IGF - Prevalence, clinical and biochemical spectrum and treatment outcome of acromega

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Prevalence, clinical and biochemical spectrum and treatment outcome of acromegaly with normal basal GH at diagnosis.

J Clin Endocrinol Metab. 2018 Jul 27;:

Authors: Espinosa-de-Los-Monteros AL, Sosa-Eroza E, Gonzalez B, Mendoza V, Mercado M

Abstract
Context: The term "micromegaly" has been used to describe a subset of patients who have elevated IGF-1 levels but apparently normal basal GH (bGH) concentrations, and frequently, a glucose-suppressed GH of < 1 ng/mL.
Objective: To evaluate the prevalence, clinical spectrum and therapeutic outcome of acromegaly with normal bGH at diagnosis.
Design and methods: Retrospective analysis of a cohort of patients with acromegaly diagnosed and treated at a tertiary care center.
Results: A cohort of 528 patients with acromegaly was stratified according to bGH at diagnosis: Group 1: < 2 ng/mL, n=16, Group 2: 2-9.9 ng/mL, n=202, Group 3: 10-99 ng/mL, n=294 and Group 4: >= 100 ng/mL, n=16. Patients in group 1 (normal bGH) constituted 3% of the total cohort and were significantly older and more frequently male than patients in the other groups. The frequency of acromegalic symptoms, signs and comorbidities was similar among the four patient groups. Group 1 patients more frequently harbored microadenomas (75%) and had significantly lower median IGF-1 and post-glucose GH levels. Surgical success rate was similar among patients from groups 1 (53.8%), 2 (54.1%) and 3 (36.9 %), whereas only 13.3% of patients in group 4 achieved remission.
Conclusion: Normal bGH acromegaly is infrequent in real life. These patients have some distinctive features that argue against this being simply acromegaly at its early stages.


PMID: 30060172 [PubMed - as supplied by publisher]



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