Serum IGF-1 level as a prognostic marker for acute ischemic stroke: a systematic review

Shayan Roshdi  Dizaji; Hamed  Zarei; Sajjad  Jabermoradi; Parsa  Paridari; Mostafa  Hosseini; Mahmoud  Yousefifard

doi:10.18502/fem.v9i1.18069

Shayan Roshdi Dizaji Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran.
Hamed Zarei Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
Sajjad Jabermoradi Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
Parsa Paridari Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
Mostafa Hosseini Pediatric Chronic Kidney Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Mahmoud Yousefifard Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/fem.v9i1.18069

Keywords: Ischemic Stroke; Insulin-Like Growth Factor I; Prognosis

Abstract

Objective: Assessing the risk levels of patients with acute ischemic stroke (AIS) can assist in making informed choices about their treatment and rehabilitation. To assess the prognostic value of serum insulin-like growth factor-1 (IGF-1) in neurological deficit (National Institutes of Health Stroke Scale [NIHSS]), functional independence (Modified Rankin Scale [mRS]), and mortality following AIS.

Methods: The search encompassed Medline, Embase, Scopus, and Web of Science until June 2023. Two autonomous researchers incorporated articles by the established inclusion and exclusion criteria. The quality of the included studies were assessed using the quality assessment of prognostic accuracy studies (QUAPAS) tool.

Results: Ten articles were included, with evidence suggesting that IGF-1 may have prognostic value in AIS outcomes. Several studies reported positive associations between IGF-1 levels, reduced neurological deficits, improved functional independence, and lower mortality. Additionally, intraindividual fluctuations in IGF-1 after AIS were identified as a potential predictor of recovery in functional independence, though significant inconsistencies exist in the findings.

Conclusion: The available studies with a very low level of evidence are not sufficient to firmly endorse the applicability of IGF-1 as a prognostic factor for mortality, neurological disability, and functional independence.