The Level Changes And Correlation Of Serum Insulin-like Growth Factor-1, Tumor Necrosis Factor-α, Interleukin-1β In Chronic Heart Failure

ObjectiveTo investigate the serum levels of Insulin-like growth factor-1(IGF-1),Tumor Necrosis Factor-α(TNF-α),Interleukin-1β(IL-1β) in patients with chronic heart failure(CHF).And the relationship within them,and the correlation between the cytokines and the change of heart function.MethodsSelecting sixty patients diagnosed chronic heart failure in the second Hospital of Shanxi Medical University from November 2005 to December 2006. The additional factors which may influence serum levels of IGF-1,TNF-α,IL-1β,were excluded,such as acute or chronic infective diseases,diabetes,acute heart failure,serious liver or kidney dysfunctions,auto immune diseases,cancer,chronic respiratory disease and instable Angina pectoris,myocardial infraction,rheumatic activity,taking immune-related medicines of late three months. At the same time 30 normal control subjects were enrolled. There is no significant difference of age or sex between CHF group and control group (p>0.05). Serum sample each was collected on an empty stomach in the morning. Serum levels of IGF-1,IL-1βwere detected by Enzyme-Linked ImmunoSorbent Assay and TNF-αis detected by immunoradiometric assay .Left ventricular ejection fraction and ejective fraction were measured by Doppler echocardiography.Results1. There is no significant difference of the serum levels of IGF-1,TNF-α,IL-1βamong different causes of CHF groups (p>0.05).2. The baseline serum levels of IGF-1 is decreased significantly in CHF patients as compared with normal control group (p<0.05), and were opposite with the classification of NYHA for heart dysfunctions. But the baseline serum levels of TNF-α,IL-1βwere increased significantly in CHF patients as compared with normal control group (p<0.05), and the level of heart functionⅣgroup is higher than heart functionⅡgroup (p<0.05).But there is no significant difference of the serum levels of TNF-α,IL-1βin heart functionⅢandⅡgroups (p>0.05),and heart functionⅣgroup andⅢgroups (p>0.05),The serum levels (TNF-α,IL-1β) of heart functionⅢgroups are higher thanⅡgroups',and heart functionⅣgroups are higher thanⅢgroups'. 3. Serum levels of TNF-αwas positively correlated with IL-1β(r=0.310,p<0.05 ),and Serum levels of TNF-α,IL-1βwere all negatively correlated with LVEF,IGF-1(r(TNF-α)=0.-331,-0.460;r(IL-1β)=-0.460,-0.350;p<0.05),and all positively correlated with LVEDd(r=0.305,0.297,p<0.05). Serum levels of IGF-1 was negatively correlated with LVEDd(r=-0.297,p<0.05),and positively correlated with LVEF(r=0.314,p<0.05).Conclusion1. There are significant difference of the serum levels of IGF-1,TNF-α,IL-1βbetween CHF group and control group(p<0.05).And the levels of cytokines are close to the state of cardiac function. IGF-1, TNF-α,IL-1βcan predicate end point independently and monitor the effect of the treatment .2. IGF-1,TNF-α,IL-1βin CHF patients are significantly correlate with each other. It can display the significantly correlated effect each other. They play an important role in the cardiac muscle remodeling and hypo function of heart by network means.3. There are significantly correlation among IGF-1,TNF-α,IL-1βand LVEF,LVEDd. It can display the significantly correlation ship among cytokines,neuroendocrine.factors and cardiac muscle remodeling. it can provide theory about intervening the cardiac muscle remodeling based on accommodating the misbalances level of cytokines and neuroendocrine factors.