Insulin-like growth factor type 2 is a better survival marker than insulin-like growth factor type 1 in patients after acute decompensated heart failure

Abstract

Introduction: A decreased insulin-like growth factor 1 (IGF-1) level has been found in heart failure (HF). There are no reports assessing IGF-2 in HF, although in vitro research has shown that IGF-2 stimulates cardiomyocyte proliferation more than IGF-1. The study aim was to compare the IGF-1 and IGF-2 concentrations depending on HF exacerbation and annual survival. Material and methods: Among 75 patients hospitalized due to newly diagnosed or exacerbated HF, the following evaluations were performed: anthropometric measurements, basic laboratory tests, heart echocardiography, and IGF-1 and IGF-2 concentrations. The annual survival was assessed. The participants were divided into NYHA II and NYHA III/IV groups. They did not differ in age, gender, body mass index (BMI), waist-hip ratio, glycated hemoglobin (HbA1c), high-density lipoprotein cholesterol, or triglycerides, but differed in echocardiographic parameters, BNP, total cholesterol (TC) and low-density lipoprotein (LDL) cholesterol levels. Nine (12%) patients died during the 12-month follow-up. Results: There were no differences in IGF-1 between NYHA groups and depending on the BMI, carbohydrate metabolism disorders and annual survival. A significantly lower IGF-2 concentration was found in NYHA III/IV vs. NYHA II: 583.71 (162.35) vs. 676.08 (172.09), p = 0.02, and in those who died: 501.47 (172.89) vs. 645.31 (166.17) nmol/l, p = 0.04. There was a positive correlation between IGF-2 and TC: r = 0.28, p = 0.015 and LDL: r = 0.29, p = 0.011 in the whole group and among patients with BMI ≥ 25 kg/m2: respectively for TC (r = 0.31, p = 0.014) and LDL (r = 0.28, p = 0.028). No IGF-1 correlation was found. Conclusions: Reduced IGF-2 concentration is a better marker of patients with more advanced HF and a higher 1-year death risk than low IGF-1. Its secretion may depend on the cholesterol concentration.