Ebinger M, Ipsen N, Leonards C O, Empl L, Hanne L, Liman T, Mai K, Strasburger C J, Spranger J, Endres M
Department of Neurology, Charité - Universitätsmedizin Berlin, Germany.
Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Germany.
Exp Clin Endocrinol Diabetes. 2015 Sep;123(8):461-5. doi: 10.1055/s-0035-1554632. Epub 2015 Jun 11.
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.
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).
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.
IGFBP-3 levels after ischemic stroke may independently predict functional outcome after one year.
胰岛素样生长因子-1（IGF-1）和胰岛素样生长因子结合蛋白-3（IGFBP-3）具有神经保护作用。我们试图确定IGF-1和IGFBP-3水平是否能预测缺血性中风后的功能结局。
在参与柏林奶油与糖研究的首次缺血性中风患者中风后的第一周测量IGF-1和IGFBP-3水平。入院时收集美国国立卫生研究院卒中量表（NIHSS）。如有可用的急性磁共振成像（MRI），则确定病灶体积。一年后根据改良Rankin量表（mRS）评估功能结局。在多变量分析中，我们确定了与不良功能结局（mRS>2）相关的参数。
我们纳入了100例患者。21例患者有不良功能结局。7例患者的IGF-1水平低于-2标准差评分（SDS），12例患者的IGF-1水平高于2 SDS。13例患者的IGFBP-3水平低于第5百分位数，没有患者的IGFBP-3水平高于第95百分位数。在单变量分析中，低水平的IGFBP-3（p=0.002）、入院时的NIHSS（p=0.043）和年龄（p=0.001）与不良功能结局相关。在包括IGFBP-3、IGF-1年龄、溶栓治疗和NIHSS的多变量分析中，只有低IGFBP-3水平（比值比7.2，95%置信区间1.8-29.0，p=0.006）与不良功能结局相关。如果纳入病灶体积（n=71），只有IGFBP-3水平（比值比7.2，95%置信区间1.5-35.5，p=0.015）与不良功能结局相关。
缺血性中风后的IGFBP-3水平可能独立预测一年后的功能结局。
