Document Detail


Conventional and novel biomarkers of treatment outcome in patients with acromegaly: discordant results after somatostatin analog treatment compared with surgery.
MedLine Citation:
PMID:  20813787     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Control of disease activity in acromegaly is critical, but the biochemical definitions remain controversial. OBJECTIVE: To compare traditional and novel biomarkers and health status in patients with acromegaly treated with either surgery alone or somatostatin analog (SA). DESIGN AND METHODS: Sixty-three patients in long-term remission based on normalized total IGF1 levels after surgery alone (n=36) or SA (n=27) were studied in a cross-sectional manner. The groups were comparable at diagnosis regarding demographic and biochemical variables. Each subject underwent 3 h of serum sampling including a 2-h oral glucose tolerance test (OGTT). Health status was measured by two questionnaires: EuroQoL and Acrostudy (Patient-assessed-Acromegaly symptom questionnaire (PASQ)). RESULTS: Total and bioactive IGF1 (μg/l) levels were similar (total: 185 ± 10 (SA) versus 171 ± 8 (surgery) (P=0.28); bioactive: 1.9 ± 0.2 vs 1.9 ± 0.1 (P=0.70)). Suppression of total and free GH (μg/l) during OGTT was blunted in the SA group (total GH(nadir): 0.59 ± 0.08 (SA) versus 0.34 ± 0.06 (surgery) (P=0.01); free GH(nadir): 0.43 ± 0.06 vs 0.19 ± 0.04 (P<0.01)). The insulin response to OGTT was delayed, and the 2-h glucose level was elevated during SA treatment (P=0.02). Disease-specific health status was better in patients after surgery (P=0.02). CONCLUSIONS: i) Despite similar and normalized IGF1 levels, SA treatment compared with surgery alone was associated with less suppressed GH levels and less symptom relief; ii) this discordance may be due to specific suppression of hepatic IGF1 production by SA; iii) we suggest that biochemical assessment during SA treatment should include both GH and IGF1.
Authors:
Kristine Z Rubeck; Michael Madsen; Caroline Marie Andreasen; Sanne Fisker; Jan Frystyk; Jens Otto L Jørgensen
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-09-02
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  163     ISSN:  1479-683X     ISO Abbreviation:  Eur. J. Endocrinol.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-08     Completed Date:  2010-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  717-26     Citation Subset:  IM    
Affiliation:
The Medical Research Laboratories, Department of Endocrinology and Internal Medicine, Clinical Institute, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark. kristinerubeck@dadlnet.dk
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MeSH Terms
Descriptor/Qualifier:
Acromegaly / blood,  drug therapy*,  surgery*
Adult
Biological Markers / blood,  metabolism
Cross-Sectional Studies
Female
Follow-Up Studies
Human Growth Hormone / antagonists & inhibitors,  blood
Humans
Insulin-Like Growth Factor I / metabolism
Male
Middle Aged
Somatostatin / analogs & derivatives*,  therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Markers; 12629-01-5/Human Growth Hormone; 51110-01-1/Somatostatin; 67763-96-6/Insulin-Like Growth Factor I

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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