Abstract
BACKGROUND: Insulin-like growth factor-binding proteins (IGFBPs) contribute to central nervous system development and may influence recovery after stroke. This study aimed to determine whether serum IGFBPs levels in acute ischemic stroke (AIS) patients are associated with 3-month outcomes. MATERIALS AND METHODS: We retrospectively reviewed data from AIS patients admitted within 24 h after stroke onset, and who had been prospectively enrolled in the Chengdu Stroke Registry. Serum IGFBPs 4, 6 and 7 levels at admission were compared between patients experienced good outcome (modified Rankin Scale scores of 0-2) or poor outcome (scores of 3-6) at 3 months after stroke onset. Factors associated with good outcome were identified using logistic regression. RESULTS: Among 194 patients, 115 (59.3%) experienced good outcome at 3 months. Patients with good outcome showed significantly higher levels of all three IGFBPs at admission. Good outcome was independently associated with higher serum levels of IGFBP 4 (OR 1.013, 95% CI 1.005-1.020) and IGFBP 7 (OR 1.012, 95% CI 1.003-1.021) after adjustment for potential confounders. Adding either or both IGFBPs to a model based on conventional clinical factors significantly improved good outcome prediction, with net reclassification improvement of 41.9-54.5% and integrated discrimination improvement of 3.8-5.8%. The model containing both IGFBPs predicted good outcome with an area of 0.878 (95% CI 0.827-0.929) under the receiver operating characteristic curve. CONCLUSIONS: Higher serum IGFBPs 4 and 7 levels may be associated with greater probability of good outcome at 3 months after AIS.