ESPE Yearbook of Paediatric Endocrinology

To read the full abstract: J Clin Endocrinol Metab. 2020 Jan 1;105(1):dgz101.

The aim of this prospective longitudinal study of 521 healthy children (8.8 ± 0.1) was to evaluate the correlation of circulating IGF-I levels with metabolic and cardiovascular parameters and the potential interaction with the Calcium-Phosphorus product (Ca*P). 158 subjects were re-evaluated after a follow-up of 5 years. Baseline IGF-I and IGF-I/IGFBP-3 molar ratio were associated with worse metabolic profiles (higher BMI, waist, systolic blood pressure (SBP), pulse pressure, insulin, HOMA-IR and triglycerides). Associations with both baseline and follow-up SBP remained independent in children in the highest Ca*P tertile even after adjusting for confounding variables.

IGF-I regulates metabolic pathways and exerts effects on the cardiovascular system. Data on the association between IGF-I levels and cardiometabolic disease risk are conflicting. In obese adults, IGF-I levels are inversely related to cardiometabolic disease risk, with low IGF-I levels associated with higher risk of ischemic heart disease (1). In the elderly, both low and high IGF-I levels have been associated with higher cardiovascular disease risk (2). In some studies obese adolescents, IGF-I is negatively associated with parameters of cardiometabolic disease risk (3). By contrast, we did not find any relationship between IGFs and metabolic syndrome components in obese children and adolescents (4).

Serum Ca*P has also been associated with higher cardiovascular disease risk, including vascular calcification and atherosclerosis. The current paper shows that IGF-I is an independent predictor of SBP and that this association strengthens with higher Ca*P. Nevertheless, as the presence of an association does not imply a causative role, further studies are required to clarify whether IGF-I, by influencing calcium metabolism, regulates cardiometabolic parameters.

References:

1. Juul A, Scheike T, Davidsen M, Gyllenborg J, Jørgensen T. Low serum insulin-like growth factor I is associated with increased risk of ischemic heart disease: a population-based case-control study. Circulation. 2002;106(8):939–44.

2. Carlzon D, Svensson J, Petzold M, Karlsson MK, Ljunggren Ö, Tivesten Å, et al. Both low and high serum IGF-1 levels associate with increased risk of cardiovascular events in elderly men. J Clin Endocrinol Metab. 2014;99(11):E2308-16.

3. Katz LE, Gralewski KA, Abrams P, Brar PC, Gallagher PR, Lipman TH, et al. Insulin-like growth factor-I and insulin-like growth factor binding protein-1 are related to cardiovascular disease biomarkers in obese adolescents. Pediatr Diabetes. 2016;17(2):77–86.

4. Inzaghi E, Baldini Ferroli B, Fintini D, Grossi A, Nobili V, Cianfarani S. Insulin-Like Growth Factors and Metabolic Syndrome in Obese Children. Horm Res Paediatr. 2017;87(6):400–4.