- Email: [email protected]
P-75 SERUM INSULIN-LIKE GROWTH FACTOR-I (IGF-I) LEVELS IN ACROMEGALIC PATIENTS WITH APPARENTLY NORMAL GH LEVELS
S38
Growth Hormone & IGF Research 16 (2006) Suppl B
benefit from adjustment of GH dosages or from assessment of possible compliance issues or underlying medical problems that impact GH Res.
Abstracts, 3rd Int. Congress of GRS & IGF Society P-77 THE ROLE OF INSULIN-LIKE-GROWTH FACTOR I (IGF-I) IN GLUCOSE INTOLERANCE IN THE PATIENTS WITH ACROMEGALY Akira Sata ° , Junko Morita, Naomi Hizuka, Izumi Fukuda, Makiko Kurimoto, Yuko Murakami, Yumiko Okubo, Yukiko Ishikawa, Kazue Takano. Department of Medicine II, Tokyo Women’s Medical University, Japan
NCGS first year mean growth rate. Solid curves: mean +/− 1 standard deviations; dotted curve: mean −2 SD; dashed curve: pretreatment mean. Naive, prepubertal at baseline, IGHD, female, ages 2−16.
P-75 SERUM INSULIN-LIKE GROWTH FACTOR-I (IGF-I) LEVELS IN ACROMEGALIC PATIENTS WITH APPARENTLY NORMAL GH LEVELS Junko Morita ° , Naomi Hizuka, Izumi Fukuda, Makiko Kurimoto, Akira Sata, Yuko Murakami, Yumiko Okubo, Kumiko Yasumoto, Kazue Takano. Department of Medicine II, Tokyo Women’s Medical University, Japan The diagnosis of acromegaly is established clinically and confirmed by elevated serum GH and IGF-I as well as lack of suppression of serum GH during oral glucose tolerance test. Recently, it has been reported that patients with acromegaly who had normal or slight elevation of random serum GH and postglucose serum GH less than 1ng/ml had high serum IGF-I levels. In the present study, we investigated whether serum IGF-I level could be the biochemical indicator for diagnosing acromegaly with apparently normal GH. In the fifty-seven newly diagnosed patients with active acromegaly (M/F: 23/34,18-76 yrs), fasting serum levels of GH and IGF-I and clinical features were studied. All patients underwent transsphenoidal surgery (TSS) and pathological diagnosis of GH producing tumor have been made. Serum IGF-I levels were greater than 2 SDS in all patients. We found five patients (9%) with random serum GH less than 5 ng/ml (G1), 11 patients (19%) with GH between 5 and 10 ng/ml (G2), and 41 patients (72%) with GH more than 10 ng/ml (G3), respectively. The median serum IGF-I levels for G1, G2, and G3 were 5.4, 6.8, and 7.2 SDS, respectively. There were no significant differences among the groups. The macro-tumor and the impaired glucose metabolism (diabetes and impaired glucose tolerance) were found in 80, 64, and 90%, and in 60, 54, and 78% of G1, G2, and G3, respectively. The incidences were not different among groups. In five patients with G1 (apparently normal GH levels and high IGF-I levels), three patients did not have clinically acromegaloid features, and one patient had acromegaloid feature and the postglucose serum GH nadir less than 1 ng/ml. These findings suggest that acromegalic patients with apparently normal GH had high IGF-I levels, and measurement of IGF-I level is critical when examining pituitary tumor and for not fail to diagnose acromegaly.
In the patients with acromegaly, glucose intolerance is one of the common complications, and the insulin resistance caused by longterm GH excess might take part in the situation. In these patients, serum IGF-I levels are also elevated as well as GH, but, it is not clear whether the excess of IGF-I that has insulin-like effect plays a role in glucose metabolism. In the present study, we investigated the serum IGF-I and glucose intolerance in patients with acromegaly and considered the role of IGF-I in glucose metabolism. Eighty-four patients with acromegaly (M/F: 31/53) were studied. Diabetes mellitus (DM), impaired glucose tolerance (IGT), normal glucose tolerance (NGT) were found in 32 (38%), 28 (33%), and 24 (29%) patients, respectively. The median serum GH levels for DM, IGT, and NGT were 23.8, 13.2 and 12.1 mg/L, respectively, and the values for DM were significantly higher than those for NGT. The median serum IGF-I levels for DM, IGT, and NGT were 702, 787.5, 650 ng/ml, and 6.9, 6.9, and 5.8 SD score, respectively. There were no statistically significant differences in serum IGF-I levels among these groups. Serum GH levels were positively correlated with IGF-I in patients with IGT and NGT. However, in patients with DM, serum GH level did not correlated with IGF-I, suggesting relatively low IGF-I to GH levels. These data indicate that glucose intolerance in patients with acromegaly might be involved mainly by GH excess and relatively low IGF-I to GH.
