title: Insulin-like growth factor I serum levels influence ischemic stroke outcome.
abstract: OBJECTIVE
  Insulin-like growth factor I (IGF-I) is neuroprotective in animal models of stroke. We investigated whether serum IGF-I levels in patients with acute ischemic stroke influence stroke severity and outcome.
  
  
  METHODS
  Concentrations of IGF-I and IGF binding protein 3 were measured in serum samples obtained within 6 hours after stroke onset from 255 patients who took part in the placebo arm of the United States and Canadian Lubeluzole in Acute Ischemic Stroke Study. Stroke severity was assessed with the National Institutes of Health Stroke Scale. Multivariate analysis was performed to assess the overall shift in modified Rankin Scale score and changes in the National Institutes of Health Stroke Scale score at 3 months. Survival curves were plotted using the Kaplan-Meier method, and the Cox proportional hazard model was used for multivariate analysis to investigate factors influencing survival.
  
  
  RESULTS
  After controlling for statistically relevant risk factors, subjects with high IGF-I levels or IGF-I/IGF binding protein 3 ratios had a better neurological and functional outcome at 3 months. Baseline stroke severity was not different between high and low IGF-I groups. In contrast to the low IGF-I group, neurological symptoms gradually improved from Day 3 in the high IGF-I group.
  
  
  CONCLUSIONS
  Our results suggest that high serum IGF-I levels just after ischemic stroke onset are associated with neurological recovery and a better functional outcome.
authors.affiliation: Department of Neurology, Center for Neurosciences, Universitair Ziekenhuis Brussel, Brussels, Belgium. ann.desmedt@uzbrussel.be
authors.forename: Ann
authors.initials: A
authors.lastname: De Smedt
authors.forename: Raf
authors.initials: R
authors.lastname: Brouns
authors.forename: Maarten
authors.initials: M
authors.lastname: Uyttenboogaart
authors.forename: Sylvie
authors.initials: S
authors.lastname: De Raedt
authors.forename: Maarten
authors.initials: M
authors.lastname: Moens
authors.forename: Nadine
authors.initials: N
authors.lastname: Wilczak
authors.forename: Gert-Jan
authors.initials: GJ
authors.lastname: Luijckx
authors.forename: Jacques
authors.initials: J
authors.lastname: De Keyser
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000097:blood* / Q000401:mortality; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood* / Q000401:mortality; D016896:Treatment Outcome
chemical_list: C515497:IGFBP3 protein, human; D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I