Neue Entwicklungen und Perspektiven in der Akromegalie

2021 ◽  
Vol 146 (15) ◽  
pp. 950-954
Author(s):  
Mario Detomas ◽  
Miriam Reuter ◽  
Timo Deutschbein
Keyword(s):  
Body Mass Index ◽  
Growth Factor ◽  
Body Mass ◽  
Ältere Patienten ◽  
Insulin Like Growth Factor ◽  
Sich Eine ◽  
Diagnostik Und Therapie ◽  
Neue Entwicklungen ◽  
Diagnostisches Vorgehen

Was ist neu? Diagnostik Bei Verdacht auf eine Akromegalie wird zunächst das Hormon Insulin-like growth factor 1 (IGF-1) als wesentlicher Mediator des Wachstumshormons (GH) bestimmt. Ist es erhöht, schließt sich eine Bestätigungsdiagnostik mittels GH-Suppressionstest an. Neue Arbeiten empfehlen für diesen Test niedrigere GH-Grenzwerte als früher, zudem sollen potenzielle Einflussgrößen (z. B. Body-Mass-Index) stärker berücksichtigt werden. Perspektivisch könnten Erkrankte mittels einer automatisierten Gesichtserkennung ggf. leichter identifiziert werden. Komorbiditäten Bei einem unkontrollierten GH-Exzess sind Lebensqualität und -erwartung zum Teil erheblich reduziert. Eine Akromegalie sowie deren typische Folgeerkrankungen (z. B. Schlafapnoe, Kardiomyopathie, Arthropathie) müssen daher frühzeitig erkannt werden. Kürzlich wurden neue Empfehlungen für ein standardisiertes diagnostisches Vorgehen publiziert. Therapie Die operative Adenomentfernung durch einen erfahrenen Hypophysenchirurgen ist Therapie der Wahl. Bei residueller Erkrankung kann perspektivisch eine Kombination aus volumetrischer Magnetresonanztomografie (MRT) und 11C-Methionin-Positronen-Emissions-Tomografie (PET) eine Folgeoperation erleichtern. Für die typische Zweitlinientherapie mit Somatostatin-Analoga (SSA) ist nun erstmals auch ein oral einzusetzendes Präparat verfügbar. Neue Daten belegen die Wirksamkeit und Sicherheit einer Hypophysenbestrahlung. Spezielle Patientenpopulationen Schwangere und ältere Patienten bedürfen besonderer Aufmerksamkeit. Gemäß aktueller Daten wirkt sich die COVID-Pandemie auch bei einer Akromegalie nachteilig auf Diagnostik und Therapie aus.

scholarly journals Postnatal growth in children born small and appropriate for gestational age during the first years of life

Medicina ◽  
2008 ◽  
Vol 45 (1) ◽  
pp. 51 ◽  
Author(s):  
Margarita Valūnienė ◽  
Agnė Danylaitė ◽  
Dovilė Kryžiūtė ◽  
Giedrė Ramanauskaitė ◽  
Danutė Lašienė ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Growth Factor ◽  
Body Mass ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Binding Protein ◽  
Insulin Like Growth Factor ◽  
Appropriate For Gestational Age ◽  
Igf Binding ◽  
Igf Binding Protein

The aim of the study was to evaluate growth pattern of small- and appropriate-for-gestationalage children and to identify prenatal and postnatal risk factors for short stature and development of components of metabolic syndrome. A total of 109 small- and 239 appropriate-for-gestational-age infants were enrolled in the study. Within 24 hours after birth and at 2, 5, 9, 12, 18, 24 months, and 6 years of age, anthropometric data were recorded for study children. Cord blood samples from study infants were collected, and insulin-like growth factor-1 (IGF), IGF-binding protein-3, and leptin levels were measured. Birth weight and height (P<0.001) and insulin-like growth factor-1, IGF-binding protein-3, and leptin levels (P<0.05) were lower in children born small for gestational age vs. children born appropriate for gestational age. At 2, 5, 12, 18, and 24 months and 6 years of age, children born small for gestational age remained shorter and weighed less (P<0.001). Waist-to-hip ratio, heart rate at 6 years of age and gain in body mass index from birth up to 6 years of age was higher in children born small for gestational age. Height gain during the first year of life was mainly influenced by birth length and target height. Maternal weight before pregnancy and cord leptin levels were the most significant factors influencing postnatal weight gain during the first years of life. Conclusions. During the first 6 years of life, children born small for gestational age remained shorter and lighter. A greater catch-up in body mass index and tendency towards central pattern of fat distribution during the first years of life might be predisposing factors for the development of long-term metabolic complications in these individuals.

