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      Decrease in Insulin-like Growth Factor 1 and Insulin-like Growth Factor 1 Ratio in the First Week of Stroke is Related to Positive Outcomes

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          Abstract

          Background

          High insulin-like growth factor-1 (IGF-1), measured once during acute-stroke, is associated with greater survival rates and lower stroke severity. However, information is lacking regarding how IGF-1 availability, determined by IGF-1’s ratio to insulin-like growth factor binding protein-3 (IGFBP-3), relates to recovery and how the response of IGF-1 during the first week of stroke relates to outcomes. The purpose of this study was to determine: 1) the relationship between percent-change in IGF-1 and IGF-1 ratio during the first week of stroke and stroke outcomes; and 2) the difference in percent-change in IGF-1 and IGF-1 ratio in individuals who discharged home and individuals who discharged to inpatient facilities.

          Methods

          IGF-1 and IGFBP-3 were quantified from blood sampled twice (<72 hours of admission; 1-week post-stroke) in fifteen individuals with acute-stroke. Length of stay, modified Rankin Scale at one-month, and discharge destination were obtained from electronic medical records.

          Results

          Percent-change in IGF-1 ratio was related to length of stay (r=.54; p=.04). Modified Rankin Scale (n=10) was related to percent-change in IGF-1 (r=.90; p<.001) and IGF-1 ratio (r=.75 p=.01). Those who went home (n=7) had decreases in IGF-1 (−24±25%) and IGF-1 ratio (−36±50%), while those who went to inpatient facilities (n=8) had increases in IGF-1 (37±46%) and IGF-1 ratio (30±40%). These differences were significant (IGF-1: p=.008; IGF-1 ratio p=.01).

          Conclusion

          Our findings suggest that a decrease in IGF-1 and IGF-1 ratio during the first week of stroke is associated with favorable outcomes: shorter length of stay, greater independence at one-month on the modified Rankin Scale, and discharging home.

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          Author and article information

          Journal
          9111633
          32751
          J Stroke Cerebrovasc Dis
          J Stroke Cerebrovasc Dis
          Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
          1052-3057
          1532-8511
          15 April 2016
          22 April 2016
          July 2016
          01 July 2017
          : 25
          : 7
          : 1800-1806
          Affiliations
          [1 ]Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS
          [2 ]Department of Neurology, The University of Kansas Hospital, Kansas City, KS
          [3 ]Advanced Comprehensive Stroke Center, The University of Kansas Hospital, Kansas City, KS
          Author notes
          Corresponding Author: Sandra A. Billinger, PT, PhD, University of Kansas Medical Center, Dept of Physical Therapy and Rehabilitation Science, 3901 Rainbow Blvd, Mail Stop 2002, Kansas City, KS 66160, 913-945-6685, 913-588-4568 (fax), sbillinger@ 123456kumc.edu
          Article
          PMC4912441 PMC4912441 4912441 nihpa776408
          10.1016/j.jstrokecerebrovasdis.2016.03.054
          4912441
          27113779
          f9d86aba-75ca-4e25-9e6a-ab1b03143b92
          History
          Categories
          Article

          length of stay,acute stroke,insulin-like growth factor-1,discharge destination

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