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Diagnosis and endocrine testing in acromegaly.
B M Chang-DeMoranville1, I M Jackson
1Department of Medicine, Brown University/Rhode Island Hospital, Providence.
Endocrinology and Metabolism Clinics of North America
|September 1, 1992
Summary
Acromegaly diagnosis involves elevated growth hormone (GH) and insulin-like growth factor-I (IGF-I). Testing confirms this excess GH by its lack of suppression after glucose intake, with IGF-binding proteins showing diagnostic promise.
Area of Science:
- Endocrinology
- Oncology
- Biochemistry
Background:
- Acromegaly stems from excessive growth hormone (GH) and insulin-like growth factor-I (IGF-I) production, often due to pituitary tumors.
- Diagnosis relies on clinical suspicion, confirmed by elevated basal GH and IGF-I levels.
- GH levels that are not suppressed by glucose load confirm the diagnosis.
Purpose of the Study:
- To outline diagnostic criteria for acromegaly.
- To discuss the role of various tests in diagnosis and monitoring.
- To explore the emerging role of IGF-binding proteins (IGFBPs) in GH disorders.
Main Methods:
- Basal GH and IGF-I level measurement.
- Oral glucose tolerance test to assess GH suppressibility.
- TRH and LHRH stimulation tests.
- Analysis of IGF-binding proteins (IGFBP-1, IGFBP-3).
Main Results:
- Persistent elevation of basal GH and IGF-I confirms acromegaly.
- Lack of GH suppression post-glucose load is a key diagnostic confirmation.
- IGFBPs show potential clinical correlation with GH status and IGF-I levels.
Conclusions:
- Established diagnostic protocols for acromegaly involve GH and IGF-I assessment.
- IGFBPs, particularly IGFBP-1 and IGFBP-3, demonstrate promising clinical utility in diagnosing GH secretion disorders.
- Further research is needed to fully establish IGFBPs as routine diagnostic tools.