IGF-I and mortality in patients with acromegaly

Area of Science:

• Endocrinology
• Metabolic Disorders
• Clinical Biochemistry

Background:

• Mortality in acromegaly patients has been linked to growth hormone (GH) levels.
• Fewer studies have investigated the relationship between insulin-like growth factor-I (IGF-I) and mortality, with mixed findings.
• GH immunoassays are more established than IGF-I immunoassays, potentially influencing study outcomes.

Purpose of the Study:

• To highlight the need for standardized measurement of both GH and IGF-I in acromegaly follow-up.
• To emphasize the importance of prospective studies for evaluating the predictive capabilities of GH and IGF-I.
• To assess the relative abilities of GH and IGF-I in predicting mortality and comorbidities in acromegaly.

Main Methods:

• Review of existing literature on GH, IGF-I, and mortality in acromegaly.
• Discussion of limitations in current studies, including sample size and assay availability.
• Proposal for a prospective approach using central laboratory measurements.

Main Results:

• Conflicting associations reported between GH/IGF-I levels and mortality in acromegaly.
• Inconsistencies may stem from differences in study design, sample size, and biomarker measurement.
• Divergent results between methods for both GH and IGF-I measurements exist.

Conclusions:

• Measuring both GH and IGF-I is essential for comprehensive acromegaly management.
• Prospective, standardized measurements are needed to accurately determine the prognostic value of GH and IGF-I.
• Future research should focus on central laboratory assessment to predict residual risk and comorbidities.