scholarly journals The Insulin-Like Growth Factor Axis and Plasma Lipid Levels in the Elderly1

1998 ◽  
Vol 83 (2) ◽  
pp. 499-502
Author(s):  
Gian Paolo Ceda ◽  
Elisabetta Dall’Aglio ◽  
Andrea Magnacavallo ◽  
Nicola Vargas ◽  
Vittorio Fontana ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Regression Analysis ◽  
Growth Factor ◽  
Body Mass ◽  
Elderly Population ◽  
Elderly Subjects ◽  
Insulin Like Growth Factor ◽  
Lipid Levels ◽  
Igf I ◽  
Igfbp 3

The activity of the hypothalamic-GH-insulin-like growth factor (IGF) network declines with age. It has recently been shown that increased cardiovascular mortality occurs in adults with GH deficiency. As hypercholesterolemia is common in GH-deficient adults, and because there is experimental evidence that GH may play a role in regulating plasma cholesterol, we decided to investigate the activity of the GH-IGF axis in an elderly population by measuring serum IGF-I, IGF-II, and IGF-binding protein-3 (IGFBP-3) levels and to study their relationship with blood lipid levels. One hundred and thirty-two elderly subjects, 52 men and 80 women, were studied (age range, 60–91 yr). Men had significantly lower levels of IGFBP-3, high density lipoprotein cholesterol (HDL-C) and apoprotein A1 (ApoA1) compared to the women, whereas IGF-I and IGF-II were only slightly lower. Using linear regression analysis, we observed an inverse relationship of age with IGF-I (r = −0.35; P &lt; 0.001), IGF-II (r = 0.40; P &lt; 0.001), IGFBP-3 (r = 0.52; P &lt; 0.001), body mass index, and lipid levels. Univariate regression analysis showed a strong and positive correlation of both IGF-I and IGFBP-3 with HDL-C and ApoA1. Partial correlation analysis, after adjustment for age and body mass index, showed that IGFBP-3 and IGF-II were still significantly and positively related to HDL-C and ApoA1. Furthermore, a strong association was documented among IGF-I, IGF-II, and IGFBP-3. These data demonstrate that even in an elderly population, further aging is accompanied by a progressive decline in circulating IGF-I, IGF-II, and IGFBP-3, suggesting a continuing diminution of the GH-IGF axis throughout aging. Moreover, the strong correlation between HDL-C and an index of GH secretion, such as IGFBP-3, suggests that GH might play an important role in lipid metabolism in healthy elderly subjects.

Insulin-like growth factor-1, insulin-like growth factor binding protein-3, and body mass index: clinical correlates of prostate volume among Black men

Urology ◽  
2002 ◽  
Vol 59 (3) ◽  
pp. 362-367 ◽  
Author(s):  
Aruna V. Sarma ◽  
Craig A. Jaffe ◽  
David Schottenfeld ◽  
Rodney Dunn ◽  
James E. Montie ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Growth Factor ◽  
Black Men ◽  
Body Mass ◽  
Prostate Volume ◽  
Binding Protein ◽  
Insulin Like Growth Factor ◽  
Clinical Correlates ◽  
Factor Binding

scholarly journals Role of insulin-like growth factor 1 in pathogenesis of acne vulgaris: relation to acne severity and body mass index

