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Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
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Hormones, the biochemical messengers produced by endocrine glands, are pivotal in regulating bodily functions and maintaining homeostasis. Each hormone's balance is crucial; imbalances can lead to significant physiological disruptions. Major hormones include oxytocin, cortisol, epinephrine, estrogen, testosterone, thyroxine, growth hormone, insulin, and glucagon.
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Related Experiment Video

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Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
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GH and mortality in acromegaly.

M C Sheppard1

  • 1School of Medicine, University of Birmingham, Edgbaston, UK. m.c.sheppard@bham.ac.uk

Journal of Endocrinological Investigation
|April 22, 2006
PubMed
Summary

Achieving growth hormone (GH) levels below 1-2 microg/l significantly reduces mortality in acromegaly patients. This target ensures long-term health outcomes comparable to the general population, underscoring GH control

Area of Science:

  • Endocrinology
  • Metabolic disorders
  • Oncology

Background:

  • Acromegaly, a condition caused by excess growth hormone (GH), is associated with increased mortality.
  • Effective biochemical control of GH and insulin-like growth factor-I (IGF-I) levels is crucial for improving patient outcomes.
  • Current treatment targets for acromegaly involve normalizing GH and IGF-I levels, but the relative importance of each parameter for long-term mortality remains debated.

Purpose of the Study:

  • To evaluate the association between growth hormone (GH) levels and mortality in acromegaly patients.
  • To determine the optimal therapeutic target for GH levels to reduce excess mortality in acromegaly.
  • To clarify the role of GH as a predictor of mortality compared to IGF-I.

Main Methods:

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  • Analysis of data from three independent studies: West Midlands Acromegaly Database (419 patients), a New Zealand study (208 patients), and a Finnish nationwide survey (334 patients), totaling 961 patients.
  • Retrospective review of patient records, focusing on serum GH levels (mean of GH day profile, nadir GH after oral glucose load, random GH, and basal GH) and mortality data.
  • Statistical analysis to identify predictors of mortality and compare mortality rates based on different GH level thresholds.

    • Main Results:

    • Multiple studies consistently show that elevated GH levels are associated with increased mortality in acromegaly.
    • A GH level of 1-2 microg/l was identified as a critical threshold, with patients above this level exhibiting significantly higher mortality rates.
    • Specifically, the Finnish study reported excess mortality (SMR 1.61, p<0.001) in patients with last known basal serum GH >2.5 microg/l.
    • The New Zealand study identified serum GH at last follow-up as the most significant predictor of mortality, with rates normalizing below 1-2 microg/l.

    Conclusions:

    • A therapeutic target of 1-2 microg/l for serum growth hormone (GH) is unequivocally supported by the analyzed data.
    • Achieving GH concentrations below this threshold is essential for reducing the excess mortality associated with acromegaly.
    • While IGF-I is also monitored, GH levels appear to be a more direct and significant predictor of long-term mortality in acromegaly patients.