The critical parameters in GH excess

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The critical parameters in GH excess. / Sheppard, Michael.

In: Journal of endocrinological investigation, Vol. 28, No. 5 Suppl, 01.01.2005, p. 92-5.

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@article{245d1b0ec24a4bd9b370cb4df7a9723d,
title = "The critical parameters in GH excess",
abstract = "Effective biochemical control of GH and IGF-I levels in subjects with acromegaly can reduce mortality to that of the general population. Post-treatment mean GH values <2 or 2.5 microg/l are associated with mortality which is not different from the general population. Virtually all evidence from epidemiological studies has related GH and not IGF-I values to long-term mortality; controversy remains regarding relative importance of GH and IGF-I values in determining post-treatment control status. Current approaches to management of acromegaly (surgery, radiotherapy, SRIF analogues) rely on post-treatment monitoring of GH and IGF-I levels. Development of GH receptor antagonist therapy, which inhibits GH activity and normalizes circulating IGF-I, GH levels remaining elevated, requires re-analysis of relationship between GH and IGF-I. Studies have reported that normalization of IGF-I is associated with normalization of SMR, a significant association of IGF-I with survival, that IGF-I is not an independent predictor of mortality, and, in the largest study (419 patients), that there is no increase in mortality in patients with raised serum IGF-I levels. Post-operative subjects with acromegaly, with normal IGF-I levels but persistently abnormal nadir GH levels after glucose, have an increased risk of disease recurrence. Discordant values for GH and IGF-I estimations may be seen in up to 30% of patients following treatment, without knowledge of the impact on morbidity and mortality of this discordance. An optimal level of both GH and IGF-I appears to be required to maintain normal health, emphasizing the need for a clearer understanding of relationship between these two parameters.",
author = "Michael Sheppard",
year = "2005",
month = jan,
day = "1",
language = "English",
volume = "28",
pages = "92--5",
journal = "Journal of endocrinological investigation",
issn = "0391-4097",
publisher = "Editrice Kurtis",
number = "5 Suppl",

}

RIS

TY - JOUR

T1 - The critical parameters in GH excess

AU - Sheppard, Michael

PY - 2005/1/1

Y1 - 2005/1/1

N2 - Effective biochemical control of GH and IGF-I levels in subjects with acromegaly can reduce mortality to that of the general population. Post-treatment mean GH values <2 or 2.5 microg/l are associated with mortality which is not different from the general population. Virtually all evidence from epidemiological studies has related GH and not IGF-I values to long-term mortality; controversy remains regarding relative importance of GH and IGF-I values in determining post-treatment control status. Current approaches to management of acromegaly (surgery, radiotherapy, SRIF analogues) rely on post-treatment monitoring of GH and IGF-I levels. Development of GH receptor antagonist therapy, which inhibits GH activity and normalizes circulating IGF-I, GH levels remaining elevated, requires re-analysis of relationship between GH and IGF-I. Studies have reported that normalization of IGF-I is associated with normalization of SMR, a significant association of IGF-I with survival, that IGF-I is not an independent predictor of mortality, and, in the largest study (419 patients), that there is no increase in mortality in patients with raised serum IGF-I levels. Post-operative subjects with acromegaly, with normal IGF-I levels but persistently abnormal nadir GH levels after glucose, have an increased risk of disease recurrence. Discordant values for GH and IGF-I estimations may be seen in up to 30% of patients following treatment, without knowledge of the impact on morbidity and mortality of this discordance. An optimal level of both GH and IGF-I appears to be required to maintain normal health, emphasizing the need for a clearer understanding of relationship between these two parameters.

AB - Effective biochemical control of GH and IGF-I levels in subjects with acromegaly can reduce mortality to that of the general population. Post-treatment mean GH values <2 or 2.5 microg/l are associated with mortality which is not different from the general population. Virtually all evidence from epidemiological studies has related GH and not IGF-I values to long-term mortality; controversy remains regarding relative importance of GH and IGF-I values in determining post-treatment control status. Current approaches to management of acromegaly (surgery, radiotherapy, SRIF analogues) rely on post-treatment monitoring of GH and IGF-I levels. Development of GH receptor antagonist therapy, which inhibits GH activity and normalizes circulating IGF-I, GH levels remaining elevated, requires re-analysis of relationship between GH and IGF-I. Studies have reported that normalization of IGF-I is associated with normalization of SMR, a significant association of IGF-I with survival, that IGF-I is not an independent predictor of mortality, and, in the largest study (419 patients), that there is no increase in mortality in patients with raised serum IGF-I levels. Post-operative subjects with acromegaly, with normal IGF-I levels but persistently abnormal nadir GH levels after glucose, have an increased risk of disease recurrence. Discordant values for GH and IGF-I estimations may be seen in up to 30% of patients following treatment, without knowledge of the impact on morbidity and mortality of this discordance. An optimal level of both GH and IGF-I appears to be required to maintain normal health, emphasizing the need for a clearer understanding of relationship between these two parameters.

M3 - Review article

C2 - 16114283

VL - 28

SP - 92

EP - 95

JO - Journal of endocrinological investigation

JF - Journal of endocrinological investigation

SN - 0391-4097

IS - 5 Suppl

ER -