Association Between Levels of Serum Insulin-like Growth Factor I and
                    Functional Recovery, Mortality, and Recurrent Stroke at a 7-year
                    Follow-up

N. David Åberg; Daniel Åberg; Cecilia Lagging; Lukas Holmegaard; Petra Redfors; Katarina Jood; Michael Nilsson; Maria Åberg; Christian Blomstrand; Johan Svensson; Christina Jern; Jörgen Isgaard

doi:10.1055/a-0833-8313

Experimental and Clinical Endocrinology & Diabetes, Table of Contents

CC BY-NC-ND 4.0 · Exp Clin Endocrinol Diabetes 2020; 128(05): 303-310
DOI: 10.1055/a-0833-8313

Article

Association Between Levels of Serum Insulin-like Growth Factor I and Functional Recovery, Mortality, and Recurrent Stroke at a 7-year Follow-up

N. David Åberg

¹Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

⁴Center of Brain Repair and Rehabilitation, The Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

,

Daniel Åberg

¹Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

,

Cecilia Lagging

²Department of Clinical Pathology and Genetics, Institute of Biomedicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

,

Lukas Holmegaard

³Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

,

Petra Redfors

³Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

,

Katarina Jood

³Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

,

Michael Nilsson

⁴Center of Brain Repair and Rehabilitation, The Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

⁵Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia

,

Maria Åberg

⁶Department of Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

,

Christian Blomstrand

³Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

,

Johan Svensson

¹Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

,

Christina Jern

²Department of Clinical Pathology and Genetics, Institute of Biomedicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

³Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

,

Jörgen Isgaard

¹Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

› Author Affiliations

Abstract

Background The association of serum insulin-like growth factor I (s-IGF-I) with favorable outcome after ischemic stroke (IS) beyond 2 years is unknown. We investigated whether the levels of s-IGF-I 3 months post-stroke were associated with functional recovery up to 7 years after IS, considering also mortality and recurrent strokes.

Methods Patients (N=324; 65% males; mean age, 55 years) with s-IGF-I levels assessed 3 months after the index IS were included from the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS). The modified Rankin Scale (mRS) was used to evaluate outcomes at 3 months, 2 and 7 years after IS, and recovery was defined as an improvement, no change, or deterioration in the shifts of mRS score. Baseline stroke severity was determined using the National Institutes of Health Stroke Scale (NIHSS).

Results The mRS score distributions were better in the above-median s-IGF-I group (>146.7 ng/ml). The s-IGF-I level was not associated with recurrent stroke (N=79) or death (N=44), although it correlated with recovery (r=0.12, P=0.035). In the regression analysis, s-IGF-I associated with recovery between 3 months and 7 years (but not between 2 and 7 years). The associations did not withstand adjustment for age and sex. For comparison, the corresponding associations between 3 months and 2 years withstood all adjustments.

Conclusion The association for s-IGF-I with long-term post-stroke recovery persists after 7 years, which is also reflected in the mRS score distributions at all time-points. The effects are however modest, and not driven by mortality or recurrent stroke.

Key words

cerebrovascular disease - insulin-like growth factor I - ischemic stroke - outcome - modified Rankin scale - NIHSS

Full Text

References

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Supplementary Material