Severe growth hormone deficiency is rare in surgically-cured acromegalics.
Growth hormone deficiency (GHD) in surgically-cured acromegalics has been reported to negatively affect their metabolic condition and quality of life (QOL). The incidence of GHD, its causes, and its effects on their physio-psychological condition remain to be examined in detail. We performed a retrospective study to investigate GH secretory function in surgically-cured acromegalics, prognostic factors of GHD, and its impact on QOL. The study population consisted of 72 acromegalics who were determined to be surgically cured according to the Cortina consensus criteria. We recorded the incidence of impaired GH secretory function based on the peak GH level during postoperative insulin tolerance test (ITT) which lowered their nadir blood sugar to under 50 mg/dL. Their QOL was evaluated by SF-36. In surgically-cured acromegalics, the incidence of severe GHD (peak GH during ITT ≦ 3.0 μg/L) was 12.5 % (9/72). The preoperative tumor size was significantly larger in patients with severe GHD than without severe GHD (21.9 ± 9.0 vs. 15.5 ± 7.1 mm, p = 0.017). The peak GH levels during postoperative ITT were statistically correlated with the physical but not the mental component summary of the SF-36 score. The incidence of GHD was 12.5 % in our surgically-cured acromegalics. As some QOL aspects are positively related with peak GH levels during postoperative ITT, efforts should be made to preserve pituitary function in acromegalic patients undergoing adenomectomy.
Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan.
Shingo
S
Fujio
Hiroshi
H
Tokimura
Hirofumi
H
Hirano
Ryosuke
R
Hanaya
Fumikatsu
F
Kubo
Shunji
S
Yunoue
Manoj
M
Bohara
Yasuyuki
Y
Kinoshita
Atsushi
A
Tominaga
Hiroshi
H
Arimura
Kazunori
K
Arita
D000172:Acromegaly / Q000097:blood* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D013006:Growth Hormone / Q000097:blood* / Q000172:deficiency*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011788:Quality of Life; D055815:Young Adult
D013006:Growth Hormone