| Conventional and novel biomarkers of treatment outcome in patients with acromegaly: discordant results after somatostatin analog treatment compared with surgery. | |
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MedLine Citation:
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PMID: 20813787 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Kristine Z Rubeck; Michael Madsen; Caroline Marie Andreasen; Sanne Fisker; Jan Frystyk; Jens Otto L Jørgensen |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2010-09-02 |
Journal Detail:
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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:
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Created Date: 2010-10-08 Completed Date: 2010-10-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9423848 Medline TA: Eur J Endocrinol Country: England |
Other Details:
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Languages: eng Pagination: 717-26 Citation Subset: IM |
Affiliation:
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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:
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Acromegaly
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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:
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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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