Revisiting the role of insulin-like growth factor-1 measurement after surgical treatment of acromegaly

2021 ◽  
Author(s):  
In-Ho Jung ◽  
Seonah Choi ◽  
Cheol Ryong Ku ◽  
Sang-Guk Lee ◽  
Eun Jig Lee ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Growth Factor ◽  
Area Under The Curve ◽  
Pituitary Tumors ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Insulin Like Growth Factor ◽  
Regression Analyses ◽  
Severance Hospital

Abstract Context In the management of growth hormone (GH)-secreting pituitary adenomas, oral glucose tolerance test (OGTT) has been the gold standard not only for diagnoses but also for the determination of biochemical remission. Insulin-like growth factor-1 (IGF-1) is an essential biomarker although it should be adjusted for both age and sex. Objective We evaluated whether IGF-1 levels could serve as a reliable alternative to an OGTT for disease monitoring after the surgical treatment of acromegaly. Design Retrospective study. Setting Severance Hospital. Patients We retrospectively reviewed the medical records of 320 patients who underwent surgical resection of their GH-secreting pituitary tumors. Main Outcome Measures Receiver operator characteristic (ROC) analyses were performed to validate the accuracy of IGF-1 levels for the assessment of remission. In addition, regression analyses were performed to identify factors associated with discrepancy between OGTT and IGF-1 levels. Results Except for 1 week after surgery, ROC analyses showed an area under the curve of greater than 0.8 for IGF-1 at all time points. Of 320 patients, 270 achieved endocrine remission after surgery alone. Among these patients, IGF-1 levels were normalized in 250 patients. The mean duration from surgery to IGF-1 normalization was 4.7 months. Regression analyses demonstrated that risk of failed IGF-1 normalization was increased by 3.1-fold when the tumor invaded the cavernous sinus and increased by 9.0-fold in patients with incomplete tumor removal. Conclusions IGF-1 level is a reliable alternative to OGTT and plays a valuable role in monitoring acromegaly status.

Is preoperative level of insulin-like growth factor 1 (IGF-1) connected with immunohistochemical phenotype of pituitary adenoma in patients with acromegaly?

2019 ◽  
Vol 55 (2) ◽  
pp. 85-90
Author(s):  
Joanna Toszek ◽  
Marek Pawlikowski ◽  
Maria Janowska ◽  
Ewa Wojtczak ◽  
Karolina Beda-Maluga ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Growth Factor ◽  
Proliferation Index ◽  
Oral Glucose ◽  
Insulin Like Growth Factor ◽  
Biochemical Tests ◽  
Ki 67 ◽  
Α Subunit ◽  
Preoperative Serum

Background: Preoperative biochemical diagnosis of acromegaly is based on the determination of the serum levels of insulin-like growth factor 1 (IGF-1) and growth hormone (GH) in the oral glucose tolerance test. In turn, although assumptions concerning the tumour hormonal phenotype may be made on the basis of biochemical tests, the final determination of the exact adenoma profile is possible only on the basis of postoperative immunohistochemical evaluation. Due to the high importance of both – preoperative determination of the concentration of IGF-1 and postoperative immunohistochemical examination of pituitary tumour, the aim of this study was to compare these parameters. Material and methods: The study group consisted of 21 patients with acromegaly and 15 with clinically nonfunctioning pituitary adenoma (CNFPA). In all the patients IGF-1 and prolactin (PRL) concentrations in serum were measured by enzyme–amplified chemiluminescent immunoassay. The immunohistochemical diagnose of the adenoma was achieved with the primary antibodies against the pituitary hormones, the α-subunit and Ki-67 – proliferation indicator. Results: In patients with acromegaly immunohistochemistry besides monohormonal tumours – “pure” somatotropinoma, also somatoprolactinoma and adenoma plurihormonale have revealed. The mean concentrations of IGF-1 were 702, 1480 and 915 ng/mL respectively in each of these groups. In most cases the proliferation index Ki-67 was less than one. In patients with CNFPA, the IGF-1 levels were mostly in reference values and almost in half of cases the Ki–67 value was above one. Conclusions: There are statistically significant differences between preoperative serum IGF-1 concentrations in the somatoprolactinoma group and other adenoma phenotypes in acromegaly patients. This result may suggest the possible link between additional prolactin component with very high concentration of IGF-1 in patients with acromegaly.

scholarly journals Growth Hormone (GH) Receptor Isoform in Acromegaly: Lower Concentrations of GH but Not Insulin-Like Growth Factor-1 in Patients with a Genomic Deletion of Exon 3 in the GH Receptor Gene

