Lower serum insulin-like growth factor-1 levels are independently associated with anemia in patients undergoing maintenance hemodialysis

Abstract

The relationship between serum insulin-like growth factor-1 (IGF-1) levels and anemia in patients undergoing maintenance hemodialysis (MHD) remains unclear. This cross-sectional study included patients who underwent MHD treatment for >3 months at our dialysis center in March 2021. Demographic and clinical data were recorded. Blood samples were collected before the hemodialysis sessions, and general serum biochemical parameters, routine blood markers, and serum IGF-1 levels were measured. Patients were divided into a group without anemia (hemoglobin ≥110 g/L) and a group with anemia (hemoglobin <110 g/L), and multivariable linear and binary logistic regression analyses were performed to study the relationship between the levels of serum IGF-1 and anemia. A total of 165 patients (male/female = 99:66) with MHD were enrolled in the study, with a median age of 66.0 (58.0, 75.0) years and a median dialysis vintage of 27.0 (12.0, 55.0) months. The mean hemoglobin level was 96.38 ± 16.72 g/L, and 126 patients had anemia (76.4%). Compared to patients without anemia, patients with anemia had lower serum IGF-1 and triglyceride levels and higher intravenous iron supplementation on dialysis (all p < 0.05). After adjusting for confounding factors in different models, the nine-model multivariate binary logistic regression analyses also confirmed that lower serum IGF-1 levels and serum IGF-1 < 197.03 ng/ml were both independently associated with anemia in patients undergoing MHD. However, further multicenter studies with larger sample sizes are required to confirm these findings.

Graphical Abstract

Keywords:

• Serum insulin-like growth factor-1
• anemia
• hemoglobin
• maintenance hemodialysis

Acknowledgements

The authors are indebted to all nephrologists and nurses in the Nephrology Department of Guangzhou Red Cross Hospital, Jinan University, for their excellent management of hemodialysis patients. We thank the patients and staff involved in this cross-sectional study. We especially thank Shilin Xu, B.S. Nurs, as all the laboratory data in the study were derived from the electronic management system for the blood purification center (Hope®, software) that he developed, which can import the laboratory test results according to the patient IDs included in the study.

Author contributions

The authors’ contributions are as follows: Shilin Xu contributed to the study design and drafting of the manuscript; Jun Ren contributed to the data collection and analysis; Yun Liu was involved in manuscript revision and data analysis; Yuping Yao and Chunjie Jiang participated in the data collection and summary; Danping Qin Xiaoshi Zhong, Yan Liu, and Rongshao Tan participated in the review and revision of the manuscript; and Wenxuan Chen contributed to the revision of important contents and the final approval of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Additional information

Funding

This work was supported by the Guangzhou Municipal Health Commission under Grant 20221A011018.