Dynamic changes and their clinical significance of serum insulin-like growth factor-1 in patients with acute traumatic brain injury

Abstract

Objective To investigate the dynamic changes of serum insulin-like growth factor-1 (IGF-1) in acute traumatic brain injury (TBI) as well as their correlations with the initial severity of TBI and prognosis. Methods A total of 229 patients with acute TBI admitted from September 2014 to June 2016 were retrospectively studied. Patients were further classified as mild TBI group (GCS 13-15 points), moderate TBI group (GCS 9-12 points) and severe TBI group (GCS 3-8 points) according to Glasgow coma score (GCS). The control group consisted of 30 healthy subjects. The prognosis was evaluated by using Glasgow outcome scale (GOS) at 6 months after TBI. The IGF-1 levels were further tested at days 1, 3, 5, 7 and 14 and their correlations with the initial GCS and GOS at 6 months after injury were evaluated. Results (1) The serum IGF-1 levels of mild, moderate and severe TBI group at all time points were significantly lower than those of the control group (P<0.05); the serum IGF-1 levels of severe and moderate TBI groups at all time points after injury were significantly lower than those of the mild TBI group (P<0.05); the serum IGF-1 levels of the severe group at days 1, 3, 5 and 7 d after injury were lower than those of the moderate TBI group (P<0.05). (2) IGF-1 levels were significantly different between the two groups (P<0.05) at different time points during the follow-up of 6 months. (3)IGF-1 levels were positively correlated with both GCS and GOS at the acute stage of TBI and sub-acute stage following TBI (P<0.05). Conclusion The dynamic changes of serum IGF-1 levels in patients with acute TBI are related to both initial severity of TBI and the neurological outcomes and can be used as a reliable biomarker for early severity assessment and prognostic prediction of TBI. Key words: Craniocerebral trauma; Insulin-like growth factor Ⅰ; Injury severity score; Prognosis