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Association Between Levels of Serum Insulin-like Growth Factor I and Functional Recovery, Mortality, and Recurrent Stroke at a 7-year Follow-up

journal contribution
posted on 18.01.2021, 03:58 by N David Åberg, Daniel Åberg, Cecilia Lagging, Lukas Holmegaard, Petra Redfors, Katarina Jood, Michael Nilsson, Maria Åberg, Christian Blomstrand, Johan Svensson, Christina Jern, Jörgen Isgaard
© 2020 J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart • New York. Background The association of serum insulin-like growth factor I (s-IGF-I) with favorable outcome after ischemic stroke (IS) beyond 2 years is unknown. We investigated whether the levels of s-IGF-I 3 months post-stroke were associated with functional recovery up to 7 years after IS, considering also mortality and recurrent strokes. Methods Patients (N=324; 65% males; mean age, 55 years) with s-IGF-I levels assessed 3 months after the index IS were included from the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS). The modified Rankin Scale (mRS) was used to evaluate outcomes at 3 months, 2 and 7 years after IS, and recovery was defined as an improvement, no change, or deterioration in the shifts of mRS score. Baseline stroke severity was determined using the National Institutes of Health Stroke Scale (NIHSS). Results The mRS score distributions were better in the above-median s-IGF-I group (>146.7 ng/ml). The s-IGF-I level was not associated with recurrent stroke (N=79) or death (N=44), although it correlated with recovery (r=0.12, P=0.035). In the regression analysis, s-IGF-I associated with recovery between 3 months and 7 years (but not between 2 and 7 years). The associations did not withstand adjustment for age and sex. For comparison, the corresponding associations between 3 months and 2 years withstood all adjustments. Conclusion The association for s-IGF-I with long-term post-stroke recovery persists after 7 years, which is also reflected in the mRS score distributions at all time-points. The effects are however modest, and not driven by mortality or recurrent stroke.


The authors wish to thank Dr. Vincent Collins for careful correction of the English language of the manuscript. This study was supported by the Swedish Medical Society (Svenska Lakaresallskapet), grants from the Swedish Government (ALFGBG-719761, ALFG-BG-751111), the Swedish Stroke Association, the Goteborg Foundation for Neurological Research, and the Yngve Land, Rune and Ulla Amlov, Edit Jacobson, Magnus Bergvall, Emelle, Lars Hierta, and John and Brit Wennerstrom Foundations.


Publication Date



Experimental and Clinical Endocrinology and Diabetes






8p. (p. 303-310)





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