2007 ◽  
Vol 53 (8) ◽  
pp. 1484-1488 ◽  
Author(s):  
Christoph Schmid ◽  
Pierre-Alexandre Krayenbuehl ◽  
René-Ludwig Bernays ◽  
Cornelia Zwimpfer ◽  
Friedrich E Maly ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Factor ◽  
Receptor Gene ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Insulin Like Growth Factor ◽  
Genomic Deletion ◽  
Gh Receptor ◽  
Study Participants ◽  
The Relationship

Abstract Background: A genomic deletion of exon 3 (d3-GHR) of the growth hormone (GH) receptor (GHR) has been linked to the effectiveness of GH therapy in children with GH deficiency. Carriers of the d3-GHR genotype had higher GH-induced growth rates than children homozygous for the full-length (fl)-GHR. The aim of this study was to test whether the relationship between GH and insulin-like growth factor-1 (IGF-1) concentrations is influenced by the GHR genotype in patients with acromegaly. Methods: Study participants were 44 adult patients with established diagnosis of acromegaly. The genotype of the GHR was determined in leukocyte DNA from peripheral blood. Clinical and biochemical findings at the time of diagnosis of acromegaly were obtained from the medical records of the patients. Results: fl-GHR homozygosity was found in 22 (50%) of patients, and 22 (50%) of patients had at least 1 d3 allele (d3-GHR). Demographic and clinical characteristics (age, height, weight, estimated duration of disease, and mean tumor size) of the 2 groups were comparable. Median (range) serum IGF-1 concentrations at the time of diagnosis were 670 (447–1443) μg/L in the fl-GHR group and 840 (342–1494) μg/L in the d3-GHR group (P = not significant). Basal GH concentrations were higher in the fl-GHR group [29.7 (3.8–159) μg/L] than in the d3-GHR group [8.4 (2.6–74 μg/L), P = 0.002], and so were mean (30.4 vs 6.1 μg/L, P = 0.005) and nadir (20.5 vs 5.1 μg/L, P = 0.003) GH concentrations during an oral glucose tolerance test. Conclusions: The GHR fl/d3 genotype modulates the relationship between GH and IGF-1 concentrations in patients presenting with acromegaly.

scholarly journals Effect of alterations in blood volume with bed rest on glucose tolerance

2016 ◽  
Vol 121 (5) ◽  
pp. 1098-1105 ◽  
Author(s):  
S. Dandanell ◽  
L. Oberholzer ◽  
S. Keiser ◽  
A. B. Andersen ◽  
T. Haider ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Plasma Volume ◽  
Area Under The Curve ◽  
Bed Rest ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Albumin Infusion ◽  
Before And After ◽  
Concomitant Reduction

Bed rest leads to rapid impairments in glucose tolerance. Plasma volume and thus dilution space for glucose are also reduced with bed rest, but the potential influence on glucose tolerance has not been investigated. Accordingly, the aim was to investigate whether bed rest-induced impairments in glucose tolerance are related to a concomitant reduction in plasma volume. This hypothesis was tested mechanistically by restoring plasma volume with albumin infusion after bed rest and parallel determination of glucose tolerance. Fifteen healthy volunteers (age 24 ± 3 yr, body mass index 23 ± 2 kg/m2, maximal oxygen uptake 44 ± 8 ml·min−1·kg−1; means ± SD) completed 4 days of strict bed rest. Glucose tolerance [oral glucose tolerance test (OGTT)] and plasma and blood volumes (carbon monoxide rebreathing) were assessed before and after 3 days of bed rest. On the fourth day of bed rest, plasma volume was restored by means of an albumin infusion prior to an OGTT. Plasma volume was reduced by 9.9 ± 3.0% on bed rest day 3 and area under the curve for OGTT was augmented by 55 ± 67%. However, no association ( R2= 0.09, P = 0.33) between these simultaneously occurring responses was found. While normalization of plasma volume by matched albumin administration (408 ± 104 ml) transiently decreased ( P < 0.05) resting plasma glucose concentration (5.0 ± 0.4 to 4.8 ± 0.3 mmol/l), this did not restore glucose tolerance. Bed rest-induced alterations in dilution space may influence resting glucose values but do not affect area under the curve for OGTT.

