Growth hormone binding protein and acid labile subunit levels in the assessment of acromegaly treatment.
OBJECTIVE
Post-treatment monitoring of acromegalic patients is a matter of controversy, as discrepancies between GH and IGF-I levels have been reported. The aim of our study was to evaluate the role of acid-labile subunit (ALS), a component of the 150 kD IGF-I/IGFBP-3/ALS complex, and the growth hormone binding protein (GHBP) in the follow-up of patients with acromegaly after therapeutic intervention.


METHODS
Forty-one patients with acromegaly, 10 at the time of diagnosis and 31 post therapeutic intervention, were studied. Patients were evaluated by the determination of baseline (fasting) IGF-I, ALS and GHBP and of glucose and GH during OGTT.


RESULTS
Significantly lower ALS and higher GHBP levels were detected in successfully treated acromegalics compared to patients before treatment (34.1+/-1.6 vs. 52.8+/-2 mg/L and 0.9+/-0.08 vs 0.4+/-0.1 ìg/L, respectively P<0.05). Furthermore, no difference was noted in ALS and GHBP values between patients successfully treated with either somatostatin analogues or another type of treatment.


CONCLUSIONS
a) Successfully treated acromegalic patients demonstrate lower ALS and higher GHBP levels than patients before treatment, and b) somatostatin analogue treatment does not have a direct effect on GHBP and ALS concentration in acromegaly. Studies in larger groups of patients are needed to disclose whether these alterations will be useful in the post-treatment assessment of acromegalic patients.
Tzanela
Marinella
M
Department of Endocrinology, Diabetes and Metabolism and Department of Medical Physics, Evangelismos Hospital, Athens, Greece. mtzanel@med.uoa.gr
Christoforaki
Marieta
M
Papastathopoulou
Lida
L
Vassiliadi
Dimitra
D
Botoula
Effie
E
Trivizas
Panagiotis
P
Thalassinos
Nikos C
NC
D000172:Acromegaly / Q000175:diagnosis* / Q000188:drug therapy*; D015415:Biomarkers / Q000032:analysis; D002352:Carrier Proteins / Q000032:analysis / Q000378:metabolism*; D003399:Craniotomy / Q000379:methods; D003430:Cross-Sectional Studies; D005260:Female; D005951:Glucose Tolerance Test; D013006:Growth Hormone / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013004:Somatostatin / Q000031:analogs & derivatives*; D016896:Treatment Outcome
D015415:Biomarkers; D002352:Carrier Proteins; D013004:Somatostatin; D013006:Growth Hormone; C051815:somatotropin-binding protein