Abstract
Background: Growth hormone (GH) stimulates the production of insulin-like growth factor 1 (IGF-1) in most tissues and together GH and IGF-1 profoundly impact adipose tissue deposition, glucose metabolism and cardiovascular function. A low serum IGF-I level has been reported as being associated with obstructive sleep apnea (OSA) and might be one of the mechanisms underlying cardio-metabolic risk in OSA patients.Methods: In a multicenter national study, 817 patients consulting for suspicion of OSA (OSA confirmed for 567 patients) underwent serum IGF-1 measurements. We analyzed the association between an IGF-1 level below the median value of the population and variables related to cardio-metabolic risk: body mass index (BMI) and waist circumference, apnea hypopnea index (AHI), cholesterol and triglycerides (expressed as median and divided into quartiles for continuous variables).Results: After adjustment for age and gender, low IGF-1 levels were associated with increased BMI and AHI (Odds ratios (OR) = 2.83; p < 0.0001 and OR = 3.03, p < 0.0001 for Quartile 4 vs. Quartile1, respectively), with elevated cholesterol levels (OR = 1.36, p = 0.0444), and elevated triglyceride levels (OR = 1.36; p = 0.0008).Conclusions: Both adiposity and sleep apnea synergistically predict low levels of IGF-1 and thus could together contribute toward cardio-metabolic risk. Further work are needed to confirm whether IGF-1 levels allow grading severity and predicting response to treatments to aim at a personalized medicine for patients suffering from OSA.
Highlights
Growth hormone (GH) stimulates the production of insulin-like growth factor 1 (IGF-1) in most tissues and together GH and IGF-1 profoundly impact adipose tissue deposition, glucose metabolism and cardiovascular function [1, 2]
body mass index (BMI), waist circumference and apnea + hypopnea index (AHI) were found to be associated with IGF-1 levels below the median
Elevated triglycerides and total cholesterol levels were linked to low IGF-1 levels whereas fasting glucose levels, LDL-cholesterol and HDLcholesterol were not (Table 2 and Figure 1)
Summary
Growth hormone (GH) stimulates the production of insulin-like growth factor 1 (IGF-1) in most tissues and together GH and IGF-1 profoundly impact adipose tissue deposition, glucose metabolism and cardiovascular function [1, 2]. GH deficiency induces low IGF-1 levels and is associated with cardio-vascular functional and morphological dysfunction, leading a higher mortality risk by cardiovascular disease [4,5,6,7]. Sleep Apnea and Low IGF-1 Level (ROS) production, and exerting anti-inflammatory, antiapoptotic, and proangiogenic effects [3]. It has been demonstrated that low IGF-1 levels correlate with insulin resistance, atherogenic dyslipidemia, and increased blood pressure that constitute the three pillars of metabolic syndrome [8, 9]. Abnormalities of GH/IGF-1 axis with GH deficiency, are associated with cardio-vascular functional and morphological dysfunction and leads a higher mortality risk by cardiovascular disease. A low serum IGF-I level has been reported as being associated with obstructive sleep apnea (OSA) and might be one of the mechanisms underlying cardio-metabolic risk in OSA patients
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