title: Growth hormone values after an oral glucose load do not add clinically useful information in patients with acromegaly on long-term somatostatin receptor ligand treatment.
abstract: The optimal method of assessing GH status in acromegalic patients receiving medical therapy with somatostatin analogs (SSA) has been matter of debate. The aim of the study has been to investigate whether OGTT may add information in patients with discordant random GH (GHr) and IGF values. Moreover, we evaluated the association of GH nadir with the prevalence of co-morbidities observed in acromegalic patients on SSA therapy. We evaluated 130 patients with proven diagnosis of acromegaly on SSA. The patients were subdivided in three groups: patients with controlled disease (both safe random GH and normal IGF-I, group A, 20.0 %), patients with uncontrolled disease (both high random GH and IGF-I, group B, 34.6 %), and patients with discordant random GH and IGF-I values (group C, 35.4 %). A high concordance rate for GH nadir with random GH and IGF-I was observed in group B, while a significant reduced concordance rate has been observed in group A (100 % sensitivity, 64.5 % specificity). By contrast, in group C, we observed concordant results between GH nadir and IGF-I only in 14/59 patients. In group A, the prevalence of diabetes was lower than in group B or C. Safe random GH was the only single criteria associated with a lower prevalence of diabetes. Discrepant IGF-I and either GH nadir or random GH values are frequently observed in acromegalic patients treated with SSA. Concordant IGF-I and random GH may influence the prevalence of metabolic complications. GH nadir measurement may help to interpret discrepancies between random GH and IGF-I data only in few cases.
authors.affiliation: Medicina Interna ad Indirizzo Endocrinologico, Dipartimento di Scienze Cliniche e Biologiche, AOU San Luigi, Università di Torino, Orbassano, Italy, giuseppe.reimondo@unito.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Reimondo
authors.forename: Marta
authors.initials: M
authors.lastname: Bondanelli
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Ambrosio
authors.forename: Franco
authors.initials: F
authors.lastname: Grimaldi
authors.forename: Barbara
authors.initials: B
authors.lastname: Zaggia
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Zatelli
authors.forename: Barbara
authors.initials: B
authors.lastname: Allasino
authors.forename: Federica
authors.initials: F
authors.lastname: Laino
authors.forename: Emiliano
authors.initials: E
authors.lastname: Aroasio
authors.forename: Angela
authors.initials: A
authors.lastname: Termine
authors.forename: Pierantonio
authors.initials: P
authors.lastname: Conton
authors.forename: Agostino
authors.initials: A
authors.lastname: Paoletta
authors.forename: Ernesto
authors.initials: E
authors.lastname: Demenis
authors.forename: Ettore Degli
authors.initials: ED
authors.lastname: Uberti
authors.forename: Massimo
authors.initials: M
authors.lastname: Terzolo
mesh_terms: D000172:Acromegaly / Q000097:blood* / Q000175:diagnosis* / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001774:Blood Chemical Analysis; D005260:Female; D005951:Glucose Tolerance Test; D019382:Human Growth Hormone / Q000032:analysis / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D017481:Receptors, Somatostatin / Q000819:agonists; D013004:Somatostatin / Q000031:analogs & derivatives / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D017481:Receptors, Somatostatin; D019382:Human Growth Hormone; D013004:Somatostatin