Kidney Week

Abstract: SA-PO363

Association of Insulin-Like Growth Factor 1 with Cardiovascular Outcomes in Individuals with or without CKD: The UK Biobank Study

Session Information

• Hypertension, CVD, and the Kidneys: Clinical Research
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Ko, Byounghwi, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)

Byounghwi Ko

• Huh, Daseul, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)

Daseul Huh, DrMed

• Kang, Dong Hoon, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)

Dong Hoon Kang, MD

• Heo, Ga Young, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)

Ga Young Heo, MD

• Park, Cheol Ho, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)

Cheol Ho Park, MD, PhD

• Kim, Hyung Woo, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)

Hyung Woo Kim, MD

• Park, Jung Tak, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)

Jung Tak Park, MD, PhD

• Yoo, Tae-Hyun, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)

Tae-Hyun Yoo, MD, PhD

• Kang, Shin-Wook, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)

Shin-Wook Kang, MD, PhD

• Han, Seung Hyeok, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)

Seung Hyeok Han, MD, PhD

Background

Insulin-like growth factor-1 (IGF-1) has been implicated in chronic noncommunicable diseases. We aimed to explore the relationship between IGF-1 and adverse outcomes among individuals with or without CKD.

Methods

We included 359,739 participants without CKD (cohort 1) and 19,249 participants with CKD (cohort 2) from the UK Biobank cohort study. CKD was defined as an estimated glomerular filtration rate<60 ml/min/1.73m² or random urine-albumin-to-creatinine-ratio>30mg/g. The main predictor was IGF-1 levels, and the primary outcome was all-cause mortality. The secondary outcome included the 3-point major-cardiovascular-event (3P-MACE), defined as a composite of non-fatal myocardial infarct, non-fatal ischemic stroke, or cardiovascular death.

Results

There were 23,100 (6.4%) deaths (the corresponding incidence rate, 4.74) over a median follow-up of 13.6 years. In cohort 1 without CKD, the adjusted hazard ratios (aHRs) (95% CIs) for all-cause mortality were 1.24 (1.19-1.30), 1.00 (0.96-1.05), 0.98 (0.93-1.02), 1.03, (0.98-1.08), and 1.09 (1.08-1.19), for 1st, 2nd, 3rd, 5th, and 6th sextile groups, respectively, compared with 4th sextile as the reference group. The U-shaped association was similar in both cohorts. In cohort 2, the corresponding HRs (95% CIs) were 1.46 (1.29-1.66), 1.17 (1.02-1.34), 1.20 (1.04-1.37), 1.13 (0.98-1.30), and 1.17 (1.02-1.35), respectively. Notably, we observed a consistent U-shaped association with 3P-MACE, only in individuals with CKD. When effect modification was examined, no significant interaction between CKD and IGF-1 levels for the risk of all-cause mortality was observed, while a significant interaction was exhibited for the risk of 3P-MACE only in individuals with IGF-1 levels above the median.

Conclusion

This study revealed a U-shaped association between IGF-1 levels with all-cause mortality and cardiovascular outcomes in CKD patients. In individuals with IGF-1 levels above the median, this association was more pronounced in individuals with CKD, suggesting that IGF-1 may serve a more potent prognostic marker in this patient population.