Endocrine Abstracts

JOINT692

Background: In acute ischemic stroke (AIS), low IGF-1 levels are associated with unfavorable prognosis; however, the relationship with GH levels remains unclear. On the other hand, some reports suggest that elevated GH levels in cardiovascular disease are associated with increased mortality. Therefore, in this study, we investigated the relationship between post-stroke GH and IGF-1 levels and the modified Rankin Scale (mRS) at three months from the onset of AIS.

Methods: Between October 2020 and December 2022, patients admitted to our hospital with AIS were included in the study. GH and IGF-1 levels were measured on or after the 7th day of hospitalization. At three months post-stroke, patients were classified into a favorable outcome group (FOG: mRS ≤1) and an unfavorable outcome group (UOG: mRS ≥2), and the relationship between GH and IGF-1 levels and prognosis was analyzed.

Results: A total of 130 participants were enrolled in this study, and 124 cases were included in the final analysis (95 males [77%], median age 62 years). Among them, 25 patients (20%) were classified into the unfavorable outcome group. The Mann–Whitney U test revealed that GH levels were significantly higher in the unfavorable outcome group (P=0.02), whereas there was no significant difference in the IGF-1 SD score (IGF-1 SDS) between the two groups. Next, a ROC-analysis was performed to determine the optimal cutoff value for GH in distinguishing the two groups, which was estimated to be 0.2 ng/ml. Based on these findings, the 124 patients were categorized into four groups using GH 0.2 ng/ml and IGF-1 SDS -2.0 as cutoff values: ‘high GH – high IGF-1,’ ‘high GH – low IGF-1,’ ‘low GH – high IGF-1,’ and ‘low GH – low IGF-1.’ Logistic regression analysis, FOG/UOG as dependent variables, revealed that both the NIHSS score (P < 0.001, OR 1.12 [1.05–1.20]) and the ‘high GH – low IGF-1’ group (compared with the ‘low GH – high IGF-1’ group, P=0.02, OR 6.23 [1.32–28.54]) were significantly associated with unfavorable prognosis.

Conclusion: Our study demonstrated that patients with high GH levels and low IGF-1 SDS are associated with poorer stroke outcomes. These findings suggest that a state of ‘GH resistance,’ characterized by elevated GH levels without a corresponding increase in IGF-1, may be a prognostic factor for poor outcomes. Further studies are currently planned to investigate the impact of ‘GH resistance’ as a determinant of prognosis in AIS.