2020 ◽  
Vol 6 (2) ◽  
pp. 147
Author(s):  
Shereen Adel ◽  
Talal A. Abd-El-Raheem ◽  
Ghada Ezzat ◽  
Nermeen M. Ismail
Keyword(s):  
Body Mass Index ◽  
Growth Factor ◽  
Body Mass ◽  
Scientific Evidence ◽  
Acne Vulgaris ◽  
Elevated Serum ◽  
Insulin Like Growth Factor ◽  
Dermatological Examination ◽  
Relationship Of

<div class="Section1"><p class="abstract"><strong>Background:</strong> Acne vulgaris is a multifactorial skin disease. A potential role for insulin-like growth factor-1 (IGF-1) has been suggested in the pathogenesis of acne. Several studies have shown that elevated levels of serum IGF-1 correlate with overproduction of sebum and acne. Objective: Measurement of the serum level of IGF-1 in acne patients in comparison to normal controls and evaluating the relationship of these levels to severity of acne and body mass index (BMI), in order to investigate the role of this factor in the pathogenesis of acne.</p><p class="abstract"><strong>Methods:</strong> Fifty-four patients with acne vulagaris and 42 healthy controls were included. History taking, dermatological examination, clinical assessments of acne severity, calculation of BMI were performed for patients. Blood samples were collected from all participants for estimation of serum IGF-1 level using enzyme linked immunosorbant assay.<strong></strong></p><p class="abstract"><strong>Results:</strong> There was a significantly higher serum IGF-1 level in acne patients (p&lt;0.05) than controls. Authors didn’t find a relation of significance between elevated serum IGF-1 level and degree of acne severity and BMI (p&gt;0.05). There was a significant positive correlation between serum IGF-1 level and age of the patients.</p><p class="abstract"><strong>Conclusions:</strong> There is a significantly higher serum IGF-1 in acne patients than controls not related to acne severity and BMI. That is adding to the scientific evidence of IGF-1 role in pathogenesis of acne vulgaris.</p></div>

scholarly journals Effect of Aging on the Sensitivity of Growth Hormone Secretion to Insulin-Like Growth Factor-I Negative Feedback*

1997 ◽  
Vol 82 (9) ◽  
pp. 2996-3004 ◽  
Author(s):  
Ian M. Chapman ◽  
Mark L. Hartman ◽  
Suzan S. Pezzoli ◽  
Frank E. Harrell ◽  
Raymond L. Hintz ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Growth Factor ◽  
Body Mass ◽  
Negative Feedback ◽  
Insulin Like Growth Factor ◽  
Gh Secretion ◽  
Igf I ◽  
Older Subjects ◽  
Young Subjects ◽  
Serum Gh

Abstract To determine the effect of aging on the suppression of GH secretion by insulin-like growth factor (IGF)-I, we studied 11 healthy young adults (6 men, 5 women, mean ± sd: 25.2 ± 4.6 yr old; body mass index 23.7 ± 1.8 kg/m2) and 11 older adults (6 men, 5 women, 69.5 ± 5.8 yr old; body mass index 24.2 ± 2.5 kg/m2). Saline (control) or recombinant human IGF-I (rhIGF-I) (2 h baseline then, in sequence, 2.5 h each of 1, 3, and 10 μg/kg·h) was infused iv during the last 9.5 h of a 40.5-h fast; serum glucose was clamped within 15% of baseline. Baseline serum GH concentrations (mean ± se: 3.3 ± 0.7 vs. 1.9 ± 0.5 μg/L, P = 0.02) and total IGF-I concentrations (219 ± 15 vs. 103 ± 19 μg/L, P &lt; 0.01) were higher in the younger subjects. In both age groups, GH concentrations were significantly decreased by 3 and 10 μg/kg·h, but not by 1μ g/kg·h rhIGF-I. The absolute decrease in GH concentrations was greater in young than in older subjects during the 3 and 10 μg/kg·h rhIGF-I infusion periods, but both young and older subjects suppressed to a similar GH level during the last hour of the rhIGF-I infusion (0.78 ± 0.24 μg/L and 0.61 ± 0.16 μg/L, respectively). The older subjects had a greater increase above baseline in serum concentrations of both total (306 ± 24 vs. 244 ± 14 μg/L, P = 0.04) and free IGF-I (8.5 ± 1.4 vs. 4.2 ± 0.6 μg/L, P = 0.01) than the young subjects during rhIGF-I infusion, and their GH suppression expressed in relation to increases in both total and free serum IGF-I concentrations was significantly less than in the young subjects. We conclude that the ability of exogenous rhIGF-I to suppress serum GH concentrations declines with increasing age. This suggests that increased sensitivity to endogenous IGF-I negative feedback is not a cause of the decline in GH secretion that occurs with aging.

