Skip to main content
Erschienen in: Pituitary 2/2007

01.06.2007

Defining normalcy of the somatotropic axis: an attainable goal?

verfasst von: Ariel L. Barkan

Erschienen in: Pituitary | Ausgabe 2/2007

Einloggen, um Zugang zu erhalten

Abstract

The diagnoses of acromegaly and dwarfism require biochemical confirmation of abnormal GH and IGF-1 concentrations. The same parameters are used for therapeutic decisions, i.e. initiation or termination of particular treatments. Therefore, reliable and epidemiologically and statistically proven criteria of normalcy for GH and IGF-1 are required for these tasks to be accomplished. Despite major progress in all these areas, the definition of what constitutes “normalcy” of the somatotropic axis is still lacking. Using an example of acromegaly, we discuss the contradictions and the uncertainties of the biochemical diagnosis of this disease.
Literatur
1.
Zurück zum Zitat Glick AM, Roth J, Yalow RS, Berson SA (1963) Immunoassay of human growth hormone in plasma. Nature 199:784–787PubMedCrossRef Glick AM, Roth J, Yalow RS, Berson SA (1963) Immunoassay of human growth hormone in plasma. Nature 199:784–787PubMedCrossRef
2.
Zurück zum Zitat Ho PJ, Friberg RD, Barkan AL (1992) Regulation of pulsatile growth hormone secretion by fasting in normal subjects and patients with acromegaly. J Clin Endocrinol Metab 75(3):812–819PubMedCrossRef Ho PJ, Friberg RD, Barkan AL (1992) Regulation of pulsatile growth hormone secretion by fasting in normal subjects and patients with acromegaly. J Clin Endocrinol Metab 75(3):812–819PubMedCrossRef
3.
Zurück zum Zitat Ho PJ, Jaffe CA, Friberg RD, Chandler WF, Barkan AL (1994) Persistence of rapid growth hormone (GH) pulsatility after successful removal of GH-producing pituitary tumors. J Clin Endocrinol Metab 78(6):1403–1410PubMedCrossRef Ho PJ, Jaffe CA, Friberg RD, Chandler WF, Barkan AL (1994) Persistence of rapid growth hormone (GH) pulsatility after successful removal of GH-producing pituitary tumors. J Clin Endocrinol Metab 78(6):1403–1410PubMedCrossRef
4.
Zurück zum Zitat Granada ML, Sanmarti A, Lucas A, Salinas I, Carrascosa A, Foz M, Audi L (1990) Assay-dependent results of immunoassayable spontaneous 24-hour growth hormone secretion in short children. Acta Paediatr Scand Suppl 379:63–70; discussion 71 Granada ML, Sanmarti A, Lucas A, Salinas I, Carrascosa A, Foz M, Audi L (1990) Assay-dependent results of immunoassayable spontaneous 24-hour growth hormone secretion in short children. Acta Paediatr Scand Suppl 379:63–70; discussion 71
6.
Zurück zum Zitat Tindall GT, Oyesiku NM, Watts NB, Clark RV, Christy JH, Adams DA (1993) Transsphenoidal adenomectomy for growth hormone-secreting pituitary adenomas in acromegaly: outcome analysis and determinants of failure. J Neurosurg 78(2):205–215PubMedCrossRef Tindall GT, Oyesiku NM, Watts NB, Clark RV, Christy JH, Adams DA (1993) Transsphenoidal adenomectomy for growth hormone-secreting pituitary adenomas in acromegaly: outcome analysis and determinants of failure. J Neurosurg 78(2):205–215PubMedCrossRef
7.
Zurück zum Zitat Bates AS, Van’t Hoff W, Jones JM, Clayton RN (1993) An audit of outcomes of treatment in acromegaly. Q J Med 86(5):293–299PubMed Bates AS, Van’t Hoff W, Jones JM, Clayton RN (1993) An audit of outcomes of treatment in acromegaly. Q J Med 86(5):293–299PubMed
8.
Zurück zum Zitat Rajasoorya C, Holdaway IM, Wrightson P, Scott DJ, Ibbertson HK (1994) Determinants of clinical outcome and survival in acromegaly. Clin Endocrinol (Oxf) 41(1):95–102 Rajasoorya C, Holdaway IM, Wrightson P, Scott DJ, Ibbertson HK (1994) Determinants of clinical outcome and survival in acromegaly. Clin Endocrinol (Oxf) 41(1):95–102
10.
Zurück zum Zitat Holdaway IM, Rajasoorya RC, Gamble GD (2004) Factors influencing mortality in acromegaly. J Clin Endocrinol Metab 89(2):667–674PubMedCrossRef Holdaway IM, Rajasoorya RC, Gamble GD (2004) Factors influencing mortality in acromegaly. J Clin Endocrinol Metab 89(2):667–674PubMedCrossRef
11.
Zurück zum Zitat Barreca A, Ciccarelli E, Minuto R, Bruzzi P, Giordano G, Camanni F (1989) Insulin-like growth factor I and daily growth hormone profile in the assessment of active acromegaly. Acta Endocrinol (Copenh) 120(5):629–635 Barreca A, Ciccarelli E, Minuto R, Bruzzi P, Giordano G, Camanni F (1989) Insulin-like growth factor I and daily growth hormone profile in the assessment of active acromegaly. Acta Endocrinol (Copenh) 120(5):629–635
12.
