title: Serum IGF-1 is higher in patients with idiopathic normal pressure hydrocephalus than in the population.
abstract: BACKGROUND
  Hypopituitarism has been reported in patients with idiopathic normal pressure hydrocephalus (iNPH), which could enhance characteristic symptoms like impaired wakefulness, gait, body balance, and subcortical cognitive deterioration.
  
  
  OBJECTIVE
  To compare basal serum levels of pituitary and sex hormones and serum insulin-like growth factor-1 (S-IGF-1) in patients with iNPH and an age-matched control population, and to correlate the preoperative hormone levels with symptoms and signs pre-operatively and three months after surgery.
  
  
  METHODS
  A cross-sectional case control design was used. Patients diagnosed with iNPH, n=108 (65 men and 43 women, mean age 72.3 years), were consecutively included during 2006-2011 at Sahlgrenska University Hospital, Gothenburg, Sweden. S-TSH, S-free T4, S-FSH, S-LH, S-prolactin, plasma ACTH, S-testosterone, S-oestradiol and S-IGF-1 were examined. Symptoms and signs were scored using the iNPH scale score. Population controls, n=146, were recruited from the WHO MONICA project, Gothenburg in 2008.
  
  
  RESULTS
  Men and women with iNPH had higher S-IGF-1 than controls (p<0.001). Women with iNPH had lower S-TSH (p=0.016) than controls, but the frequency of levothyroxine substitution was similar. Among men, a higher level of S-IGF-1 was associated with milder symptoms, while higher levels of S-FSH and S-LH were associated with more severe symptoms.
  
  
  CONCLUSIONS
  Patients with iNPH did not have lower levels of pituitary or sex hormones but presented with higher levels of S-IGF-1, compared with healthy, age-matched controls. Higher S-IGF-1 in men was related to milder mental and physical symptoms and signs.
authors.affiliation: Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 11, Box 430, SE-405 30 Gothenburg, Sweden.. Electronic address: yi.yang_89@hotmail.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Section for Endocrinology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gröna stråket 8, Sahlgrenska University Hospital, S-413 45 Gothenburg, Sweden. Electronic address: kerstin.landin-wilhelmsen@gu.se.
authors.forename: K
authors.initials: K
authors.lastname: Landin-Wilhelmsen
authors.affiliation: Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 11, Box 430, SE-405 30 Gothenburg, Sweden. Electronic address: henrik.zetterberg@clinchem.gu.se.
authors.forename: H
authors.initials: H
authors.lastname: Zetterberg
authors.affiliation: Department of Clinical Chemistry and Transfusion Medicine, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Medicinaregatan 1 G, S-413 45 Gothenburg, Sweden. Electronic address: goran.olerod@clinchem.gu.se.
authors.forename: G
authors.initials: G
authors.lastname: Oleröd
authors.affiliation: Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Guldhedsgatan 10, S-413 46 Gothenburg, Sweden. Electronic address: jorgen.isgaard@medic.gu.se.
authors.forename: J
authors.initials: J
authors.lastname: Isgaard
authors.affiliation: Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 11, Box 430, SE-405 30 Gothenburg, Sweden.. Electronic address: carsten.wikkelso@neuro.gu.se.
authors.forename: C
authors.initials: C
authors.lastname: Wikkelsö
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000097:blood*; D007018:Hypopituitarism / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D011388:Prolactin / Q000097:blood; D013739:Testosterone / Q000097:blood; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood
chemical_list: C583557:IGF1 protein, human; D013739:Testosterone; D004958:Estradiol; D007334:Insulin-Like Growth Factor I; D000324:Adrenocorticotropic Hormone; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D013972:Thyrotropin; D013974:Thyroxine
keywords: IGF-1; Normal pressure hydrocephalus; Pituitary hormones; Sex hormones