Gender and age in the biochemical assessment of cure of acromegaly

被引：51

作者：

Freda P.U. ^{[1
]}

Landman R.E. ^{[1
]}

Sundeen R.E. ^{[1
]}

Post K.D. ^{[2
]}

机构：

[1] Department of Medicine, Columbia College of Physicians and Surgeons, NY

[2] Department of Neurosurgery, Mount Sinai School of Medicine, NY

来源：

Pituitary | 2001年 / 4卷 / 3期

基金：

美国国家卫生研究院;

关键词：

Acromegaly; Growth hormone; IGF-I;

D O I：

10.1023/A:1015314906972

中图分类号：

学科分类号：

摘要：

The principal biochemical criteria for cure in acromegaly are normalization of both glucose-suppressed GH levels and IGF-I levels. As we have reported previously, measurement of GH by highly sensitive assay in conjunction with IGF-I levels has led to a re-appraisal of "normal" GH suppression criteria during an OGTT in subjects with acromegaly. In some patients with active acromegaly, glucose-suppressed GH levels as measured by highly sensitive assay are much lower than could previously be appreciated with less sensitive GH assays and some other patients in apparent remission have subtle abnormalities of GH suppression. A question to arise is whether gender differences in glucose-suppressed GH levels as found by others in young healthy subjects should be considered in our interpretation of OGTT criteria for cure in acromegaly. Therefore, we have evaluated parameters of GH secretion in a larger number of subjects from our cohort of postoperative patients with acromegaly and in healthy subjects in order to determine if gender or age associated differences in these parameters exist. Ninety-two subjects with acromegaly (49 men, 43 women) and 46 age-matched healthy subjects (26 men, 20 women) were evaluated with baseline GH and IGF-I levels and nadir GH levels after a 100 g. OGTT. GH was assayed by highly sensitive IRMA (DSL). Basal GH levels were higher in female than in male healthy subjects, but the fall in GH from baseline (% suppression) was also greater in females resulting in no significant difference in mean nadir GH levels in female vs. male healthy subjects (0.09 vs. 0.08 μg/L). In the subjects with acromegaly, there were no significant gender differences in basal, % GH suppression or nadir GH levels. Basal and nadir GH levels correlated significantly only in subjects with active disease (r = 0.84, p < .0001). Similarly, IGF-I levels correlated significantly with basal (r = 0.573, p = .0012), and nadir (r = .702, p < .0001) GH levels only in subjects with active disease. Gender differences in IGF-I levels were not apparent in any group of subjects. As expected, IGF-I levels declined with age in those groups of subjects with normal IGF-I levels. Nadir GH levels did not vary with age. In conclusion, we have not found significant gender or age-related differences in nadir GH levels and thus our data does not support separate OGTT criteria for cure in men and women with acromegaly.

引用

页码：163 / 171

页数：8

共 48 条

[1] Daughaday W.H., New criteria for evaluation of acromegaly, N. Engl. J. Med, 301, 21, pp. 1175-1176, (1979)
[2] Lamberts S.W., Acromegaly and its treatment, J. Endocrinol, 155, SUPPL. 1, (1997)
[3] Jaffe C.A., Barkan A.L., Acromegaly. Recognition and treatment, Drugs, 47, 3, pp. 425-445, (1994)
[4] Giustina A., Barkan A., Casanueva F.F., Cavagnini F., Frohman L., Ho K., Veldhuis J., Wass J., Von Werder K., Melmed S., Criteria for cure of acromegaly: A consensus statement, J. Clin. Endocrinol. Metab, 85, 2, pp. 526-529, (2000)
[5] Barkan A.L., Beitins I.Z., Kelch R.P., Plasma insulin-like growth factor-I/somatomedin-C in acromegaly: Correlation with the degree of growth hormone hypersecretion, J. Clin. Endocrinol. Metab, 67, 1, pp. 69-73, (1988)
[6] Schatz H., Stracke H., Zapf J., [Diagnosis in acromegaly. Insulin-like growth factor as a parameter of activity], Dtsch. Med. Wochenschr, 108, 37, pp. 1391-1395, (1983)
[7] Clemmons D.R., Van Wyk J.J., Ridgway E.C., Kliman B., Kjellberg R.N., Underwood L.E., Evaluation of acromegaly by radioimmunoassay of somatomedin-C, N. Engl. J. Med, 301, 21, pp. 1138-1142, (1979)
[8] Oppizzi G., Petroncini M.M., Dallabonzana D., Cozzi R., Verde G., Chiodini P.G., Liuzzi A., Relationship between somatomedin-C and growth hormone levels in acromegaly: Basal and dynamic evaluation, J. Clin. Endocrinol. Metab, 63, 6, pp. 1348-1353, (1986)
[9] Freda P.U., Post K.D., Powell J.S., Wardlaw S.L., Evaluation of disease status with sensitive measures of growth hormone secretion in 60 postoperative patients with acromegaly, J. Clin. Endocrinol. Metab, 83, 11, pp. 3808-3816, (1998)
[10] Bates A.S., Evans A.J., Jones P., Clayton R.N., Assessment of GH status in acromegaly using serum growth hormone, serum insulin-like growth factor-1 and urinary growth hormone excretion, Clin. Endocrinol. (Oxf), 42, 4, pp. 417-423, (1995)

← 1 2 3 4 5 →