title: Diagnostic utility of serum GH, IGF-1 and IGFBP3 in patients of acromegaly with uncontrolled diabetes: a pilot study.
abstract: OBJECTIVE
  Diagnosis of acromegaly in presence of uncontrolled diabetes mellitus is not well validated.
  
  
  METHODS
  The study included 10 patients of active acromegaly with uncontrolled blood glucose, 10 patients of type 2 diabetes mellitus with poor glycemic control and 10 healthy subjects. The growth hormone level following oral glucose tolerance test and insulin-like growth factor-1 (IGF-1) and insulin-like growth factor-binding protein-3 (IGFBP-3) were done at baseline in all the 3 groups and it was repeated after short term glycemic control in type 2 diabetics and acromegalics with diabetics
  
  
  RESULTS
  In the acromegalic group the basal GH value was very high (36.5 + 1.6) ng/ml and it was non-suppressible (32.5 + 1.43) ng/ml after OGTT. The mean IGF-1 and IGFBP-3 values were also high at baseline (208.38 + 38.51) ng/ml, and 7322 + 370 ng/ml respectively. In the non-acromegalic diabetic patients, the basal growth hormone value was marginally elevated (2.3 + 0.02) ng/ml. However, it was suppressible to 0.2 + 0.04 ng/ml after oral glucose load. In them the IGF-1 and IGFBP-3 values were not elevated and comparable to that of healthy controls.
  
  
  CONCLUSIONS
  Basal serum GH and IGFBP-3 levels are not influenced by degree of glycemic control however serum IGF-1 levels should be interpreted with caution in patients of acromegaly with diabetes. Oral glucose load test has discriminating ability to diagnose acromegaly even with poorly controlled diabetes.
authors: Pinaki
authors: P
authors: Dutta
authors: Saurabh
authors: S
authors: Singhal
authors: Naresh Kumar
authors: NK
authors: Sachdeva
authors: Viral N
authors: VN
authors: Shah
authors: Ashish
authors: A
authors: Pathak
authors: K K
authors: KK
authors: Mukherjee
authors: Anil
authors: A
authors: Bhansali
mesh_terms: D000172:Acromegaly / Q000097:blood / Q000175:diagnosis*; D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D013006:Growth Hormone / Q000097:blood*; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008297:Male; D010865:Pilot Projects
chemical_list: C515497:IGFBP3 protein, human; D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone