Associations of insulin‐like growth factor‐I and its binding proteins and testosterone with frailty in older men. (10th April 2013)

• Record Type: Journal Article
• Authors: Yeap, B. B.; Paul Chubb, S. A.; Lopez, Derrick; Ho, K. K. Y.; Hankey, Graeme J.; Flicker, Leon
• Is Part Of: Clinical endocrinology. Volume 78:Number 5(2013:May)
• Page Start: 752
• Page End: 759
• Publication Date: 2013-04-10
• Subjects: Endocrinology -- Periodicals; 616.4005
• DOI: 10.1111/cen.12052
• Languages: English
• ISSNs: 0300-0664

Abstract

<abstract abstract-type="main" id="cen12052-abs-0001"> <title>Summary</title> <sec id="cen12052-sec-0001" sec-type="section"> <title>Objective</title> <p>Ageing is associated with frailty and decreased anabolic hormones, insulin‐like growth factor‐I (IGF‐I) and testo;?>sterone. We hypothesized that components of the IGF‐I system, in conjunction with testosterone, modulate frailty risk in the elderly. We examined associations between IGF‐I, its binding proteins IGFBP1 and IGFBP3 and testosterone with frailty in men.</p> </sec> <sec id="cen12052-sec-0002" sec-type="section"> <title>Design</title> <p>Observational study of 3 447 community‐dwelling men aged 70–89 years assessed in 2001–04, with 1 654 reassessed in 2008–09.</p> </sec> <sec id="cen12052-sec-0003" sec-type="section"> <title>Methods</title> <p>Baseline total IGF‐I, IGFBP1, IGFBP3 and testosterone were assayed. Frailty was assessed using the FRAIL scale, comprising 5 domains: fatigue; difficulty climbing stairs; difficulty walking >100 m; >5 illnesses; weight loss >5%. Men with ≥ 3 domains were considered frail.</p> </sec> <sec id="cen12052-sec-0004" sec-type="section"> <title>Results</title> <p>At baseline, 527 men (15·3%) were frail. Frail men had lower IGFBP3 (3 630 ng/ml <italic>vs</italic> not frail: 3 800 ng/ml, <italic>P</italic> < 0·001) and comparable IGFBP1 (23·5 <italic>vs</italic> 21·5 ng/ml, <italic>P</italic> = 0·09). In multivariate analyses, higher IGFBP1 was associated with increased prevalence of frailty (highest <italic>vs</italic> lowest quartile Q4:Q1, adjusted odds ratio [OR] = 1·39, 95% CI = 1·03–1·88). New‐onset frailty arose in 260 (17·5%) of 1 484 men. Lower baseline IGF‐I predicted new‐onset frailty (Q1:Q4 OR = 1·48, 95% CI = 1·00–2·20) as did higher IGFBP1 (Q4:Q1 OR = 1·59, 95% CI = 1·01–2·50). Men with both IGF‐I and free testosterone in Q1 had greater odds of prevalent frailty (OR = 2·13, 95% CI = 1·54–2·95).</p> </sec> <sec id="cen12052-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Older men with higher IGFBP1 level, or both lower IGF‐I and testosterone, are more likely to be frail, while those with lower IGF‐I and higher IGFBP1 are more likely to become frail. Components of the IGF‐I system may be biomarkers or independent predictors of frailty.</p> </sec> </abstract>