Dynamic changes and their clinical significance of serum insulin-like growth factor-1 in patients with acute traumatic brain injury / 中华创伤杂志

ABSTRACT

Objective To investigate the dynamic changes of serum insulin-like growth factor-1 (IGF-1) in acute traumatic brain injury (TBI) as well as their correlations with the initial severity of TBI and prognosis.Methods A total of 229 patients with acute TBI admitted from September 2014 to June 2016 were retrospectively studied.Patients were further classified as mild TBI group (GCS 13-15 points),moderate TBI group (GCS 9-12 points) and severe TBI group (GCS 3-8 points) according to Glasgow coma score (GCS).The control group consisted of 30 healthy subjects.The prognosis was evaluated by using Glasgow outcome scale (GOS) at 6 months after TBI.The IGF-1 levels were further tested at days 1,3,5,7 and 14 and their correlations with the initial GCS and GOS at 6 months after injury were evaluated.Results (1) The serum IGF-1 levels of mild,moderate and severe TBI group at all time points were significantly lower than those of the control group (P ＜ 0.05);the serum IGF-1 levels of severe and moderate TBI groups at all time points after injury were significantly lower than those of the mild TBI group (P ＜0.05);the serum IGF-1 levels of the severe group at days 1,3,5 and 7 d after injury were lower than those of the moderate TBI group (P＜0.05).(2) IGF-1 levels were significantly different between the two groups (P ＜ 0.05) at different time points during the follow-up of 6 months.(3)IGF-1 levels were positively correlated with both GCS and GOS at the acute stage of TBI and sub-acute stage following TBI (P ＜ 0.05).Conclusion The dynamic changes of serum IGF-1 levels in patients with acute TBI are related to both initial severity of TBI and the neurological outcomes and can be used as a reliable biomarker for early severity assessment and prognostic prediction of TBI.