First trimester prediction of maternal glycemic status

2015 ◽  
Vol 43 (3) ◽  
Author(s):  
Rinat Gabbay-Benziv ◽  
Lauren E. Doyle ◽  
Miriam Blitzer ◽  
Ahmet A. Baschat
Keyword(s):  
Risk Score ◽  
Predictive Value ◽  
Challenge Test ◽  
Area Under The Curve ◽  
First Trimester ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Operating Characteristics ◽  
Maternal Characteristics ◽  
Predictive Algorithm

AbstractTo predict gestational diabetes mellitus (GDM) or normoglycemic status using first trimester maternal characteristics.We used data from a prospective cohort study. First trimester maternal characteristics were compared between women with and without GDM. Association of these variables with sugar values at glucose challenge test (GCT) and subsequent GDM was tested to identify key parameters. A predictive algorithm for GDM was developed and receiver operating characteristics (ROC) statistics was used to derive the optimal risk score. We defined normoglycemic state, when GCT and all four sugar values at oral glucose tolerance test, whenever obtained, were normal. Using same statistical approach, we developed an algorithm to predict the normoglycemic state.Maternal age, race, prior GDM, first trimester BMI, and systolic blood pressure (SBP) were all significantly associated with GDM. Age, BMI, and SBP were also associated with GCT values. The logistic regression analysis constructed equation and the calculated risk score yielded sensitivity, specificity, positive predictive value, and negative predictive value of 85%, 62%, 13.8%, and 98.3% for a cut-off value of 0.042, respectively (ROC-AUC – area under the curve 0.819, CI – confidence interval 0.769–0.868). The model constructed for normoglycemia prediction demonstrated lower performance (ROC-AUC 0.707, CI 0.668–0.746).GDM prediction can be achieved during the first trimester encounter by integration of maternal characteristics and basic measurements while normoglycemic status prediction is less effective.

Five batches representative of Ontario-grown American ginseng root produce comparable reductions of postprandial glycemia in healthy individualsThis article is one of a selection of papers published in this special issue (part 1 of 2) on the Safety and Efficacy of Natural Health Products.

2007 ◽  
Vol 85 (9) ◽  
pp. 856-864 ◽  
Author(s):  
Anamaria Dascalu ◽  
John L. Sievenpiper ◽  
Alexandra L. Jenkins ◽  
Mark P. Stavro ◽  
Lawrence A. Leiter ◽  
...  
Keyword(s):  
Fasting Blood Glucose ◽  
Area Under The Curve ◽  
Postprandial Glucose ◽  
American Ginseng ◽  
Tolerance Test ◽  
Ginseng Root ◽  
Oral Glucose ◽  
Natural Health Products ◽  
Water Control ◽  
Postprandial Glycemia

Evidence indicates that the glycemia-lowering effect of American ginseng root may be batch dependent. We therefore evaluated the effect of 5 root batches, representative of Ontario-grown American ginseng, on postprandial glucose and insulin indices. Twelve healthy subjects (5 male, 7 female), mean ± SE age 26.5 ± 2 years, body mass index 23.96 ± 3.41 kg/m2, fasting blood glucose 4.77 ± 0.04 mmol/L, were assigned to consume 9 g of American ginseng from 5 farms (A–E), administered in randomized sequence on 5 separate visits, and a water-control during the 6th and last visit. Treatments were consumed 40 min before a 2-hour 75-gram oral glucose tolerance test. Plasma glucose and insulin were measured at baseline, before, and during the test. Compared with control, batches A and C reduced glucose incremental area under the curve (IAUC) by 35.2% (156 vs. 240 mmol·min/L) and 32.6% (162 vs. 240 mmol·min/L), respectively. Batches A, C, and E reduced incremental peak glucose by 1.3, 1.2, and 1.1 mmol/L, respectively. Batch C reduced the insulin IAUC by 27.7% (15.8 vs. 21.8 nmol·min/L). Effects on glucose and insulin parameters were not different across ginseng treatments. The mean of the 5 ginseng treatments reduced peak postprandial glucose by 1.0 mmol/L, glucose IAUC by 27.7% (173 vs. 240 mmol·min/L), and insulin IAUC by 23.8% (16.6 vs. 21.8 nmol·min/L) relative to control. (All results statistically significant at p < 0.05.) American ginseng decreased postprandial glycemia and insulinemia; however, 40% of the batches did not reduce glycemia with the anticipated magnitude, irrespective of their saponin composition.

scholarly journals Glucose area under the curve during oral glucose tolerance test as an index of glucose intolerance

2015 ◽  
Vol 7 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Kazuhiko Sakaguchi ◽  
Kazuo Takeda ◽  
Mitsuo Maeda ◽  
Wataru Ogawa ◽  
Toshiyuki Sato ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Glucose Intolerance ◽  
Glucose Tolerance Test ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance

Unique Circulating MicroRNA Associations with Dysglycemia in People Living with HIV and Alcohol Use

2021 ◽  
Author(s):  
Brianna L Bourgeois ◽  
Hui-Yi Lin ◽  
Alice Y Yeh ◽  
Danielle E. Levitt ◽  
Stefany DePrato Primeaux ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Circulating Microrna ◽  
People Living With Hiv ◽  
Regression Analyses ◽  
Circulating Micrornas ◽  
Altered Glucose ◽  
Function Correlation ◽  
Living With Hiv

