Evidence map›Paper›PMID 30081862›Full record

Observational studyBMC neurology2018

Altered levels of circulating insulin-like growth factor I (IGF-I) following ischemic stroke are associated with outcome - a prospective observational study.

N David Åberg, Daniel Åberg, Katarina Jood, Michael Nilsson, Christian Blomstrand, H Georg Kuhn, Johan Svensson, Christina Jern, Jörgen Isgaard

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC neurology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
  5. Article
  6. Article
  7. Article
  8. Observational
  9. Review
  10. Preclinical and clinical evidence of IGF-1 as a prognostic marker and acute intervention with ischemic stroke.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2021
    Article
  11. Article
  12. Article
  13. Review
  14. Observational
  15. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 3 countries.

N David ÅbergDepartment of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gröna Stråket 8, SE-413 45, Gothenburg, Sweden. david.aberg@medic.gu.se.
Daniel ÅbergDepartment of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gröna Stråket 8, SE-413 45, Gothenburg, Sweden.
Katarina JoodDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Michael NilssonDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Christian BlomstrandDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
H Georg KuhnDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Johan SvenssonDepartment of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gröna Stråket 8, SE-413 45, Gothenburg, Sweden.
Christina JernInstitute of Biomedicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Jörgen IsgaardDepartment of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gröna Stråket 8, SE-413 45, Gothenburg, Sweden.
University of Gothenburg · SECharité - Universitätsmedizin Berlin · DE

Funding

Grants from the Swedish Government ALFGBG-493761Hjärt-Lungfonden 20100256STROKE-Riksförbundet N/AVetenskapsrådet K2015-63X-20117-10-4
6 · The paper itself

Abstract

backgroundInsulin-like growth factor I (IGF-I) has neuroprotective effects in experimental ischemic stroke (IS). However, in patients who have suffered IS, various associations between the levels of serum IGF-I (s-IGF-I) and clinical outcome have been reported, probably reflecting differences in sampling time-points and follow-up periods. Since changes in the levels of post-stroke s-IGF-I have not been extensively explored, we investigated whether decreases in the levels of s-IGF-I between the acute time-point (median, 4 days) and 3 months (ΔIGF-I, further transformed into ΔIGF-I-quintiles, ΔIGF-I-q) are associated with IS severity and outcome.

methodsIn the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS) conducted in Gothenburg, Sweden, patients with IS who had s-IGF-I measurements available were included (N = 354; 65% males; mean age, 55 years). Baseline stroke severity was evaluated using the National Institutes of Health Stroke Scale (NIHSS) and converted into NIHSS-quintiles (NIHSS-q). Outcomes were assessed using the modified Rankin Scale (mRS) at 3 months and 2 years.

resultsIn general, the levels of s-IGF-I decreased (positive ΔIGF-I), except for those patients with the most severe NIHSS-q. After correction for sex and age, the 3rd ΔIGF-I-q showed the strongest association to mRS 0-2 [Odds Ratio (OR) 5.11, 95% confidence interval (CI) 2.18-11.9], and after 2 years, the 5th ΔIGF-I-q (OR 3.63, 95% CI 1.40-9.38) showed the strongest association to mRS 0-2. The associations remained significant after multivariate correction for diabetes, smoking, hypertension, and hyperlipidemia after 3 months, but were not significant (p = 0.057) after 2 years. The 3-month associations withstood additional correction for baseline stroke severity (p = 0.035), whereas the 2-year associations were further attenuated (p = 0.31).

conclusionsChanges in the levels of s-IGF-I are associated primarily with temporally near 3-month outcomes, while associations with long-term 2-year outcomes are weakened and attenuated by other factors. The significance of the change in post-stroke s-IGF-I is compatible with a positive role for IGF-I in IS recovery. However, the exact mechanisms are unknown and probably reflects combinations of multiple peripheral and central actions.

Indexed as

Brain IschemiaFemaleHumansInsulin-Like Growth Factor IMaleMiddle AgedProspective StudiesSeverity of Illness IndexStrokeSwedenIGF1 protein, humanInsulin-Like Growth Factor IInsulin-like growth factor IIschemic strokeOutcome

Identifiers

PMID30081862
PMCPMC6091156
OpenAlexW2886386029

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.