Abstract
ObjectiveThe aim of the study was to assess the relationship between insulin-like growth factor I (IGF-I) serum levels and acute ischemic stroke (AIS) in a Chinese population.MethodsAll consecutive patients with first-ever AIS from August 1, 2011 to July 31, 2013 were recruited to participate in the study. The control group comprised 200 subjects matched for age, gender, and conventional vascular risk factors. IGF-I serum levels were determined by chemiluminescence immunoassay. The National Institutes of Health Stroke Scale (NIHSS) score was assessed on admission blinded to serum IGF-I levels.ResultsThe median serum IGF-1 levels were significantly (P = 0.011) lower in AIS patients (129; IQR, 109–153 ng/mL) compared with control cases (140; IQR, 125–159 ng/mL). We found that an increased risk of AIS was associated with IGF-I levels ≤135 ng/mL (unadjusted OR: 4.17; 95% CI: 2.52–6.89; P = 0.000). This relationship was confirmed in the dose-response model. In multivariate analysis, there was still an increased risk of AIS associated with IGF-I levels ≤135 ng/mL (OR: 2.16; 95% CI:1.33–3.52; P = 0.002) after adjusting for possible confounders.ConclusionLower IGF-I levels are significantly related to risk of stroke, independent from other traditional and emerging risk factors, suggesting that they may play a role in the pathogenesis of AIS. Thus, strokes were more likely to occur in patients with low serum IGF-I levels in the Chinese population; further, post-ischemic IGF-I therapy may be beneficial for stroke.
Highlights
As the most common cause of neurologic disability, ischemic stroke is often associated with sensor motor and cognitive impairments due to neuronal degeneration
Associations between the severity of stroke evaluated by National Institutes of Health Stroke Scale (NIHSS) scores and the serum levels of Insulin-like growth factor I (IGF-I) were assessed by using ordered logistic regression models with multivariate adjustment for possible confounders, for instance, age, gender, alcohol abuse, smoking habit, hypertension, diabetes, atrial fibrillation, hyperlipoproteinemia, infarct volume, and serum levels of white blood cells, triglyceride, cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), D-dimer, glucose, high-sensitivity C-reactive protein, and homocysteine (HCY)
There was a modest correlation between serum IGF-I levels and age (r = 20.200, P = 0.004), as shown in Fig. 2a, and inverse correlations between the levels of IGF-I and the NIHSS (r = 20.453, P = 0.000; Fig. 2b) and Hs-CRP levels (r = 2 0.178, P = 0.009; Fig. 2c)
Summary
All consecutive patients with first-ever AIS from August 1, 2011 to July 31, 2013 were recruited to participate in the study. The control group comprised 200 subjects matched for age, gender, and conventional vascular risk factors. IGF-I serum levels were determined by chemiluminescence immunoassay. The National Institutes of Health Stroke Scale (NIHSS) score was assessed on admission blinded to serum IGF-I levels
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