Insulin-Like Growth Factor-1 as a Prognostic Marker in Patients with Acute Ischemic Stroke

Objective: Insulin-like growth factor-1 (IGF-1) has been associated with cardiovascular risk factors and atherosclerosis. The aim of the present study was to evaluate the prognostic value of IGF-1 levels in patients with acute ischemic stroke (AIS). Methods: All patients with first-ever AIS from August 1, 2012 to August 31, 2013 were recruited to participate in the study. Clinical data were collected. The National Institutes of Health Stroke Scale (NIHSS) score was assessed on admission blinded to serum IGF-1 levels. For the assessment of functional outcome at 90 days Modified Rankin Scale (mRS) was used. On admission, serum IGF-1 levels were determined by chemiluminescence immunoassay. The influence of IGF-1 levels on functional outcome and death was assessed by multivariate logistic regression analysis. Results: Patients with an unfavorable outcomes and non-survivors had significantly decreased serum IGF-1 levels on admission (P,0.0001 for both). IGF-1 was an independent prognostic marker of functional outcome and death [odds ratio 0.89 (0.84–0.93) and 0.90 (0.84–0.95), respectively, P,0.0001 for both, adjusted for age, NIHSS score and other predictors] in patients with ischemic stroke. Serum IGF-1 levels#130 ng/mL was as an value indicator for unfavorable functional outcome (OR 3.31, 95 % CI:1.87–5.62; P,0.0001), after adjusting for other significant confounders. Conclusions: We reported a significant association between low serum IGF-1 levels and unfavorable functional outcome and death