[Relation between insulin-like growth factor-1 and insulin resistance in patients with acute stroke]

To study the changes of plasma insulin-like growth factor -1 (IGF-1) and IGF binding protein 3 (IGFBP3) in patients with acute cerebral infarct (ACI) and acute cerebral hemorrhage (ACH) and the correlation of IGF-1 and IGFBP3 with plasma fasting insulin (FINS) related to insulin resistance (IR) and with insulin sensitive index (ISI).

The plasma IGF-1, IGFBP3 and FINS of 34 patients with ACI and 40 patients with ACH (within 2 days after onset) were measured by radioimmunoassay. Meanwhile, the fasting blood glucose (GS) of these patients was measured. 30 patients with ACH during convalescence (3 approximately 6 months after stroke) and 30 age-matched healthy individuals served as control groups.

(1) The plasma IGF-1 and IGFBP3 and ISI were 17.3 +/- 7.0 mmol/L, 72.9 +/- 11.4 mmol/L and -4.2 +/- 0.3 respectively in the ACI group, 14.4 +/- 5.8 mmol/L, 57.8 +/- 17.2 mmol/L and -4.7 +/- 0.6 in the ACH group; 28.8 +/- 13.6 mmol/L, 87.4 +/- 18.3 mmol/L and -3.9 +/- 0.4 in the convalescence group; and 31.5 +/- 18.9 mmol/L, 93.1 +/- 28.0 mmol/L and -3.6 +/- 0.3 in the healthy control group. The values in the former two groups were significantly lower than those in the two control groups (F = 18.3, 20.2 and 17.2 respectively, P < 0.01). The plasma glucose was 6.1 +/- 1.0 mmol/L in ACI group, 6.4 +/- 2.1 mmol/L in ACH group, and 4.8 +/- 0.5 mmol/L in healthy control group (F = 8.5, P < 0.01). The plasma FINS was 15.7 +/- 3.1 mIU/L in ACI group, 19.7 +/- 9.6 mIU/L in ACH group, and 10.6 +/- 3.2 mIU/L in healthy control group (F = 10.6, P < 0.01). (2) In patients with ACI and ACH, there was a significant positive correlation between plasma IGF-1 and IGFBP3 (P < 0.01), between plasma IGF-1 and ISI (P < 0.01), and between IGFBP3 and ISI (P < 0.05); and there was a significant negative correlation between plasma IGF-1 and FINS and between IGFBP3 and FINS (P < 0.01).

The plasma IGF-1 and IGFBP3 participates in the pathophysiologic course of ACI and ACH in the early stage. Insulin resistance exists in ACI and ACH. Plasma IGF-1 may play an important role in IR in ACI and ACH.