scholarly journals Growth Hormone/Insulin-Like Growth Factor-1 
Axis as Related to Body Mass Index in Patients with Idiopathic Short Stature

2013 ◽  
Vol 5 (1) ◽  
pp. 13-19 ◽  
Author(s):  
Cengiz Pınar ◽  
Baş Firdevs ◽  
Atalar Fatmahan ◽  
Uçar Ahmet ◽  
Darendeliler Feyza ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Growth Hormone ◽  
Growth Factor ◽  
Short Stature ◽  
Body Mass ◽  
Idiopathic Short Stature ◽  
Insulin Like Growth Factor

scholarly journals Relation between insulin-like growth factor-I, body mass index, and clinical status in cystic fibrosis

1997 ◽  
Vol 76 (4) ◽  
pp. 304-309 ◽  
Author(s):  
A M Taylor ◽  
A Bush ◽  
A Thomson ◽  
P J Oades ◽  
J L Marchant ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cystic Fibrosis ◽  
Growth Factor ◽  
Body Mass ◽  
Clinical Status ◽  
Insulin Like Growth Factor ◽  
Factor I ◽  
Growth Factor I

Insulin-like growth factor-binding protein-1 is correlated with low density lipoprotein cholesterol in normal subjects

1994 ◽  
Vol 140 (3) ◽  
pp. 521-524 ◽  
Author(s):  
K D Hopkins ◽  
E D Lehmann ◽  
J R Parker ◽  
R G Gosling
Keyword(s):  
Body Mass Index ◽  
Growth Factor ◽  
Body Mass ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
The Body ◽  
Low Density ◽  
Insulin Like Growth Factor ◽  
Igf I

Abstract Insulin-like growth factor-I (IGF-I) has been inversely associated with low-density lipoprotein (LDL) cholesterol in normal women with slightly elevated cholesterol levels and hypothyroid women. More than 95% of IGF-I circulates bound to binding proteins (IGFBPs); of these IGFBP-1 is of particular interest as it is inversely regulated by insulin and is thought to inhibit the action of IGF-I and IGF-II. We examined the relationship between IGFBP-1 and LDL cholesterol in 41 healthy adult subjects. LDL cholesterol correlated with the body mass index (r=0·40, P<0·01), sex (r=0·51, P<0·001) and IGFBP-1 levels (r=0·36, P<0·02). LDL cholesterol did not correlate with age (r=0·25, P=not significant) or IGF-I (r=0·06, P=not significant). Upon multivariate regression analysis, sex, body mass index and IGFBP-1 were all independent predictors of LDL cholesterol (all P<0·05). Elevated IGFBP-1 levels have been associated with an inhibition of serum IGF-I bioactivity in children with insulin-dependent diabetes. IGFBP-1 also appears to inhibit IGF-I hexose-stimulated uptake. IGFBP-1 may also be inhibiting the effect of IGFs on the cellular metabolism of LDL cholesterol. Journal of Endocrinology (1994) 140, 521–524

Sign in / Sign up

Export Citation Format

Share Document