- Title
- Altered levels of circulating insulin-like growth factor I (IGF-I) following ischemic stroke are associated with outcome - a prospective observational study
- Creator
- Åberg, N. David; Åberg, Daniel; Jood, Katarina; Nilsson, Michael; Blomstrand, Christian; Kuhn, H. Georg; Svensson, Johan; Jern, Christina; Isgaard, Jörgen
- Relation
- BMC Neurology Vol. 18, Issue 1, no. 106
- Publisher Link
- http://dx.doi.org/10.1186/s12883-018-1107-3
- Publisher
- Springer
- Resource Type
- journal article
- Date
- 2018
- Description
- Background: Insulin-like growth factor I (IGF-I) has neuroprotective effects in experimental ischemic stroke (IS). However, in patients who have suffered IS, various associations between the levels of serum IGF-I (s-IGF-I) and clinical outcome have been reported, probably reflecting differences in sampling time-points and follow-up periods. Since changes in the levels of post-stroke s-IGF-I have not been extensively explored, we investigated whether decreases in the levels of s-IGF-I between the acute time-point (median, 4 days) and 3 months (ΔIGF-I, further transformed into ΔIGF-I-quintiles, ΔIGF-I-q) are associated with IS severity and outcome. Methods: In the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS) conducted in Gothenburg, Sweden, patients with IS who had s-IGF-I measurements available were included (N = 354; 65% males; mean age, 55 years). Baseline stroke severity was evaluated using the National Institutes of Health Stroke Scale (NIHSS) and converted into NIHSS-quintiles (NIHSS-q). Outcomes were assessed using the modified Rankin Scale (mRS) at 3 months and 2 years. Results: In general, the levels of s-IGF-I decreased (positive ΔIGF-I), except for those patients with the most severe NIHSS-q. After correction for sex and age, the 3rd ΔIGF-I-q showed the strongest association to mRS 0–2 [Odds Ratio (OR) 5.11, 95% confidence interval (CI) 2.18–11.9], and after 2 years, the 5th ΔIGF-I-q (OR 3.63, 95% CI 1.40–9.38) showed the strongest association to mRS 0–2. The associations remained significant after multivariate correction for diabetes, smoking, hypertension, and hyperlipidemia after 3 months, but were not significant (p = 0.057) after 2 years. The 3-month associations withstood additional correction for baseline stroke severity (p = 0.035), whereas the 2-year associations were further attenuated (p = 0.31). Conclusions: Changes in the levels of s-IGF-I are associated primarily with temporally near 3-month outcomes, while associations with long-term 2-year outcomes are weakened and attenuated by other factors. The significance of the change in post-stroke s-IGF-I is compatible with a positive role for IGF-I in IS recovery. However, the exact mechanisms are unknown and probably reflects combinations of multiple peripheral and central actions.
- Subject
- insulin-like growth factor; ischemic stroke; outcome; National Institutes of Health Stroke Scale (NIHSS); SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1447293
- Identifier
- uon:43109
- Identifier
- ISSN:1471-2377
- Language
- eng
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