Multiple system atrophy is associated with changes in peripheral insulin-like growth factor system.

: Insulin-like growth factors (IGF-I and IGF-II) have been shown to have several neurotrophic actions and IGF sys-tem may be impaired in neurodegenerative disorders. The aim of this study was to investigate the IGF system in patients with MSA and to evaluate correlations between this endocrine sys-tem and clinical features of the disease. Serum levels of IGF-I, IGF-II, insulin, IGF-binding protein 1 (BP1), and IGF-binding protein 3 (BP3) were measured in 25 patients with probable MSA and 25 age, sex and BMI-matched healthy controls. Clin-ical status of each patient was evaluated with the Unified Mul-tiple System Atrophy Rating Scale (UMSARS) Part II and the Hoehn and Yahr rating scale. IGF-I levels were significantly higher in MSA (164.1 1 66.2 lg/L) than in healthy controls (111.7 1 60.3 lg/L; p 5 0.001). Insulin levels were signifi-cantly higher in MSA patients (21.9 6 14.4 lU/mL) than in healthy controls (13.3 6 5.1 lU/mL, p 5 0.048). No signifi-cant difference was found in serum IGF-II, IGF-BP1, and IGF-BP3 levels between patients with MSA an d healthy controls. There was a trend toward significantly higher IGF-II levels in MSA patients with UMSARS score < 2 6 (1026 .3 6 442.6 l g/L) than MSA patients with UMSARS score > 26 (796.1 6 234 l g/L , p 5 0.055). The results of this study d emonstrated that IGF system is altered in MSA. The d eg enerative process in MSA could lead to a c ompensatory increase in IGF-I and insulin in an attempt to provide additional su pport to degenerating neuro ns.