P-79 CLINICAL CHARACTERISTICS OF FIVE ACROMEGALIC PATIENTS WITH PAPILLARY THYROID CARCINOMA Yu Yamakado ° , Makiko Kurimoto, Izumi Fukuda, Naomi Hizuka, Kazue Takano. Department of Medicine II, Tokyo Women’s Medical University, Japan It has been reported that patients with acromegaly may have an increased risk for the development of cancers. However, some reports did not support those findings and whether acromegaly is associated with an increased prevalence of cancer or not is still controversial. In our previous study, We have investigated patients with 140 active acromegaly, and found as follows: (1) five patients had thyroid carcinoma and the relative risk for thyroid carcinoma was increased in male patients. (2) Among benign tumors, multinodular goiter, colonic polyps, gastric polyps, and gallbladder polyps were observed in 57%, 39%, 21%, and 15% of the patients, respectively. In the present study, we investigated clinical characteristics of five patients with acromegaly associated with papillary thyroid carcinoma, who visited at our outpatient clinic in the past seven years (2000–2006). The age, sex, and duration of acromegaly in the patients were 58 (37−68) years old, all female, and 20 (1−37) years, respectively. The median IGF-I SD score was 7.4 (2.7−16.2) SD. In addition to papillary thyroid carcinoma, all patients had other benign tumors. In particular, one patient had simultaneously four neoplasms (colonic polyps, gastric polyps, nasal polyps and intraduct papilloma). These data demonstrate that acromegalic patients with papillary thyroid carcinoma tend to have many neoplasms. The excess of IGF-I might play some roles in the development of neoplasms. It is recommended that patients with acromegaly with persistently elevated IGF-I should undergo total body check including palpation or ultrasonography of thyroid gland. In the patients who have thyroid nodules, careful monitoring including fineneedle aspiration might be important to detect thyroid carcinoma.
Growth Hormone & IGF Research 16 (2006) Suppl B
benefit from adjustment of GH dosages or from assessment of possible compliance issues or underlying medical problems that impact GH Res.
Abstracts, 3rd Int. Congress of GRS & IGF Society P-77 THE ROLE OF INSULIN-LIKE-GROWTH FACTOR I (IGF-I) IN GLUCOSE INTOLERANCE IN THE PATIENTS WITH ACROMEGALY Akira Sata ° , Junko Morita, Naomi Hizuka, Izumi Fukuda, Makiko Kurimoto, Yuko Murakami, Yumiko Okubo, Yukiko Ishikawa, Kazue Takano. Department of Medicine II, Tokyo Women’s Medical University, Japan
NCGS first year mean growth rate. Solid curves: mean +/− 1 standard deviations; dotted curve: mean −2 SD; dashed curve: pretreatment mean. Naive, prepubertal at baseline, IGHD, female, ages 2−16.
