Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2007) 13 P225

SFEBES2007 Poster Presentations AMEND Young Investigator's Award (21 abstracts)

Evaluation of acromegaly status following surgery by OGTT, GH day curve and IGF-I: relationships between these parameters

Niki Karavitaki , Alberto Fernandez , Violet Fazal-Sanderson , Helen E Turner & John AH Wass


Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, United Kingdom.


Background: Nadir GH<2 mU/l in OGTT, normal IGF-I and mean GH<5 mU/l in the growth hormone day curve (GHDC) are considered the therapeutic endpoints in patients with acromegaly. However, discrepancies between these parameters have been reported.

Aim: To compare the utility of the above tests in assessing the acromegaly status following surgical treatment.

Patients and methods: Twenty-six consecutive patients (16 females) diagnosed with acromegaly and macroadenoma had OGTT, GHDC and IGF-I measurement 16–18 weeks following transsphenoidal adenomatectomy. Data were analysed with appropriate statistical methods.

Results: Among patients with nadir GH<2 mU/l in the OGTT, 83% had mean GH in the OGTT <5. Among those with nadir GH >2 in the OGTT, 63% had mean GH in the OGTT >5. Among subjects with nadir GH <2 in OGTT, 11% had mean GH >5 in GHDC and 0% had high IGF-I. Among those with nadir GH >2 in OGTT, 25% had mean GH <5 in the GHDC and 63% had normal IGF-I. Among patients with mean GH <5 in the GHDC, 0% had high IGF-I and among those with mean GH >5 in the GHDC, 63% had normal IGF-I. Nadir GH <2.14 in OGTT had sensitivity 89%, specificity 75%, positive predictive value (PPV) 89% and negative predictive value (NPV) 75% in predicting GH <5 in the GHDC and sensitivity 78%, specificity 0%, PPV 100% and NPV 38% in predicting normal IGF-I. Mean GH <4.13 in OGTT had sensitivity 89%, specificity 87%, PPV 94% and NPV 78% in predicting GH <5 in GHDC. Mean GH <10 in the OGTT had sensitivity 96%, specificity 100%, PPV 100% and NPV 75% in predicting normal IGF-I.

Conclusions: Reluctantly, in cases of acromegaly following adenomatectomy, the OGTT and the GHDC do not always provide consistent data making both tests necessary for the assessment of the therapeutic result.

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