Consistent patterns in the inconsistent associations of Insulin-like growth factor 1 (IGF-1), C-Reactive Protein (C-RP) and Interleukin 6 (IL-6) levels with delirium in surgical populations. A systematic review and meta-analysis

2021 ◽  
pp. 104518
Author(s):  
Dimitrios Adamis ◽  
Willem A. van Gool ◽  
Piet Eikelenboom
Keyword(s):  
Systematic Review ◽  
Growth Factor ◽  
Interleukin 6 ◽  
Protein C ◽  
Meta Analysis ◽  
Insulin Like Growth Factor ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Interleukin-6, C-reactive protein, fibrinogen, and risk of recurrence after ischaemic stroke: Systematic review and meta-analysis

2021 ◽  
pp. 239698732098400
Author(s):  
JJ McCabe ◽  
E O’Reilly ◽  
S Coveney ◽  
R Collins ◽  
L Healy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Random Effects ◽  
Interleukin 6 ◽  
Inflammatory Markers ◽  
Recurrent Stroke ◽  
Meta Analysis ◽  
Randomised Trials ◽  
C Reactive Protein ◽  
Vascular Events ◽  
Reactive Protein

Background Recent randomised trials showed benefit for anti-inflammatory therapies in coronary disease but excluded stroke. The prognostic value of blood inflammatory markers after stroke is uncertain and guidelines do not recommend their routine measurement for risk stratification. Methods We performed a systematic review and meta-analysis of studies investigating the association of C-reactive protein (CRP), interleukin-6 (IL-6) and fibrinogen and risk of recurrent stroke or major vascular events (MVEs). We searched EMBASE and Ovid Medline until 10/1/19. Random-effects meta-analysis was performed for studies reporting comparable effect measures. Results Of 2,515 reports identified, 39 met eligibility criteria (IL-6, n = 10; CRP, n = 33; fibrinogen, n = 16). An association with recurrent stroke was reported in 12/26 studies (CRP), 2/11 (fibrinogen) and 3/6 (IL-6). On random-effects meta-analysis of comparable studies, CRP was associated with an increased risk of recurrent stroke [pooled hazard ratio (HR) per 1 standard-deviation (SD) increase in loge-CRP (1.14, 95% CI 1.06–1.22, p < 0.01)] and MVEs (pooled HR 1.21, CI 1.10–1.34, p < 0.01). Fibrinogen was also associated with recurrent stroke (HR 1.26, CI 1.07–1.47, p < 0.01) and MVEs (HR 1.31, 95% CI 1.15–1.49, p < 0.01). Trends were identified for IL-6 for recurrent stroke (HR per 1-SD increase 1.17, CI 0.97–1.41, p = 0.10) and MVEs (HR 1.22, CI 0.96–1.55, p = 0.10). Conclusion Despite evidence suggesting an association between inflammatory markers and post-stroke vascular recurrence, substantial methodological heterogeneity was apparent between studies. Individual-patient pooled analysis and standardisation of methods are needed to determine the prognostic role of blood inflammatory markers and to improve patient selection for randomised trials of inflammatory therapies.

505 INTERLEUKIN-6, C-REACTIVE PROTEIN, FIBRINOGEN, AND RISK OF RECURRENCE AFTER ISCHEMIC STROKE: SYSTEMATIC REVIEW AND META-ANALYSIS

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii1-ii4
Author(s):  
J J McCabe ◽  
E O’Reilly ◽  
S Coveney ◽  
J Harbison ◽  
R Collins ◽  
...  
Keyword(s):  
Systematic Review ◽  
Random Effects ◽  
Interleukin 6 ◽  
Inflammatory Markers ◽  
Recurrent Stroke ◽  
Meta Analysis ◽  
Randomised Trials ◽  
C Reactive Protein ◽  
Vascular Events ◽  
Reactive Protein

Abstract Background Recent randomised trials showed benefit for anti-inflammatory therapies in coronary disease but excluded stroke. The prognostic value of blood inflammatory markers after stroke is uncertain and guidelines do not recommend their routine measurement for risk stratification. Methods We performed a systematic review and meta-analysis of studies investigating the association of C-reactive protein (CRP), interleukin-6 (IL-6) and fibrinogen and risk of recurrent stroke or major vascular events (MVEs). We searched EMBASE and Ovid Medline until 10/1/19. Random-effects meta-analysis was performed for studies reporting comparable effect measures. Results Of 2,515 reports identified, 39 met eligibility criteria (IL-6, n = 10; CRP, n = 33; fibrinogen, n = 16). An association with recurrent stroke was reported in 12/26 studies (CRP), 2/11 (fibrinogen) and 3/6 (IL-6). On random-effects meta-analysis of comparable studies, CRP was associated with an increased risk of recurrent stroke [pooled hazard ratio (HR) per 1 standard-deviation (SD) increase in loge-CRP (1.14, 95% CI 1.06-1.22, p &lt; 0.01)] and MVEs (pooled HR 1.21, CI 1.10-1.34, p &lt; 0.01). Fibrinogen was also associated with recurrent stroke (HR 1.26, CI 1.07-1.47, p &lt; 0.01) and MVEs (HR 1.31, 95% CI 1.15-1.49, p &lt; 0.01). Trends were identified for IL-6 for recurrent stroke (HR per 1-SD increase 1.17, CI 0.97-1.41, p = 0.10) and MVEs (HR 1.22, CI 0.96-1.55, p = 0.10). Conclusion Despite evidence suggesting an association between inflammatory markers and post-stroke vascular recurrence, substantial methodological heterogeneity was apparent between studies. Individual-patient pooled analysis and standardisation of methods are needed to determine the prognostic role of blood inflammatory markers and to improve patient selection for randomised trials of inflammatory therapies.

Prognostic role of C-reactive protein and Interleukin-6 in dialysis patients: a systematic review and meta-analysis

2012 ◽  
Vol 26 (2) ◽  
pp. 243-253 ◽  
Author(s):  
Wei Zhang ◽  
Jing He ◽  
Fengmei Zhang ◽  
Chengjin Huang ◽  
Ying Wu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Interleukin 6 ◽  
Meta Analysis ◽  
C Reactive Protein ◽  
Dialysis Patients ◽  
Prognostic Role ◽  
Reactive Protein

Διαταραχές στον άξονα της αυξητικής ορμόνης σε ασθενείς της μονάδας εντατικής θεραπείας με σήψη

2013 ◽  
Author(s):  
Χρυσούλα Παπαστάθη
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Growth Factor ◽  
Interleukin 6 ◽  
Insulin Like Growth Factor ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Septic Episode ◽  
Igf I ◽  
Igfbp 3

Objective: To investigate the Growth Hormone (GH)/Insulin-like Growth Factor-I (IGF-I)axis and identify the factors that determine IGF-I levels in adult septic patients of variable severity,i.e., with sepsis, severe sepsis or septic shock, in the acute phase of disease.Design: Prospective study comparing septic patients treated in a general intensive care unitand healthy volunteers.Methods: In 107 consecutive septic patients (44 with sepsis, 13 with severe sepsis, and 50with septic shock), GH, IGF-I, Insulin-like Growth Factor Binding Protein-3 (IGFBP-3), insulin,cortisol, albumin, thyroid hormones, C-reactive protein and interleukin-6 serum levels weremeasured once within 48 hrs after onset of a septic episode. Twenty-nine healthy volunteers servedas controls.Results: IGF-I and IGFBP-3 levels were decreased in patients with sepsis and severe sepsis(versus controls), decreasing further in patients with septic shock (versus sepsis). IGF-I levels were positively related to IGFBP-3, albumin, triiodothyronine and thyroxine, and inversely related to cortisol, sepsis severity, C-reactive protein, interleukin-6 and age. In multiple regression analysis, IGF-I levels were independently related to IGFBP-3 and albumin (lower in patients with decreasedIGFBP-3 and albumin levels) (p<0.001 and p=0.01, respectively), and cortisol (lower in patientswith increased cortisol levels) (p=0.04). IGFBP-3 accounted for most of the variance explained bythe model (R2=0.519). GH levels were not related to IGF-I levels or mortality. IGF-I and IGFBP-3levels were associated with mortality.Conclusions: The GH/IGF-I axis is severely disrupted in septic patients. IGFBP-3 is themajor determinant of IGF-I levels, whereas albumin and cortisol are secondary determinants.

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