People living with HIV (PLWH) have increased prevalence of comorbid conditions including insulin resistance and at-risk alcohol use. Circulating microRNAs (miRs) may serve as minimally invasive indicators of pathophysiological states. We aimed to identify whether alcohol modulates circulating miR associations with measures of glucose/insulin dynamics in PLWH. PLWH (N=96; 69.8% male) enrolled in the Alcohol & Metabolic Comorbidities in PLWH: Evidence-Driven Interventions (ALIVE-Ex) study were stratified into negative phosphatidylethanol (PEth<8ng/ml, N=42) and positive PEth (PEth≥8ng/ml, N=54) groups. An oral glucose tolerance test (OGTT) was administered, and total RNA was isolated from fasting plasma to determine absolute miR expression. Circulating miRs were selected based on their role in skeletal muscle (miR-133a, miR-206), pancreatic β-cell (miR-375), liver (miR-20a), and adipose tissue (miR-let-7b, miR-146a, miR-221) function. Correlation and multiple regression analyses between miR expression and adiponectin, 2h glucose, insulin, and C-peptide values were performed adjusting for BMI category, age, sex, and viral load. miR-133a was negatively associated with adiponectin (p=0.002) in the negative PEth group, and miR-20a was positively associated with 2h glucose (p=0.013) in the positive PEth group. Regression analyses combining miRs demonstrated that miR-133a (p<0.001) and miR-221 (p=0.010) together predicted adiponectin in the negative PEth group. miR-20a (p<0.001) and miR-375 (p=0.002) together predicted 2h glucose in the positive PEth group. Our results indicate that associations between miRs and measures of glucose/insulin dynamics differed between PEth groups suggesting that the pathophysiological mechanisms contributing to altered glucose homeostasis in PLWH are potentially modulated by alcohol use.

scholarly journals The SLC16A11 Risk Haplotype for Type 2 Diabetes (T2D) Is Associated to Differentiated Responses in Weight Loss, and Glucose Metabolism After Treatments to Prevent T2D

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1275-1275
Author(s):  
Magdalena Sevilla ◽  
Donaji Gomez-Velasco ◽  
Ivette Cruz-Bautista ◽  
Laura Lazaro-Carrera ◽  
Paloma Almeda-Valdes ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Area Under The Curve ◽  
Postprandial Glucose ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Prolonged Release ◽  
Risk Haplotype ◽  
The Impact

Abstract Objectives A haplotype in SLC16A11 is associated with decreased insulin action, and risk for type 2 diabetes (T2D) in Mexicans. We aim to determine the impact of the risk haplotype on SLC16A11 on early therapeutic responses in treatments to prevent T2D. Methods We recruited subjects with at least one prediabetes criteria according to the American Diabetes Association, and body mass index 25–45 kg/m2. Subjects were randomized in two groups: lifestyle intervention (LSI): hypocaloric diet, 25 kcal/kg of ideal weight, 45% of the total intake of carbohydrates, 30% lipids and 15% protein sources + physical activity (&gt;150 min medium intensity per week), or LSI + metformin (750 mg prolonged release twice a day). Interventions were prescribed by standardized dietitians. The goal was to achieve &gt;3% weight loss. We evaluated the early treatment response in a follow-up period of 12 weeks with intermediate visits each 3 weeks to reinforce knowledge and treatment goals. Evaluations (baseline and post-treatment) included an oral glucose tolerance test (OGTT), and dual-energy X-ray absorptiometry. Adherence to treatment was measured trough electronic recordings. Participants were genotyped for the risk allele rs13342232. Researchers remained blinded to the genotype results. The effects of the risk haplotype were evaluated with linear and logistic regressions adjusted by age, sex, and baseline body fat %. Results We evaluated 61 subjects, 30 carriers, and 31 non-carriers. Most of participants (57%) achieved ≥3% weight loss. The LSI + metformin treatment increased in carriers, 2 times OR 3 IC95% (1.07 – 8.6) (P = 0.04) the probability to reach the ≥3% weight loss goal compared with LSI and non-carriers. In the same treatment, carriers had a greater decrease in the total and incremental area under the curve of insulin in the OGTT IC95% (−1.75 −0.11) (P = 0.02) compared with non-carriers and LSI. Carriers also had higher decrease in postprandial glucose compared with non-carriers regardless of treatment −12.63 + 30.38 vs 0.71 30.24 (P = 0.02). Conclusions After 12 weeks of treatment, carriers with prediabetes showed a higher probability achieve weight loss and to improve insulin secretion with metformin. Regardless of the treatment, carriers were prone to improve postprandial glucose. Funding Sources Miguel Aleman Medical Research Award.

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