HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: EJE-09-0222v1 161/1/37    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ronchi, C L Articles by Beck-Peccoz, P Search for Related Content PubMed PubMed Citation Articles by Ronchi, C L Articles by Beck-Peccoz, P

Prevalence of GH deficiency in cured acromegalic patients: impact of different previous treatments

¹ Department of Medical Sciences, University of Milan, 20122 Milan, Italy² Unit of Endocrinology and Diabetology, Pad. Granelli, Fondazione IRCCS Ospedale Maggiore Policlinico, Via F. Sforza, 35, 20122 Milan, Italy³ Unit of Endocrinology and Diabetology, Department of Medical and Surgical Sciences, University of Milan, IRCCS Policlinico S. Donato, 20097 S. Donato (MI), Italy⁴ Unit of Endocrine Diseases, Ospedale S. Giuseppe, 20093 Milan, Italy

(Correspondence should be addressed to C L Ronchi; Email: cristina.ronchi{at}unimi.it)

Objective: Radiotherapy (RT) for pituitary adenomas, including GH-secreting ones, frequently leads to GH deficiency (GHD). Data on the effects of surgery alone (S) on dynamic GH secretion are limited. The aim of the study was to investigate the occurrence of GHD in acromegalic patients treated with different therapeutic options.

Design and methods: Fifty-six patients in remission from acromegaly, (33 F & 23 M, age: 54±13 years, body mass index (BMI): 28.4±4.1 kg/m², 21 with adequately substituted pituitary deficiencies) treated by S alone (n=33, group 1) or followed by RT (n=23, group 2), were investigated for GHD by GHRH plus arginine testing, using BMI-adjusted cut-offs. Several metabolic and cardiovascular parameters (waist circumference, body fat percentage, blood pressure, fasting and post-oral glucose tolerance test glucose, HbA1c, insulin resistance and lipid profile) were evaluated in all the patients and 28 control subjects with known diagnosis of GHD.

Results: Serum GH peak after challenge was 8.0±9.7 µg/l, without any correlation with post-glucose GH nadir and IGF-1 levels. The GH response indicated severe GHD in 34 patients (61%) and partial GHD in 15 patients (27%). IGF-1 were below the normal range in 14 patients (25%). The frequency of GHD was similar in the two treatment groups (54% in group 1 and 70% in group 2). No significant differences in metabolic parameters were observed between acromegalic patients and controls with GHD.

Conclusions: Severe GHD may occur in about 60% of patients treated for acromegaly, even when cured after S alone. Thus, a stimulation test (i.e. GHRH plus arginine) is recommended in all cured acromegalic patients, independently from previous treatment.

This article has been cited by other articles:

				K. K. Miller, T. Wexler, P. Fazeli, L. Gunnell, G. J. Graham, C. Beauregard, L. Hemphill, L. Nachtigall, J. Loeffler, B. Swearingen, et al. Growth Hormone Deficiency after Treatment of Acromegaly: A Randomized, Placebo-Controlled Study of Growth Hormone Replacement J. Clin. Endocrinol. Metab., February 1, 2010; 95(2): 567 - 577. [Abstract] [Full Text] [PDF]