Circulating insulin-like growth factor 1 (IGF-1) and short-term functional change in amyotrophic lateral sclerosis (ALS): exploratory evidence for systemic trophic-metabolic reserve.

Higher prior circulating insulin-like growth factor 1 (IGF-1) in 23 people with amyotrophic lateral sclerosis (ALS) is linked to 1.40-point less subsequent ALSFRS-R decline per 1-SD.

• Why it matters: ALS functional decline varies, and systemic metabolic or trophic reserve could help explain short-term differences in progression. This work tests whether IGF-1 measured in blood predicts near-future functional change.
• What they did: Serum IGF-1 was measured in 37 ALS participants and 25 healthy controls, then lagged regression related prior-visit IGF-1 to next-visit change in Revised ALS Functional Rating Scale (ALSFRS-R), adjusting for inter-visit interval, body mass index, age, and sex.
• The result: Baseline IGF-1 did not differ between ALS and controls (p = 0.12) or across disease-duration progression categories (F(2, 34) = 0.13, p = 0.88), but prior IGF-1 predicted less decline (95% CI: 0.03 to 2.77, p = 0.045), with similar estimates in generalized estimating equations (beta = 1.50, p = 0.030).

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