I M Holdaway1. 1. Department of Endocrinology, Greenlane Clinical Centre, Auckland City Hospital, Auckland, New Zealand. ian@adhb.govt.nz
Abstract
BACKGROUND: Increased production of growth hormone (GH) and insulin-like growth factor-I (IGF-I) in patients with acromegaly is associated with a twofold increase in mortality compared with the general population. The range of standardised mortality rates in various studies ranges from 1.2 to 3.6. PREDICTORS OF MORTALITY: Multivariate analysis has indicated that post-treatment serum GH levels and, in a number of studies, serum IGF-I levels are the most powerful predictors of outcome. Normal IGF-I concentrations and random GH levels <2.5 microg/l measured by polyclonal radioimmunoassay result in optimal outcome. Other factors adversely influencing mortality include hypertension and a long interval between onset of the disorder and diagnosis. CONCLUSIONS: Analysis of recent reports suggests that adoption of treatment guidelines with appropriate post-treatment target ranges for GH and IGF-I, together with the availability of newer methods to control GH oversecretion, has significantly improved patient outcomes. Copyright (c) 2007 S. Karger AG,Basel.
BACKGROUND: Increased production of growth hormone (GH) and insulin-like growth factor-I (IGF-I) in patients with acromegaly is associated with a twofold increase in mortality compared with the general population. The range of standardised mortality rates in various studies ranges from 1.2 to 3.6. PREDICTORS OF MORTALITY: Multivariate analysis has indicated that post-treatment serum GH levels and, in a number of studies, serum IGF-I levels are the most powerful predictors of outcome. Normal IGF-I concentrations and random GH levels <2.5 microg/l measured by polyclonal radioimmunoassay result in optimal outcome. Other factors adversely influencing mortality include hypertension and a long interval between onset of the disorder and diagnosis. CONCLUSIONS: Analysis of recent reports suggests that adoption of treatment guidelines with appropriate post-treatment target ranges for GH and IGF-I, together with the availability of newer methods to control GH oversecretion, has significantly improved patient outcomes. Copyright (c) 2007 S. Karger AG,Basel.
Authors: Tamara L Wexler; Ronen Durst; David McCarty; Michael H Picard; Lindsay Gunnell; Zehra Omer; Pouneh Fazeli; Karen K Miller; Anne Klibanski Journal: Growth Horm IGF Res Date: 2010-07-03 Impact factor: 2.372
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