Produção Nacional
Revisado por pares
Discordant Nadir GH After Oral Glucose and IGF-I Levels on Treated Acromegaly: Refining the Biochemical Markers of Mild Disease Activity
2009; Thieme Medical Publishers (Germany); Volume: 42; Issue: 01 Linguagem: Inglês
10.1055/s-0029-1239522
ISSN1439-4286
AutoresPaula Condé Lamparelli Elias, Helena Barbosa Lugão, Mirian Cláudia de Souza Pereira, Hélio Rubens Machado, Margaret de Castro, Ayrton Custódio Moreira,
Tópico(s)Adrenal and Paraganglionic Tumors
ResumoBiochemical markers for remission on acromegaly activity are controversial. We studied a subset of treated acromegalic patients with discordant nadir GH levels after oral glucose tolerance test (oGTT) and IGF-I values to refine the current consensus on acromegaly remission. We also compared GH results by two GH immunoassays. From a cohort of 75 treated acromegalic patients, we studied 13 patients who presented an elevated IGF-I despite post-oGTT nadir GH of ≤1 μg/l. The 12-h daytime GH profile (GH-12 h), nadir GH after oGTT, and basal IGF-I levels were studied in patients and controls. Bland-Altman method showed high concordance between GH assays. Acromegalic patients showed higher mean GH-12 h values (0.71±0.36 vs. 0.31±0.28 μg/l; p<0.05) and nadir GH after oGTT (0.48±0.32 vs. 0.097±0.002 μg/l; p<0.05) as compared to controls. Nadir GH correlated with mean GH-12 h (r=0.92, p 0.3 and ≤1 μg/l had IGF-I >130% ULNR and mean GH-12 h of 0.93±0.24 μg/l. Our data integrate daytime GH secretion, nadir GH after oGTT, and plasma IGF-I concentrations showing a continuum of mild residual activity in a subgroup of treated acromegaly with nadir GH values ≤1 μg/l. The degree of increased IGF-I levels and nadir GH after oGTT are correlated with the subtle abnormalities of daytime GH secretion.
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