Zurück zum Zitat Barkan AL, Beitins IZ, Kelch RP (1998) Plasma insulin-like growth factor-I/somatomedin-C in acromegaly: correlation with the degree of growth hormone hypersecretion. J Clin Endocrinol Metab 67(1):69–73 Barkan AL, Beitins IZ, Kelch RP (1998) Plasma insulin-like growth factor-I/somatomedin-C in acromegaly: correlation with the degree of growth hormone hypersecretion. J Clin Endocrinol Metab 67(1):69–73
13.
Zurück zum Zitat Jenkins PJ, Bates P, Carson MN, Stewart PM, Wass JA (2006) Conventional pituitary irradiation is effective in lowering serum growth hormone and insulin-like growth factor-I in patients with acromegaly. J Clin Endocrinol Metab 91(4):1239–1245PubMedCrossRef Jenkins PJ, Bates P, Carson MN, Stewart PM, Wass JA (2006) Conventional pituitary irradiation is effective in lowering serum growth hormone and insulin-like growth factor-I in patients with acromegaly. J Clin Endocrinol Metab 91(4):1239–1245PubMedCrossRef
14.
Zurück zum Zitat Barkan AL (2003) Radiotherapy in acromegaly: the argument against. Clin Endocrinol (Oxf) 58(2):132–135CrossRef Barkan AL (2003) Radiotherapy in acromegaly: the argument against. Clin Endocrinol (Oxf) 58(2):132–135CrossRef
15.
Zurück zum Zitat Dimaraki EV, Jaffe CA, DeMott-Friberg R, Chandler WL, Barkan AL (2002) Acromegaly with apparently normal GH secretion: implications for diagnosis and follow-up. J Clin Endocrinol Metab 87(8):3537–3542PubMedCrossRef Dimaraki EV, Jaffe CA, DeMott-Friberg R, Chandler WL, Barkan AL (2002) Acromegaly with apparently normal GH secretion: implications for diagnosis and follow-up. J Clin Endocrinol Metab 87(8):3537–3542PubMedCrossRef
16.
Zurück zum Zitat Desailloud R, Crepin-Hemon S, Simovic-Corroyer B (2005) Acromegaly in elderly people. Ann Endocrinol (Paris) 66(6):540–544 Desailloud R, Crepin-Hemon S, Simovic-Corroyer B (2005) Acromegaly in elderly people. Ann Endocrinol (Paris) 66(6):540–544
17.
Zurück zum Zitat Freda PU, Nuruzzaman AT, Reyes CM, Sundeen RE, Post KD (2004) Significance of “abnormal” nadir growth hormone levels after oral glucose in postoperative patients with acromegaly in remission with normal insulin-like growth factor-I levels. J Clin Endocrinol Metab 89(2):495–500PubMedCrossRef Freda PU, Nuruzzaman AT, Reyes CM, Sundeen RE, Post KD (2004) Significance of “abnormal” nadir growth hormone levels after oral glucose in postoperative patients with acromegaly in remission with normal insulin-like growth factor-I levels. J Clin Endocrinol Metab 89(2):495–500PubMedCrossRef
18.
Zurück zum Zitat Costa AC, Rossi A, Martinelli CE Jr, Machado HR, Moreira AC (2002) Assessment of disease activity in treated acromegalic patients using a sensitive GH assay: should we achieve strict normal GH levels for a biochemical cure? J Clin Endocrinol Metab 87(7):3142–3147PubMedCrossRef Costa AC, Rossi A, Martinelli CE Jr, Machado HR, Moreira AC (2002) Assessment of disease activity in treated acromegalic patients using a sensitive GH assay: should we achieve strict normal GH levels for a biochemical cure? J Clin Endocrinol Metab 87(7):3142–3147PubMedCrossRef
19.
Zurück zum Zitat Vierhapper H, Heinze G, Gessl A, Exner M, Bieglmayr D (2003) Use of the oral glucose tolerance test to define remission in acromegaly. Metabolism 52(2):181–185PubMedCrossRef Vierhapper H, Heinze G, Gessl A, Exner M, Bieglmayr D (2003) Use of the oral glucose tolerance test to define remission in acromegaly. Metabolism 52(2):181–185PubMedCrossRef
20.
Zurück zum Zitat Ronchi CL, Varca V, Giavoli C, Epaminonda P, Beck-Peccoz P, Spada A, Arosio M (2005) Long-term evaluation of postoperative acromegalic patients in remission with pervious and newly proposed criteria. J Clin Endocrinol Metab 90(3):1377–1382PubMedCrossRef Ronchi CL, Varca V, Giavoli C, Epaminonda P, Beck-Peccoz P, Spada A, Arosio M (2005) Long-term evaluation of postoperative acromegalic patients in remission with pervious and newly proposed criteria. J Clin Endocrinol Metab 90(3):1377–1382PubMedCrossRef
21.
Zurück zum Zitat Swearingen B, Barker FG 2nd, Katznelson L, Biller BM, Grinspoon S, Klibanski A, Moayeri N, Black PM, Zervas NT (1998) Long-term mortality after transsphenoidal surgery and adjunctive therapy for acromegaly. J Clin Endocrinol Metab 83:3419–3426PubMedCrossRef Swearingen B, Barker FG 2nd, Katznelson L, Biller BM, Grinspoon S, Klibanski A, Moayeri N, Black PM, Zervas NT (1998) Long-term mortality after transsphenoidal surgery and adjunctive therapy for acromegaly. J Clin Endocrinol Metab 83:3419–3426PubMedCrossRef
22.
