ECEESPE2025 ePoster Presentations Pituitary, Neuroendocrinology and Puberty (220 abstracts)
The role of IGF-1 in monitoring prolactinoma patients: paradox or additional diagnosis?
Patricia-Maria Anton 1 , Nicoleta Baculescu 1,2 , Iulia Florentina Burcea 1,2 , Ramona Dobre 1,2 , Roxana Dusceac 1,2 , Găloiu Simona Andreea 1,2 , Dan Alexandru Niculescu 1,2 , Serban Radian 1,2 , Raluca Trifanescu 1,2 , Cristina Capatina 1,2 & Catalina Poiana 1,2
1"CI Parhon" National Institute of Endocrinology, Pituitaru Disorders, Bucharest, Romania; 2University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
JOINT1510
Introduction: Pituitary adenomas secreting prolactin primarily consist of lactotroph cells; however, co-secretion of growth hormone (GH) may also occur at diagnosis or during follow-up. Levels of IGF-1 may paradoxically increase during Dopamine Agonist (DA) treatment.
Objective: To assess IGF-1 levels in patients with prolactinoma at baseline and during DA treatment and determine the frequency of silent acromegaly diagnosed during follow-up.
Methods: We retrospectively analysed 53 patients with prolactinoma who were followed up in our department, with IGF-1 levels measured at baseline and during DA treatment without intervening surgery. The median follow-up was 32.1 months (IQR: 14.9-68).
Results: 67.9% of cases were male, and the median age was 40 years (IQR: 32–56). Median baseline IGF-1 level was 174.2 ng/ml (IQR: 118.5–200.2), with 9.4% exceeding the upper limit of normal (ULN) (1-1.15 × ULN). The median prolactin level was 707 ng/ml (IQR: 164.5–3404.8). Macroadenomas were identified in 79.3% of cases, with a median tumour diameter of 20 mm (IQR: 10.6–35 mm). During DA treatment, the median IGF-1 level increased significantly to 211.6 ng/ml (IQR: 153.5–260.4, P = 0.001). The proportion exceeding ULN rose from 9.4% to 22.6% (P = 0.07) (1-2.13 × ULN). During follow-up, only one patient was diagnosed with silent acromegaly 22 months after the diagnosis of prolactinoma (1.89%). Among those exceeding the ULN (12 cases), eight underwent OGTT with normal GH suppression (mostly during DA treatment). Of the others, one was lost to follow-up, and three experienced IGF-1 normalisation after 2-2.5 years. IGF-1 peaked within the first two years, followed by a significant decline after 24 months (P = 0.001), suggesting transient elevations.
Conclusion: IGF-1 increased significantly during DA treatment, with most elevations occurring in the first two years, followed by a decreasing trend. Silent acromegaly was rare (1.89%). When IGF-1 exceeds ULN, GH assessment during OGTT and IGF-1 reassessment after DA discontinuation are advised. Periodic IGF-1 monitoring should be considered for patients with prolactinoma.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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