older adults, which may explain the influence of the GH/IGF-I axis on lifespan and health.

Original languageEnglish (US)
Pages (from-to)267-278
Number of pages12
JournalJournal of Clinical Endocrinology and Metabolism
Issue number1
StatePublished - Jan 1 2017

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical


Dive into the research topics of 'Insulinlike growth factor binding protein-1 and ghrelin predict health outcomes among older adults: Cardiovascular health study cohort'. Together they form a unique fingerprint.

Cite this