Zurück zum Zitat Beauregard C, Truong U, Hardy J, Serri O (2003) Long-term outcome and mortality after Transsphenoidal adenomectomy for acromegaly. Clin Endocrinol (Oxf) 58(1):86–91CrossRef Beauregard C, Truong U, Hardy J, Serri O (2003) Long-term outcome and mortality after Transsphenoidal adenomectomy for acromegaly. Clin Endocrinol (Oxf) 58(1):86–91CrossRef
23.
Zurück zum Zitat Holdaway IM, Rajasoorya CR, Gamble GD, Stewart AW (2003) Long-term treatment outcome in acromegaly. Growth Horm IGF Res 13(4):185–192PubMedCrossRef Holdaway IM, Rajasoorya CR, Gamble GD, Stewart AW (2003) Long-term treatment outcome in acromegaly. Growth Horm IGF Res 13(4):185–192PubMedCrossRef
24.
Zurück zum Zitat Clemmons DR, Van Wyk JJ, Ridgway EC, Kliman B, Kjellberg RN, Underwood LE (1979) Evaluation of acromegaly by radioimmunoassay of somatomedin-C. N Engl J Med 301(21):1138–1142PubMedCrossRef Clemmons DR, Van Wyk JJ, Ridgway EC, Kliman B, Kjellberg RN, Underwood LE (1979) Evaluation of acromegaly by radioimmunoassay of somatomedin-C. N Engl J Med 301(21):1138–1142PubMedCrossRef
25.
Zurück zum Zitat Walker JL, Crock PA, Behncken SN, Rowlinson SW, Nicholson LM, Boulton TJC, Waters MJ (1998) A novel mutation affecting the interdomain link region of the growth hormone receptor in a Vietnamese girl, and response to long-term treatment with recombinant human insulin-like growth factor-i and luteinizing hormone-releasing hormone analogue. J Clin Endocrinol Metab 83:2554–2561PubMedCrossRef Walker JL, Crock PA, Behncken SN, Rowlinson SW, Nicholson LM, Boulton TJC, Waters MJ (1998) A novel mutation affecting the interdomain link region of the growth hormone receptor in a Vietnamese girl, and response to long-term treatment with recombinant human insulin-like growth factor-i and luteinizing hormone-releasing hormone analogue. J Clin Endocrinol Metab 83:2554–2561PubMedCrossRef
26.
Zurück zum Zitat Barkan AL, Beitins IZ, Kelch RP (1988) Plasma insulin-like growth factor-1/somatomedin in acromegaly: correlation with the degree of growth hormone hypersecretion. J Clin Endocrinol. Metab 67:69–73PubMedCrossRef Barkan AL, Beitins IZ, Kelch RP (1988) Plasma insulin-like growth factor-1/somatomedin in acromegaly: correlation with the degree of growth hormone hypersecretion. J Clin Endocrinol. Metab 67:69–73PubMedCrossRef
27.
Zurück zum Zitat Freda PU (2003) Pitfalls in the biochemical assessment of acromegaly. Pituitary 6(3):135–140PubMedCrossRef Freda PU (2003) Pitfalls in the biochemical assessment of acromegaly. Pituitary 6(3):135–140PubMedCrossRef
28.
Zurück zum Zitat Ho KK, O’Sullivan AJ, Wolthers T, Leung KC (2003) Metabolic effects of oestrogens: impact of the route of administration. Ann Endocrinol (Paris) 64(2):170–7 Ho KK, O’Sullivan AJ, Wolthers T, Leung KC (2003) Metabolic effects of oestrogens: impact of the route of administration. Ann Endocrinol (Paris) 64(2):170–7
29.
Zurück zum Zitat Yakar S, Pennisi P, Wu Y, Zhao H, LeRoith D (2005) Clinical relevance of systemic and local IGF-1. Endocr Dev 9:11–16PubMedCrossRef Yakar S, Pennisi P, Wu Y, Zhao H, LeRoith D (2005) Clinical relevance of systemic and local IGF-1. Endocr Dev 9:11–16PubMedCrossRef
30.
Zurück zum Zitat Isgaard J, Carlsson L, Isaksson OG, Jansson JO. Pulsatile intravenous growth hormone (GH) infusion to hypophysectomized rats increases insulin-like growth factor I messenger ribonucleic acid in skeletal tissues more effectively than continuous GH infusion Isgaard J, Carlsson L, Isaksson OG, Jansson JO. Pulsatile intravenous growth hormone (GH) infusion to hypophysectomized rats increases insulin-like growth factor I messenger ribonucleic acid in skeletal tissues more effectively than continuous GH infusion
31.
Zurück zum Zitat Bonapart IE, van Domburg R, ten Have SM, de Herder WW, Erdman RA, Janssen JA, van der Lely AJ (2005) The “bio-assay” quality of life might be a better marker of disease activity in acromegalic patients than serum total IGF-1 concentrations. Eur J Endocrinol 152(2):217–224PubMedCrossRef Bonapart IE, van Domburg R, ten Have SM, de Herder WW, Erdman RA, Janssen JA, van der Lely AJ (2005) The “bio-assay” quality of life might be a better marker of disease activity in acromegalic patients than serum total IGF-1 concentrations. Eur J Endocrinol 152(2):217–224PubMedCrossRef
Metadaten
Titel
Defining normalcy of the somatotropic axis: an attainable goal?
verfasst von
Ariel L. Barkan
Publikationsdatum
01.06.2007
Erschienen in
Pituitary / Ausgabe 2/2007
Print ISSN: 1386-341X
Elektronische ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-007-0029-7

