| The role of insulin-like growth factor-1 and growth hormone in the mortality of patients with acromegaly after trans-sphenoidal surgery. | |
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MedLine Citation:
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PMID: 20943425 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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CONTEXT: Acromegaly is associated with a significant increase in mortality. With the development of new modalities of treatment, it has become important to identify prognostic factors relating to mortality. OBJECTIVE: This study aimed to determine the all-cause mortality of patients with acromegaly after trans-sphenoidal surgery, and assess the impact of biochemical markers on survival. DESIGN: Two hundred thirty-four patients were admitted to the Taipei Veterans General Hospital for acromegaly between 1979 and 2007. Of the 163 patients who underwent trans-sphenoidal surgery, 142 had data available for insulin-like growth factor-1 (IGF-1), and their survival status was analyzed. Serial data for fasting growth hormone (GH) and IGF-1 were collected. This study also used the last follow-up data for mortality analysis. The patients with acromegaly were grouped according to the last follow-up GH level (≤2 or >2 μg/L) and IGF-1 SD score (≤2 or >2). All-cause mortality was followed to the end of 2007 and compared to the general Taiwanese population by standardized mortality ratios. RESULTS: Serial GH and IGF-1 data revealed that the GH levels in the first 3 years after surgery were important predictors of mortality in acromegaly. However, there are insufficient IGF-1 data for deceased patients to determine the significance of a raised IGF-1 immediately following treatment. Comparison of crude death rates suggests that a fasting GH level of 2 μg/L and normalization of the IGF-1 level are appropriate targets. After subgroup analysis to assess the impact of discordant GH and IGF-1 levels on survival, the data showed that the elevated GH group had a trend toward a higher mortality than the elevated IGF-1 group. CONCLUSIONS: An elevated GH value in the first 3 years after surgery may be the best predictor of mortality. Thus, the follow-up of patients with acromegaly at relatively frequent intervals after trans-sphenoidal surgery should be routine. |
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Authors:
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Tzu-En Wu; Hong-Da Lin; Ron-A Lu; Mei-Li Wang; Ru-Lin Chen; Harn-Shen Chen |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-10-12 |
Journal Detail:
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Title: Growth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society Volume: 20 ISSN: 1532-2238 ISO Abbreviation: Growth Horm. IGF Res. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-30 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9814320 Medline TA: Growth Horm IGF Res Country: Scotland |
Other Details:
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Languages: eng Pagination: 411-5 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Growth Hormone Research Society. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
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Institute of Public Health, National Yang-Ming University School of Medicine, Taipei, Taiwan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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