Endocrine Abstracts

Objective: to determine the need for screening for IGF-1 levels in patients with prolactinomas and without obvious symptoms of acromegaly.

Matherials and methods: A pilot cross-sectional study, based on the analysis of medical records of patients with confirmed prolactinoma, who applied to the Moscow Regional Research and Clinical Institute named by M.F. Vladimirsky. A total of 88 patients were included in the study. The frequency of studying the level of IGF-1, and the frequency of detecting cases of acromegaly were evaluated in patients with prolactinoma. The level of IGF-1 was determined in 60/88 patients with prolactinoma. Among patients with prolactinoma, women with microadenoma (Fmi) - 17, women with macroadenoma (Fma)- 16, men with microadenoma (Mmi) - 7, men with macroadenoma (Mma) - 20. The median level of prolactin at the onset of the disease was 2330 mU/l (1010; 4389) in Fmi, 10006.5 mU/l in Fma (1917.6;95106.3), in Mmi 2017.52 mU/l (1626;4382), in Mma 6080 mU/l (14000;104700).

Results: Among patients with a known level of IGF-1, its increase was recorded in 6/60 patients with prolactinomas. An oral glucose load (OGL) was performed in all 6 patients. The diagnosis of acromegaly was confirmed in 2 Fmi. The percentage of excess of the IGF-1 levels above the upper limit of the normal in patients with a negative test – 20.1%, 45.58%, 46.09% and 115.1%, in patients with diagnosed acromegaly – 70.8% and 217.6%.

Conclusions: In real clinical practice, the level of IGF-1 was determined in 68.2% of patients with prolactinomas. At the same time, the proportion of identified patients with acromegaly among the examined patients with prolactinomas but without obvious clinical signs of acromegaly, was 3.33%. Considering the obtained results, the question of the necessity of screening the level of IGF-1 in patients with prolactinomas requires further study.