Circulating Insulin-like Growth Factor Binding Protein-3 Predicts One-year Outcome after Ischemic Stroke

M. Ebinger; N. Ipsen; C. O. Leonards; L. Empl; L. Hanne; T. Liman; K. Mai; C. J. Strasburger; J. Spranger; M. Endres

doi:10.1055/s-0035-1554632

Experimental and Clinical Endocrinology & Diabetes, Table of Contents

Exp Clin Endocrinol Diabetes 2015; 123(08): 461-465
DOI: 10.1055/s-0035-1554632

Article

Circulating Insulin-like Growth Factor Binding Protein-3 Predicts One-year Outcome after Ischemic Stroke

M. Ebinger

¹Department of Neurology, Charité – Universitätsmedizin Berlin, Germany

²Center for Stroke Research Berlin, Charité – Universitätsmedizin Berlin, Germany

,

N. Ipsen

¹Department of Neurology, Charité – Universitätsmedizin Berlin, Germany

²Center for Stroke Research Berlin, Charité – Universitätsmedizin Berlin, Germany

,

C. O. Leonards

²Center for Stroke Research Berlin, Charité – Universitätsmedizin Berlin, Germany

,

L. Empl

³International Graduate Program Medical Neurosciences, Charité – Universitätsmedizin Berlin, Germany

,

L. Hanne

²Center for Stroke Research Berlin, Charité – Universitätsmedizin Berlin, Germany

,

T. Liman

²Center for Stroke Research Berlin, Charité – Universitätsmedizin Berlin, Germany

,

K. Mai

⁴Department of Endocrinology and Metabolism, Charité – Universitätsmedizin Berlin, Germany

⁵Experimental and Clinical Research Centre, Max Delbrück Centre and Charité – Universitätsmedizin Berlin, Germany

,

C. J. Strasburger

⁴Department of Endocrinology and Metabolism, Charité – Universitätsmedizin Berlin, Germany

,

J. Spranger

⁴Department of Endocrinology and Metabolism, Charité – Universitätsmedizin Berlin, Germany

⁵Experimental and Clinical Research Centre, Max Delbrück Centre and Charité – Universitätsmedizin Berlin, Germany

⁶German Center for Cardiovascular Research, Charité – Universitätsmedizin Berlin, Germany

,

M. Endres

¹Department of Neurology, Charité – Universitätsmedizin Berlin, Germany

²Center for Stroke Research Berlin, Charité – Universitätsmedizin Berlin, Germany

⁶German Center for Cardiovascular Research, Charité – Universitätsmedizin Berlin, Germany

⁷Excellence Cluster NeuroCure, Charité – Universtiätsmedizin Berlin, Germany

⁸German Center for Neurodegenerative Diseases, Helmholtz Association of German Research Centres, Germany

› Author Affiliations

Abstract

Background: Insulin-like Growth Factor-1 (IGF-1) and Insulin-like Growth Factor Binding Protein-3 (IGFBP-3) have been ascribed neuroprotective effects. We sought to determine whether levels of IGF-1 and IGFBP-3 predict functional outcome after ischemic stroke.

Methods: IGF-1 and IGFBP-3 levels were measured in the first week after stroke in patients with first ischemic stroke who were enrolled in the Berlin Cream&Sugar Study. National Institutes of Health Stroke Scale (NIHSS) was collected at admission. Lesion volume was determined from acute MRI if available. Functional outcome according to the modified Rankin Scale (mRS) was assessed after one year. In multivariate analyses we identified parameters associated with unfavourable functional outcome (mRS>2).

Results: We included 100 patients. 21 patients had an unfavourable functional outcome. IGF-1 levels were<− 2 standard deviation score (SDS) in 7 patients, and>2 SDS in 12 patients. IGFBP-3 levels were<the 5^th percentile in 13 patients, and no patient had IGFBP-3 levels>the 95^th percentile. Low levels of IGFBP-3 (p=0.002), NIHSS at admission (p=0.043) and age (p=0.001) were associated with unfavourable functional outcome in the univariate analyses. In multivariate analysis including IGFBP-3, IGF-1, age, thrombolysis and NIHSS only low IGFBP-3 levels (OR 7.2, 95%CI 1.8–29.0, p=0.006) were associated with unfavourable functional outcome. If lesion volume was incuded (n=71), only IGFBP-3 levels (OR 7.2, 95%CI 1.5–35.5, p=0.015) were associated with unfavourable functional outcome.

Conclusion: IGFBP-3 levels after ischemic stroke may independently predict functional outcome after one year.

Key words

acute cerebral infarction - neuroprotectors - mRS

Full Text

References

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