title: Circulating insulin-like growth factor binding protein-3 predicts one-year outcome after ischemic stroke.
abstract: BACKGROUND
  Insulin-like Growth Factor-1 (IGF-1) and Insulin-like Growth Factor Binding Protein-3 (IGFBP-3) have been ascribed neuroprotective effects. We sought to determine whether levels of IGF-1 and IGFBP-3 predict functional outcome after ischemic stroke.
  
  
  METHODS
  IGF-1 and IGFBP-3 levels were measured in the first week after stroke in patients with first ischemic stroke who were enrolled in the Berlin Cream&Sugar Study. National Institutes of Health Stroke Scale (NIHSS) was collected at admission. Lesion volume was determined from acute MRI if available. Functional outcome according to the modified Rankin Scale (mRS) was assessed after one year. In multivariate analyses we identified parameters associated with unfavourable functional outcome (mRS>2).
  
  
  RESULTS
  We included 100 patients. 21 patients had an unfavourable functional outcome. IGF-1 levels were<- 2 standard deviation score (SDS) in 7 patients, and>2 SDS in 12 patients. IGFBP-3 levels were<the 5(th) percentile in 13 patients, and no patient had IGFBP-3 levels>the 95(th) percentile. Low levels of IGFBP-3 (p=0.002), NIHSS at admission (p=0.043) and age (p=0.001) were associated with unfavourable functional outcome in the univariate analyses. In multivariate analysis including IGFBP-3, IGF-1, age, thrombolysis and NIHSS only low IGFBP-3 levels (OR 7.2, 95%CI 1.8-29.0, p=0.006) were associated with unfavourable functional outcome. If lesion volume was incuded (n=71), only IGFBP-3 levels (OR 7.2, 95%CI 1.5-35.5, p=0.015) were associated with unfavourable functional outcome.
  
  
  CONCLUSIONS
  IGFBP-3 levels after ischemic stroke may independently predict functional outcome after one year.
authors.affiliation: Department of Neurology, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Ebinger
authors.affiliation: Department of Neurology, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Ipsen
authors.affiliation: Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: C O
authors.initials: CO
authors.lastname: Leonards
authors.affiliation: International Graduate Program Medical Neurosciences, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Empl
authors.affiliation: Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Hanne
authors.affiliation: Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Liman
authors.affiliation: Department of Endocrinology and Metabolism, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Mai
authors.affiliation: Department of Endocrinology and Metabolism, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: C J
authors.initials: CJ
authors.lastname: Strasburger
authors.affiliation: Department of Endocrinology and Metabolism, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Spranger
authors.affiliation: Department of Neurology, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Endres
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000097:blood* / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; 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; D011859:Radiography; D020521:Stroke / Q000097:blood* / Q000000981:diagnostic imaging
chemical_list: C583557:IGF1 protein, human; C515497:IGFBP3 protein, human; D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I