Zhejiang Chinese Medical University, Hangzhou, China.
Department of Rehabilitation and Traditional Chinese Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
BMJ Open. 2022 Jun 15;12(6):e045776. doi: 10.1136/bmjopen-2020-045776.
To assess the association of insulin-like growth factor 1 (IGF-1) with the risk of incident ischaemic stroke and outcome after ischaemic stroke.
A systematic review of primary studies.
Hospitals in Western Sweden, Italy, China and Denmark.
A search was carried out in eligible studies in electronic databases (PubMed, Scopus, Embase, China National Knowledge Infrastructure and Web of Science) updated to 29 December 2020. The relevant data were extracted in order to conduct the meta-analysis. Review Manager V.5.2 was used to pool data and calculate the mean difference (MD) and its 95% CI. Heterogeneity, subgroup analysis, sensitivity analysis and publication bias were also performed in this meta-analysis.
A total of 2277 patients were included in 17 studies. This meta-analysis indicated that higher serum IGF-1 levels were significantly correlated with less risk of ischaemic stroke (MD=-45.32 95% CI -63.70 to -26.94], p < 0.00001, I=99%) and better improvement of outcome after ischaemic stroke (MD=27.52, 95% CI 3.89 to 51.14, p=0.02, I=96%). According to subgroup analysis, heterogeneity comes from country, sample size, male and the time from symptom onset to blood collection. Sensitivity analysis showed that there was no significant influence of any individual study on the pooled MD. The effect of high heterogeneity on result credibility was eliminated when four included studies were merged (MD=-30.32, 95% CI -36.52 to -24.11, p< 0.00001, I=0%). Moreover, no potential publication bias was discovered in this meta-analysis.
Higher serum IGF-1 was significantly correlated with a lower risk of ischaemic stroke. In view of the high degree of heterogeneity, it may need more studies to confirm the prognostic value of serum IGF-1 levels in ischaemic stroke and explore the sources of heterogeneity.
评估胰岛素样生长因子 1（IGF-1）与缺血性卒中发病风险和缺血性卒中后结局的关系。
对原始研究进行系统评价。
瑞典西部、意大利、中国和丹麦的医院。
在符合条件的研究中对电子数据库（PubMed、Scopus、Embase、中国国家知识基础设施和 Web of Science）进行了检索，检索更新至 2020 年 12 月 29 日。提取相关数据进行荟萃分析。使用 Review Manager V.5.2 汇总数据并计算均数差（MD）及其 95%置信区间（CI）。还对该荟萃分析进行了异质性、亚组分析、敏感性分析和发表偏倚。
共有 2277 名患者纳入 17 项研究。该荟萃分析表明，较高的血清 IGF-1 水平与缺血性卒中风险降低显著相关（MD=-45.32，95%CI-63.70 至-26.94]，p<0.00001，I=99%），且缺血性卒中后结局改善更好（MD=27.52，95%CI 3.89 至 51.14，p=0.02，I=96%）。根据亚组分析，异质性来源于国家、样本量、性别和从症状发作到采血的时间。敏感性分析表明，任何单个研究对汇总 MD 的影响均无显著影响。当合并四项纳入研究时，高异质性对结果可信度的影响消除（MD=-30.32，95%CI-36.52 至-24.11，p<0.00001，I=0%）。此外，该荟萃分析未发现潜在的发表偏倚。
较高的血清 IGF-1 与缺血性卒中的风险降低显著相关。鉴于高度异质性，可能需要更多的研究来证实血清 IGF-1 水平对缺血性卒中的预后价值，并探讨异质性的来源。
