Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2007) 14 P603

ECE2007 Poster Presentations (1) (659 abstracts)

Growth hormone deficiency in patients with acromegaly after ‘successful’ transsphenoidal surgery

Milan Petakov 1 , Tatjana Isailovic 1 , Marina Djurovic 1 , Djuro Macut 1 , Miloje Joksimovic 2 , Bojana Popovic 1 , Ivana Bozic 1 & Svetozar Damjanovic 1


1Institute of Endocrinology, Clinical Center of Serbia, Belgrade, Serbia; 2Clinic for Neurosurgery, Belgrade, Serbia.


The diagnosis of adult growth hormone deficiency (GHD) in patients with pituitary disease relies predominantly on provocative tests of GH secretion. The incidence of GHD in treated acromegalic patients has not been fully documented. Therefore, the aim of the present study was to elucidate GH response to insulin-induced hypoglycaemia (ITT, 0.15 IU/kg i.v.) in a cohort of 10 patients with acromegly considered cured solely by transsphenoidal surgery (6 females and 4 males, mean age 51±2.6 years), and 6 healthy age-matched controls (3 females and 3 males). All patients cured for acromegaly (biochemical criteria for remission-‘cure” were the normalization of IGF-I level and GH suppression to less then 1 μg/l during the OGTT) had normal residual pituitary function i.e. had no signs of pituitary ACTH and TSH deficiency. The mean (±S.E.M) peak GH response to ITT in cured acromegalics was significantly lower in comparison with healthy subjects (8.19±2.05 vs. 17.45±3.1 μg/l; P<0.05). In five ‘cured’ acromegalic patients (50%) we confirmed the presence of severe growth hormone deficiency (peak GH during ITT less then 3 μg/l). In conclusion, it has been increasingly recognized that some patients previously concerned cured after surgery for acromegaly, in fact have the GH deficiency. It is necessary to check GH secretory capacity in every cured patient previously operated for acromegaly even if no other pituitary hormone deficit exist. Possibly, some of so-called cured patients with acromegaly should be treated with GH substitution, concerning the possible premature morbidity and mortality due to GH deficiency.

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