Acromegaly: paradoxical GH response to OG reflects clinical features

  • Mukai K & al.
  • J Clin Endocrinol Metab
  • 23 Nov 2018

  • curated by Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • A retrospective study suggests that insulin-like growth factor-1 (IGF-1) levels and glucose metabolism are associated with a paradoxical growth hormone response (an increase) to oral glucose in patients with acromegaly.

Why this matters

  • A paradoxical growth hormone response to oral glucose is common in patients with acromegaly, but associated clinical characteristics were poorly understood.

Key results

  • Response to oral glucose was associated with higher presurgery IGF-1 levels (P<.05 style="list-style-type:circle;">
  • This difference was not significant after pituitary surgery (P=.69).
  • Response to oral glucose was associated with higher presurgery 120-minute plasma glucose, 120-minute immunoreactive insulin, and HbA1c: markers of glucose metabolism (P<.01 p and respectively style="list-style-type:circle;">
  • These differences were not significant after surgery (P=.89, P=.58, and P=1.00, respectively).
  • Response to oral glucose was associated with better efficacy of octreotide (Sandostatin) and bromocriptine (Parlodel; P<.05 for both>
  • Oral glucose responders had a higher proportion of pituitary tumors with hypointensity on T2-weighted MRI (P<.05>

    Study design

    • 63 patients with acromegaly, 19 who responded to oral glucose and 44 who did not, were analyzed for associated clinical features.
    • Funding: None.

    Limitations

    • Retrospective study.
    • Small patient sample size.
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