Literature DB >> 21795450

Meta-analysis and dose-response metaregression: circulating insulin-like growth factor I (IGF-I) and mortality.

Anne Marij G Burgers1, Nienke R Biermasz, Jan W Schoones, Alberto M Pereira, Andrew G Renehan, Marcel Zwahlen, Matthias Egger, Olaf M Dekkers.   

Abstract

CONTEXT: IGF-I plays a central role in metabolism and growth regulation. High IGF-I levels are associated with increased cancer risk and low IGF-I levels with increased risk for cardiovascular disease.
OBJECTIVE: Our objective was to determine the relationship between circulating IGF-I levels and mortality in the general population using random-effects meta-analysis and dose-response metaregression. DATA SOURCES: We searched PubMed, EMBASE, Web of Science, and Cochrane Library from 1985 to September 2010 to identify relevant studies. STUDY SELECTION: Population-based cohort studies and (nested) case-control studies reporting on the relation between circulating IGF-I and mortality were assessed for eligibility. DATA EXTRACTION: Data extraction was performed by two investigators independently, using a standardized data extraction sheet. DATA SYNTHESIS: Twelve studies, with 14,906 participants, were included. Overall, risk of bias was limited. Mortality in subjects with low or high IGF-I levels was compared with mid-centile reference categories. All-cause mortality was increased in subjects with low as well as high IGF-I, with a hazard ratio (HR) of 1.27 (95% CI = 1.08-1.49) and HR of 1.18 (95% CI = 1.04-1.34), respectively. Dose-response metaregression showed a U-shaped relation of IGF-I and all-cause mortality (P = 0.003). The predicted HR for the increase in mortality comparing the 10th IGF-I with the 50th percentile was 1.56 (95% CI = 1.31-1.86); the predicted HR comparing the 90th with the 50th percentile was 1.29 (95% CI = 1.06-1.58). A U-shaped relationship was present for both cancer mortality and cardiovascular mortality.
CONCLUSIONS: Both low and high IGF-I concentrations are associated with increased mortality in the general population.

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Year:  2011        PMID: 21795450     DOI: 10.1210/jc.2011-1377

Source DB:  PubMed          Journal:  J Clin Endocrinol Metab        ISSN: 0021-972X            Impact factor:   5.958


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