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Elevated insulin-like growth factor-1 in Cushing's disease
Katherine English1,2, Viral Chikani1, Goce Dimeski2,3
1Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
Clinical Endocrinology
|March 23, 2019
Summary
Patients with Cushing's disease have higher serum insulin-like growth factor-1 (IGF-1) levels. Following successful treatment, IGF-1 levels decrease, indicating remission and ruling out excess growth hormone (GH).
Area of Science:
- Endocrinology
- Metabolic Disorders
Background:
- Cushing's disease is a rare endocrine disorder caused by prolonged exposure to excess cortisol.
- Elevated serum insulin-like growth factor-1 (IGF-1) is sometimes observed in Cushing's disease, but its significance is debated.
Purpose of the Study:
- To compare serum IGF-1 levels in patients with untreated Cushing's disease versus matched controls.
- To assess the change in serum IGF-1 levels after successful treatment and remission of Cushing's disease.
Main Methods:
- A retrospective case-control study design was employed.
- Serum IGF-1 levels were measured in 25 patients with Cushing's disease and 49 controls, matched for key clinical factors.
- Paired analysis of pre-operative and post-operative (remission) serum IGF-1 was conducted in 13 cases.
Main Results:
- Patients with untreated Cushing's disease exhibited significantly higher mean serum IGF-1 levels compared to controls (32 ± 12 nmol/L vs. 25 ± 8 nmol/L, P=0.005).
- A higher proportion of cases had elevated IGF-1 compared to matched controls (35% vs. 4%, P=0.02).
- Following remission, serum IGF-1 significantly decreased from 31 nmol/L to 23 nmol/L (P < 0.001).
Conclusions:
- Untreated Cushing's disease is associated with elevated serum IGF-1.
- Serum IGF-1 levels decrease upon remission of Cushing's disease.
- Mildly elevated IGF-1 in Cushing's disease does not necessarily indicate pathological growth hormone excess.