Changes in serum insulin-like growth factor-1 and insulin-like growth factor-binding protein-3,and their significance in children with left-to-right shunt congenital heart disease associated with heart failure

Objective To investigate changes in serum insulin-like growth factor-1(IGF-1) and insulin-like growth factor-binding protein-3(IGFBP-3) and their significance in children with left-to-right shunt congenital heart disease(CHD) associated with heart failure(HF).Methods Twenty healthy children(control group),20 children with HF,without basic heart disease(HF group),20 children with left-to-right shunt CHD,without HF(CHD group),and 30 children with left-to-right shunt CHD associated with HF(CHD+HF group) were included in the study.These groups were compared in terms of serum IGF-1 and IGFBP-3 levels.According to the New York Heart Association(NYHA) Functional Classification,the CHD+HF group was further divided into NYHA-II,NYHA-III and NYHA-IV subgroups and the subgroups were compared in terms of serum IGF-1,IGFBP-3,and cardiac troponin I(cTnI) levels.The correlation of serum IGF-1 and IGFBP-3 levels with serum cTnI level in the CHD+HF group was analyzed.Results The CHD group showed decreased serum IGF-1 and IGFBP-3 levels compared with the control group(P0.01).The CHD+HF group showed a significantly decreased serum IGF-1 level compared with the control group(P0.01) and CHD group(P0.05).The HF group had significantly increased serum IGF-1 and IGFBP-3 levels compared with other groups(P0.01).The NYHA-II subgroup had the highest serum IGF-1 level and the NYHA-IV subgroup had the lowest serum IGF-1 level(P0.01).In the CHD+HF group,serum IGF-1 and IGFBP-3 levels were negatively correlated with serum cTnI level(r=-0.692,P0.05;r=-0.530,P0.05).Conclusions Serum IGF-1 level can be used as an objective condition evaluation indicator for CHD,and low serum IGF-1 level is a risk factor for HF.This also provides a clinical basis for treatment of HF using exogenous IGF-1.