Altered levels of circulating insulin-like growth factor I (IGF-I) following ischemic stroke are associated with outcome - a prospective observational study
Abstract 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 differen...
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| Format: | Article |
| Language: | English |
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BMC
2018-08-01
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| Series: | BMC Neurology |
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| Online Access: | http://link.springer.com/article/10.1186/s12883-018-1107-3 |
| _version_ | 1818360842013376512 |
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| author | N. David Åberg Daniel Åberg Katarina Jood Michael Nilsson Christian Blomstrand H. Georg Kuhn Johan Svensson Christina Jern Jörgen Isgaard |
| author_facet | N. David Åberg Daniel Åberg Katarina Jood Michael Nilsson Christian Blomstrand H. Georg Kuhn Johan Svensson Christina Jern Jörgen Isgaard |
| author_sort | N. David Åberg |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-13T21:07:12Z |
| format | Article |
| id | doaj.art-ba4b665d3dd340fba24ad32393086597 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-12-13T21:07:12Z |
| publishDate | 2018-08-01 |
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| spelling | doaj.art-ba4b665d3dd340fba24ad323930865972022-12-21T23:31:27ZengBMCBMC Neurology1471-23772018-08-0118111210.1186/s12883-018-1107-3Altered levels of circulating insulin-like growth factor I (IGF-I) following ischemic stroke are associated with outcome - a prospective observational studyN. David Åberg0Daniel Åberg1Katarina Jood2Michael Nilsson3Christian Blomstrand4H. Georg Kuhn5Johan Svensson6Christina Jern7Jörgen Isgaard8Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of GothenburgDepartment of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of GothenburgDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of GothenburgDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of GothenburgDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of GothenburgDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of GothenburgDepartment of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of GothenburgInstitute of Biomedicine, The Sahlgrenska Academy at University of GothenburgDepartment of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of GothenburgAbstract 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.http://link.springer.com/article/10.1186/s12883-018-1107-3Insulin-like growth factor IIschemic strokeOutcome |
| spellingShingle | N. David Åberg Daniel Åberg Katarina Jood Michael Nilsson Christian Blomstrand H. Georg Kuhn Johan Svensson Christina Jern Jörgen Isgaard Altered levels of circulating insulin-like growth factor I (IGF-I) following ischemic stroke are associated with outcome - a prospective observational study BMC Neurology Insulin-like growth factor I Ischemic stroke Outcome |
| title | Altered levels of circulating insulin-like growth factor I (IGF-I) following ischemic stroke are associated with outcome - a prospective observational study |
| title_full | Altered levels of circulating insulin-like growth factor I (IGF-I) following ischemic stroke are associated with outcome - a prospective observational study |
| title_fullStr | Altered levels of circulating insulin-like growth factor I (IGF-I) following ischemic stroke are associated with outcome - a prospective observational study |
| title_full_unstemmed | Altered levels of circulating insulin-like growth factor I (IGF-I) following ischemic stroke are associated with outcome - a prospective observational study |
| title_short | Altered levels of circulating insulin-like growth factor I (IGF-I) following ischemic stroke are associated with outcome - a prospective observational study |
| title_sort | altered levels of circulating insulin like growth factor i igf i following ischemic stroke are associated with outcome a prospective observational study |
| topic | Insulin-like growth factor I Ischemic stroke Outcome |
| url | http://link.springer.com/article/10.1186/s12883-018-1107-3 |
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