PMID- 15336580
OWN - NLM
STAT- MEDLINE
DCOM- 20040917
LR  - 20071115
IS  - 0002-9343 (Print)
IS  - 0002-9343 (Linking)
VI  - 117
IP  - 5
DP  - 2004 Sep 1
TI  - Insulin-like growth factor 1 as a predictor of ischemic stroke outcome in the 
      elderly.
PG  - 312-7
AB  - PURPOSE: To examine whether serum insulin-like growth factor 1 (IGF-1) and IGF 
      binding protein 3 (IGFBP-3) concentrations, determined early after the onset of 
      stroke, are predictive of clinical outcome in elderly patients. METHODS: The 
      sample comprised 85 patients (mean [+/- SD] age, 83 +/- 7.4 years; range, 67 to 
      99 years; 34% male) who were admitted with acute stroke to a geriatric ward 
      between January 1998 and June 2000, and 88 control patients who were similar in 
      age and sex. Clinical and laboratory assessments, computed tomographic scan of 
      the head, carotid ultrasonography, and electrocardiography were employed to 
      define the clinical and etiologic stroke subtype. Fasting blood samples were 
      collected within 24 hours of admission for IGF-I and IGFBP-3 measurement. 
      Univariate and multiple logistic regression analyses, with adjustment for other 
      related clinical covariates, were used to assess the relation of IGF-I and 
      IGFBP-3 to poor outcome, defined as severe disability (Barthel index <60/100) or 
      death, at 1 month (or at discharge), 3 months, and 6 months. RESULTS: Mean (+/- 
      SD) IGF-1 levels were lower in patients with stroke than in controls (69 +/- 45 
      ng/mL vs. 102 +/- 67 ng/mL, P adjusted for age = 0.001). The mean IGF-1/IGFBP-3 
      molar ratio was also lower in stroke patients (0.12 +/- 0.07 vs. 0.19 +/- 0.09, P 
      adjusted for age <0.0001). However, there was no relation of hormone levels to 
      either the clinical subtype of stroke or the extent of neurologic impairment. 
      IGF-1 levels were inversely related to poor outcome (mainly death) at 3 and 6 
      months, independent of other clinical covariates that were highly predictive of 
      outcome, such as age and stroke scale score on admission (hazard ratio for death 
      at 6 months for each 20-ng/mL increase = 0.7; 95% confidence interval: 0.5 to 
      0.9). An independent association of the molar ratio with death at 3 and 6 months 
      was also found. CONCLUSION: Low levels of circulating IGF-1 may predict the 
      clinical outcome of stroke in elderly patients.
FAU - Denti, Licia
AU  - Denti L
AD  - Department of Internal Medicine and Biomedical Sciences, Section of Geriatrics, 
      University of Parma, Parma, Italy.
FAU - Annoni, Valentina
AU  - Annoni V
FAU - Cattadori, Evelina
AU  - Cattadori E
FAU - Salvagnini, Maria Angela
AU  - Salvagnini MA
FAU - Visioli, Sandra
AU  - Visioli S
FAU - Merli, Maria Francesca
AU  - Merli MF
FAU - Corradi, Francesco
AU  - Corradi F
FAU - Ceresini, Graziano
AU  - Ceresini G
FAU - Valenti, Giorgio
AU  - Valenti G
FAU - Hoffman, Andrew R
AU  - Hoffman AR
FAU - Ceda, Gian Paolo
AU  - Ceda GP
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Med
JT  - The American journal of medicine
JID - 0267200
RN  - 0 (Insulin-Like Growth Factor Binding Protein 3)
RN  - 67763-96-6 (Insulin-Like Growth Factor I)
SB  - IM
MH  - Activities of Daily Living
MH  - Acute Disease
MH  - Aged
MH  - Aged, 80 and over
MH  - Analysis of Variance
MH  - Biological Availability
MH  - Brain Ischemia/*complications
MH  - California/epidemiology
MH  - Case-Control Studies
MH  - Fasting
MH  - Female
MH  - Geriatric Assessment
MH  - Humans
MH  - Immunoradiometric Assay
MH  - Insulin-Like Growth Factor Binding Protein 3/*metabolism
MH  - Insulin-Like Growth Factor I/*metabolism
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Risk Factors
MH  - Stroke/*blood/etiology/*mortality
MH  - Survival Analysis
EDAT- 2004/09/01 05:00
MHDA- 2004/09/21 05:00
CRDT- 2004/09/01 05:00
PHST- 2003/04/28 00:00 [received]
PHST- 2004/02/26 00:00 [revised]
PHST- 2004/02/26 00:00 [accepted]
PHST- 2004/09/01 05:00 [pubmed]
PHST- 2004/09/21 05:00 [medline]
PHST- 2004/09/01 05:00 [entrez]
AID - S0002-9343(04)00334-1 [pii]
AID - 10.1016/j.amjmed.2004.02.049 [doi]
PST - ppublish
SO  - Am J Med. 2004 Sep 1;117(5):312-7. doi: 10.1016/j.amjmed.2004.02.049.