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Exp Clin Endocrinol Diabetes 2017; 125(07): 485-491
DOI: 10.1055/s-0043-103965
Article
© Georg Thieme Verlag KG Stuttgart · New York

Circulating Insulin-like Growth Factor-1 and Insulin-like Growth Factor Binding Protein-3 predict Three-months Outcome after Ischemic Stroke

Moritz Armbrust
1   Center for Stroke Research Berlin, Charité – Universitätsmedizin Berlin, Charitéplatz 1, Berlin, Germany
,
Hans Worthmann
3   Department of Neurology, Hannover Medical School, Carl-Neuberg-Strasse 1, Hannover, Germany
,
Reinhard Dengler
3   Department of Neurology, Hannover Medical School, Carl-Neuberg-Strasse 1, Hannover, Germany
,
Helmut Schumacher
5   Statistical Consultant, Ingelheim, Germany
,
Ralf Lichtinghagen
6   Institute for Clinical Chemistry, Hannover Medical School, Carl-Neuberg-Strasse 1, Hannover, Germany
,
Christoph Cyrill Eschenfelder
4   Boehringer Ingelheim Pharma GmbH & Co KG, Ingelheim, Germany
,
Matthias Endres
1   Center for Stroke Research Berlin, Charité – Universitätsmedizin Berlin, Charitéplatz 1, Berlin, Germany
2   Department of Neurology, Charité – Universitätsmedizin Berlin, Charitéplatz 1, Berlin, Germany
,
Martin Ebinger
1   Center for Stroke Research Berlin, Charité – Universitätsmedizin Berlin, Charitéplatz 1, Berlin, Germany
2   Department of Neurology, Charité – Universitätsmedizin Berlin, Charitéplatz 1, Berlin, Germany
› Author Affiliations
Further Information

Publication History

received 24 July 2016
revised 11 February 2017

accepted 14 February 2017

Publication Date:
19 July 2017 (online)

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Abstract

Objective

Reports on neuroprotective effects of Insulin-like growth factor-1 (IGF-1) and Insulin-like growth factor binding protein-3 (IGFBP-3) in ischemic brain tissue are inconsistent. The aim of this study was to determine if plasma levels of IGF-1 and IGFBP-3 in acute stroke patients are indicative of 3 months functional outcome.

Methods

Plasma levels were measured via chemiluminescence immunoassay in heparin blood samples of patients included in the EARLY trial (NCT00562588). Plasma samples were drawn on admission and 8 days post-stroke. Neurological deficits were assessed via modified Rankin Scale (mRS) 3 months post-stroke, resulting in favorable (mRS=0–2) or unfavorable (mRS=3–6) outcome. A multiple binary logistic regression including IGF-1 and IGFBP-3 levels and confounders was conducted.

Results

Out of 404 included patients, 89 patients had an unfavorable outcome. Mean mRS on admission as well as 3 months post-stroke was 2 (±1). Low IGF-1 levels (day 8) were independently associated with a decreased risk of an unfavorable outcome (OR 0.61; 95%CI 0.37–0.99; p=0.044). Low IGFBP-3 levels (day 8) were independently associated with an unfavorable outcome (OR 2.75; 95%CI 1.56–4.84; p<0.001).

Interpretation

Low IGFBP-3 levels and high IGF-1 levels in the subacute phase are predictive of unfavorable outcome 3 months after stroke.

Key words

neuroprotection - acute cerebral infarction - modified Rankin Scale
 

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