Weitere Artikel der Ausgabe 2/2007

Pituitary 2/2007 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Herzinfarkt mit 85 – trotzdem noch intensive Lipidsenkung?

16.05.2024 Hypercholesterinämie Nachrichten

Profitieren nach einem akuten Myokardinfarkt auch Betroffene über 80 Jahre noch von einer intensiven Lipidsenkung zur Sekundärprävention? Um diese Frage zu beantworten, wurden jetzt Registerdaten aus Frankreich ausgewertet.

Erstmanifestation eines Diabetes-Typ-1 bei Kindern: Ein Notfall!

16.05.2024 DDG-Jahrestagung 2024 Kongressbericht

Manifestiert sich ein Typ-1-Diabetes bei Kindern, ist das ein Notfall – ebenso wie eine diabetische Ketoazidose. Die Grundsäulen der Therapie bestehen aus Rehydratation, Insulin und Kaliumgabe. Insulin ist das Medikament der Wahl zur Behandlung der Ketoazidose.

CKD bei Diabetes: Neuheiten und Zukunftsaussichten

16.05.2024 DDG-Jahrestagung 2024 Kongressbericht

Jeder Mensch mit Diabetes muss auf eine chronische Nierenerkrankung gescreent werden – diese neue Empfehlung spricht die KDIGO aus. Die Therapie erfolgt individuell und je nach Szenario mit verschiedenen Substanzklassen. Künftig kommt wahrscheinlich, neben RAS-Hemmung, SGLT2-Inhibition und nsMRA, eine vierte Therapiesäule hinzu.

Riesenzellarteriitis: 15% der Patienten sind von okkulter Form betroffen

16.05.2024 Riesenzellarteriitis Nachrichten

In einer retrospektiven Untersuchung haben Forschende aus Belgien und den Niederlanden die okkulte Form der Riesenzellarteriitis genauer unter die Lupe genommen. In puncto Therapie und Rezidivraten stellten sie keinen sehr großen Unterschied zu Erkrankten mit kranialen Symptomen fest.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.