Insulin-Like Growth Factor 1 (IGF- 1) Levels And Left Ventricular Meridional End Systolic Stress (LVMESS) Interrelationship In Middle- Aged And Elderly Obese Subject With Type 2 Diabetes Mellitus

Abstract

Background: Left ventricular meridional end systolic stress (LVMESS) is a quantitative determinant index of LV afterload which is an essential determinant of LV performance. The key factors influencing LVMSS, notably ventricular wall thickness, chamber size and configuration are shown to be altered by both obesity and type2 diabetes mellitus (T2DM). There exist reports implicating high free insulin-like growth factor 1 (IGF-1) but not growth hormone (GH) levels, with increased left ventricular mass index (LVMI), abnormal LV geometric remodeling, and A1c levels. Objective: to explore whether a meaningful link exists between LVMESS and free IGF-1 plasma levels, in obese middle-aged and elderly individuals with or without T2DM. Methodology: In this cross sectional study, a total of 145 participants Involved. Middle aged and elderly obese individuals with or without T2 DM were matched with healthy lean subjects of the same age group, with or without T2 DM. LVMESS and IGF-1 levels were compared between groups; group differences were analyzed using unpaired t test and linear correlation test. Data were expressed as the mean ± S.D, using SPSS version 18). Results: LVMESS values showed significant decrease in diabetic patients compared to control in both middle and old aged subjects. IGF-1, concentration levels were lower in the elderly obese diabetics compared to control, with significant (r=0.462; p= 0.04) negative correlation with LVMESS in healthy obese old aged, and a negative but non-significant correlation with LVMESS in lean old aged with or without diabetics Conclusion: Nonlinear correlation of IGF-1 levels with LVMESS obtained. It could be hypothesized that because of its negative significant correlation with LVMESS in the elderly non diabetic obese, IGF-1 free level could be utilized to serve as a predictor of impaired LV systolic function in these subjects. In addition the results could shed some light on IGF-1- LVMESS relationship, when considering IGF-1 therapy in certain conditions. Recommendation: It is suggested that using IGF-1 plasma levels in the elderly with or without T2DM could aid as predictor for LV global systolic dysfunction .However, larger sample size are to be considered.