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Do "so-called" normal growth hormone concentrations (2-5 micrograms/l) indicate cure in acromegaly?
N S Levitt1, B D Ratanjee, M J Abrahamson
1Department of Medicine, University of Cape Town, South Africa.
Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Metabolisme
|April 1, 1995
Summary
Acromegaly patients with mean growth hormone (GH) levels of 2-5 micrograms/l show active disease after treatment. These patients require further therapeutic consideration following hypophysectomy.
Area of Science:
- Endocrinology
- Oncology
- Metabolic Disorders
Background:
- Acromegaly is a serious condition caused by excess growth hormone (GH).
- Assessing biochemical activity post-treatment is crucial for patient management.
Purpose of the Study:
- To determine if acromegalic patients with mean GH concentrations of 2-5 micrograms/l have biochemically active disease after pituitary surgery or radiotherapy.
- To evaluate diagnostic markers for active acromegaly in treated patients.
Main Methods:
- Measured GH and IGF-1 concentrations in 22 acromegalic patients (post-surgery/radiotherapy) and 6 controls.
- Utilized oral glucose tolerance tests (OGTT), TRH tests, and 8-hour GH sampling.
- Grouped patients based on mean GH levels: >5, 2-5, and <2 micrograms/l.
Main Results:
- Patients with mean GH of 2-5 micrograms/l exhibited active disease, with inadequate GH suppression post-OGTT and elevated IGF-1.
- Higher GH concentrations (>5 micrograms/l) correlated with more pronounced biochemical abnormalities.
- GH pulse amplitude was significantly higher in the >5 micrograms/l group.
Conclusions:
- Mean GH concentrations of 2-5 micrograms/l indicate biochemically active acromegaly.
- Patients in this GH range require consideration for further therapy post-hypophysectomy.
- OGTT, IGF-1 levels, and TRH tests are valuable in assessing disease activity.