title: Clinical predictors of GH deficiency in surgically cured acromegalic patients.
abstract: OBJECTIVE
  Even in patients with cured acromegaly, GH deficiency (GHD) after transsphenoidal adenomectomy (TSA) adversely affects body composition and inflammatory biomarkers of cardiovascular risk. In this study, clinical parameters for predicting GHD after TSA in 123 cured acromegalic patients were investigated.
  
  
  METHODS
  GH levels were measured at 6, 12, 18, 24, 48, and 72 h after TSA and serial insulin tolerance tests were conducted at 6 months, 2 years, and then every 2 years after TSA.
  
  
  RESULTS
  GHD was found in 12 patients (9.8%) at 4.1 (range: 0.5-4.1) years after TSA. IGF1 levels were significantly lower at 6 months after TSA in GHD group than intact GH group (175.9 vs 316.8 μg/l, range: 32.0-425.0 and 96.9-547.3 respectively, P=0.008). Adenomas involving both sides of the pituitary gland were significantly more frequent in GHD patients (29.7 vs 83.3%; P=0.002). Furthermore, immediate postoperative 72-h GH levels after TSA were significantly lower (0.17 vs 0.45, range: 0.02-0.93 and 0.02-5.95 respectively, P=0.019) in GHD patients. In multiple logistic regression analysis, bilaterality of tumor involvement (odds ratio (OR)=10.678, P=0.003; 95% CI=2.248-50.728) and immediate postoperative 72-h GH level (OR=0.079, P=0.047; 95% CI=0.006-0.967) showed significant power for predicting GHD.
  
  
  CONCLUSIONS
  These data suggest that bilateral involvement of a pituitary adenoma and severely decreased immediate postoperative serum GH levels at 72 h after TSA may be independent risks factor for accelerated GHD in acromegalic patients.
authors: EndocrinologyInstitute of Endocrine ResearchPituitary Tumor ClinicNeurosurgeryYonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of KoreaDepartment of Internal MedicineIlsan-Paik Hospital, College of Medicine, Inje University, Koyang, Gyeonggi-do, Republic of KoreaEndocrinologyInstitute of Endocrine ResearchPituitary Tumor ClinicNeurosurgeryYonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of KoreaDepartment of Internal MedicineIlsan-Paik Hospital, College of Medicine, Inje University, Koyang, Gyeonggi-do, Republic of KoreaEndocrinologyInstitute of Endocrine ResearchPituitary Tumor ClinicNeurosurgeryYonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of KoreaDepartment of Internal MedicineIlsan-Paik Hospital, College of Medicine, Inje University, Koyang, Gyeonggi-do, Republic of Korea.
authors: Cheol Ryong
authors: CR
authors: Ku
authors: EndocrinologyInstitute of Endocrine ResearchPituitary Tumor ClinicNeurosurgeryYonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of KoreaDepartment of Internal MedicineIlsan-Paik Hospital, College of Medicine, Inje University, Koyang, Gyeonggi-do, Republic of Korea.
authors: Jae Won
authors: JW
authors: Hong
authors: EndocrinologyInstitute of Endocrine ResearchPituitary Tumor ClinicNeurosurgeryYonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of KoreaDepartment of Internal MedicineIlsan-Paik Hospital, College of Medicine, Inje University, Koyang, Gyeonggi-do, Republic of KoreaEndocrinologyInstitute of Endocrine ResearchPituitary Tumor ClinicNeurosurgeryYonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of KoreaDepartment of Internal MedicineIlsan-Paik Hospital, College of Medicine, Inje University, Koyang, Gyeonggi-do, Republic of KoreaEndocrinologyInstitute of Endocrine ResearchPituitary Tumor ClinicNeurosurgeryYonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of KoreaDepartment of Internal MedicineIlsan-Paik Hospital, College of Medicine, Inje University, Koyang, Gyeonggi-do, Republic of Korea.
authors: Eui Hyun
authors: EH
authors: Kim
authors: EndocrinologyInstitute of Endocrine ResearchPituitary Tumor ClinicNeurosurgeryYonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of KoreaDepartment of Internal MedicineIlsan-Paik Hospital, College of Medicine, Inje University, Koyang, Gyeonggi-do, Republic of KoreaEndocrinologyInstitute of Endocrine ResearchPituitary Tumor ClinicNeurosurgeryYonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of KoreaDepartment of Internal MedicineIlsan-Paik Hospital, College of Medicine, Inje University, Koyang, Gyeonggi-do, Republic of KoreaEndocrinologyInstitute of Endocrine ResearchPituitary Tumor ClinicNeurosurgeryYonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of KoreaDepartment of Internal MedicineIlsan-Paik Hospital, College of Medicine, Inje University, Koyang, Gyeonggi-do, Republic of Korea ejlee423@yuhs.ac sunkim@yuhs.ac.
authors: Sun Ho
authors: SH
authors: Kim
authors: EndocrinologyInstitute of Endocrine ResearchPituitary Tumor ClinicNeurosurgeryYonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of KoreaDepartment of Internal MedicineIlsan-Paik Hospital, College of Medicine, Inje University, Koyang, Gyeonggi-do, Republic of KoreaEndocrinologyInstitute of Endocrine ResearchPituitary Tumor ClinicNeurosurgeryYonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of KoreaDepartment of Internal MedicineIlsan-Paik Hospital, College of Medicine, Inje University, Koyang, Gyeonggi-do, Republic of KoreaEndocrinologyInstitute of Endocrine ResearchPituitary Tumor ClinicNeurosurgeryYonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of KoreaDepartment of Internal MedicineIlsan-Paik Hospital, College of Medicine, Inje University, Koyang, Gyeonggi-do, Republic of Korea ejlee423@yuhs.ac sunkim@yuhs.ac.
authors: Eun Jig
authors: EJ
authors: Lee
mesh_terms: D000172:Acromegaly / Q000097:blood / Q000601:surgery*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D019382:Human Growth Hormone / Q000097:blood / Q000172:deficiency*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011237:Predictive Value of Tests; D055815:Young Adult
chemical_list: D015415:Biomarkers; D019382:Human Growth Hormone