Evaluation of acromegaly by measurement of 24-hourly urinary growth hormone excretion.
Twenty-four hourly urinary growth hormone excretion (24-h uGH) has been quantified using a combination of ultrafiltration and conventional immunoradiometric assay. Twenty-four hourly uGH was measured in 20 normal adults and in 42 patients with acromegaly (9 untreated, 28 treated but with above-normal IGF-I levels, and 5 treated and cured). The means and ranges were as follows: 3.7 (1-9) ng/24 h for normals and 160 (40-540), 66 (2-380) and 5.2 (4-8) ng/24 h for the three groups of acromegalic patients, respectively. Ten patients with pituitary adenomas without acromegaly had 24-h uGH within the normal range. Twenty-four hourly uGH therefore gives a clear differentiation between controls and untreated patients. Log-transformed values for subjects with acromegaly showed significant correlations between 24-h uGH and levels of IGF-I (r = 0.63, p < 0.01), fasting plasma GH (r = 0.92, p < 0.001) and plasma GH after glucose loading (r = 0.85, p < 0.001). Twenty-four hourly uGH was also determined in three acromegalic patients before and during SMS 201-995 therapy. Twenty-four hourly uGH reflected the corresponding changes in mean levels for hourly sampling over 12 h of plasma GH and IGF-I and in clinical signs after 3-6 months of therapy. The results of this study indicate that 24-h uGH is an accurate indicator of GH secretion in acromegalic patients and could therefore be used both in diagnosis and in monitoring the progress of therapy in these patients.
Pholséna
M
M
Laboratoire d'Explorations Endocriniennes, Hôpital Trousseau, Paris, France.
Le Bouc
Y
Y
Rousseau
E
E
Christol
R
R
Birman
P
P
Périn
L
L
Girard
F
F
D000172:Acromegaly / Q000097:blood / Q000175:diagnosis / Q000628:therapy / Q000652:urine*; D000236:Adenoma / Q000652:urine; D000328:Adult; D000368:Aged; D002940:Circadian Rhythm; D005260:Female; D013006:Growth Hormone / Q000097:blood / Q000652:urine*; D006801:Humans; D015592:Immunoradiometric Assay; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use; D010911:Pituitary Neoplasms / Q000652:urine; D012044:Regression Analysis; D014462:Ultrafiltration
D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D015282:Octreotide