P-75 SERUM INSULIN-LIKE GROWTH FACTOR-I (IGF-I) LEVELS IN ACROMEGALIC PATIENTS WITH APPARENTLY NORMAL GH LEVELS Junko Morita ° , Naomi Hizuka, Izumi Fukuda, Makiko Kurimoto, Akira Sata, Yuko Murakami, Yumiko Okubo, Kumiko Yasumoto, Kazue Takano. Department of Medicine II, Tokyo Women’s Medical University, Japan The diagnosis of acromegaly is established clinically and confirmed by elevated serum GH and IGF-I as well as lack of suppression of serum GH during oral glucose tolerance test. Recently, it has been reported that patients with acromegaly who had normal or slight elevation of random serum GH and postglucose serum GH less than 1ng/ml had high serum IGF-I levels. In the present study, we investigated whether serum IGF-I level could be the biochemical indicator for diagnosing acromegaly with apparently normal GH. In the fifty-seven newly diagnosed patients with active acromegaly (M/F: 23/34,18-76 yrs), fasting serum levels of GH and IGF-I and clinical features were studied. All patients underwent transsphenoidal surgery (TSS) and pathological diagnosis of GH producing tumor have been made. Serum IGF-I levels were greater than 2 SDS in all patients. We found five patients (9%) with random serum GH less than 5 ng/ml (G1), 11 patients (19%) with GH between 5 and 10 ng/ml (G2), and 41 patients (72%) with GH more than 10 ng/ml (G3), respectively. The median serum IGF-I levels for G1, G2, and G3 were 5.4, 6.8, and 7.2 SDS, respectively. There were no significant differences among the groups. The macro-tumor and the impaired glucose metabolism (diabetes and impaired glucose tolerance) were found in 80, 64, and 90%, and in 60, 54, and 78% of G1, G2, and G3, respectively. The incidences were not different among groups. In five patients with G1 (apparently normal GH levels and high IGF-I levels), three patients did not have clinically acromegaloid features, and one patient had acromegaloid feature and the postglucose serum GH nadir less than 1 ng/ml. These findings suggest that acromegalic patients with apparently normal GH had high IGF-I levels, and measurement of IGF-I level is critical when examining pituitary tumor and for not fail to diagnose acromegaly.
In the patients with acromegaly, glucose intolerance is one of the common complications, and the insulin resistance caused by longterm GH excess might take part in the situation. In these patients, serum IGF-I levels are also elevated as well as GH, but, it is not clear whether the excess of IGF-I that has insulin-like effect plays a role in glucose metabolism. In the present study, we investigated the serum IGF-I and glucose intolerance in patients with acromegaly and considered the role of IGF-I in glucose metabolism. Eighty-four patients with acromegaly (M/F: 31/53) were studied. Diabetes mellitus (DM), impaired glucose tolerance (IGT), normal glucose tolerance (NGT) were found in 32 (38%), 28 (33%), and 24 (29%) patients, respectively. The median serum GH levels for DM, IGT, and NGT were 23.8, 13.2 and 12.1 mg/L, respectively, and the values for DM were significantly higher than those for NGT. The median serum IGF-I levels for DM, IGT, and NGT were 702, 787.5, 650 ng/ml, and 6.9, 6.9, and 5.8 SD score, respectively. There were no statistically significant differences in serum IGF-I levels among these groups. Serum GH levels were positively correlated with IGF-I in patients with IGT and NGT. However, in patients with DM, serum GH level did not correlated with IGF-I, suggesting relatively low IGF-I to GH levels. These data indicate that glucose intolerance in patients with acromegaly might be involved mainly by GH excess and relatively low IGF-I to GH.
P-79 CLINICAL CHARACTERISTICS OF FIVE ACROMEGALIC PATIENTS WITH PAPILLARY THYROID CARCINOMA Yu Yamakado ° , Makiko Kurimoto, Izumi Fukuda, Naomi Hizuka, Kazue Takano. Department of Medicine II, Tokyo Women’s Medical University, Japan It has been reported that patients with acromegaly may have an increased risk for the development of cancers. However, some reports did not support those findings and whether acromegaly is associated with an increased prevalence of cancer or not is still controversial. In our previous study, We have investigated patients with 140 active acromegaly, and found as follows: (1) five patients had thyroid carcinoma and the relative risk for thyroid carcinoma was increased in male patients. (2) Among benign tumors, multinodular goiter, colonic polyps, gastric polyps, and gallbladder polyps were observed in 57%, 39%, 21%, and 15% of the patients, respectively. In the present study, we investigated clinical characteristics of five patients with acromegaly associated with papillary thyroid carcinoma, who visited at our outpatient clinic in the past seven years (2000–2006). The age, sex, and duration of acromegaly in the patients were 58 (37−68) years old, all female, and 20 (1−37) years, respectively. The median IGF-I SD score was 7.4 (2.7−16.2) SD. In addition to papillary thyroid carcinoma, all patients had other benign tumors. In particular, one patient had simultaneously four neoplasms (colonic polyps, gastric polyps, nasal polyps and intraduct papilloma). These data demonstrate that acromegalic patients with papillary thyroid carcinoma tend to have many neoplasms. The excess of IGF-I might play some roles in the development of neoplasms. It is recommended that patients with acromegaly with persistently elevated IGF-I should undergo total body check including palpation or ultrasonography of thyroid gland. In the patients who have thyroid nodules, careful monitoring including fineneedle aspiration might be important to detect thyroid carcinoma.