scholarly journals Research Progress of the Influence of Acromegaly on Cardiovascular Diseases

2021 ◽  
Vol 5 (5) ◽  
pp. 147-151
Author(s):  
Yalan Wang ◽  
Jiahe Xie
Keyword(s):  
Growth Hormone ◽  
Cardiovascular Diseases ◽  
Growth Factor ◽  
Mortality Rate ◽  
Cardiovascular System ◽  
Pituitary Adenomas ◽  
Progressive Disease ◽  
The Body ◽  
Research Progress

Acromegaly is a progressive disease caused by an increased in the levels of growth hormone (GH), followed by an increased in the levels of insulin-like growth factor-1 (IGF-1). Most cases are caused by GH-secreting pituitary adenomas. Long-term exposure to excessive GH would affect all systems of the body, of which the cardiovascular system has the highest incidence rate and mortality rate. This review discusses the influence of acromegaly on cardiovascular diseases and its treatment.

scholarly journals Multicenter, Observational Study of Lanreotide Autogel for the Treatment of Patients with Acromegaly in Routine Clinical Practice in Germany, Austria and Switzerland

2020 ◽  
Author(s):  
Sylvère Störmann ◽  
Jochen Schopohl ◽  
Catharina Bullmann ◽  
Christoph Terkamp ◽  
Mirjam Christ-Crain ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Growth Hormone ◽  
Growth Factor ◽  
Real World ◽  
Insulin Like Growth Factor ◽  
Biochemical Control ◽  
Factor I ◽  
Lanreotide Autogel

Abstract Background Evidence from controlled trials has shown that lanreotide autogel is effective in achieving biochemical and symptom control in patients with acromegaly. However, it is important to better understand the real-world patient population receiving lanreotide autogel treatment. Methods In this non-interventional study the long-term treatment response to lanreotide autogel in adult patients with acromegaly from office-based centers or clinics in Germany, Austria and Switzerland was studied. Assessments included growth hormone and insulin-like growth factor-I levels, symptoms, quality of life, lanreotide plasma levels and tumor somatostatin receptor subtype expression. The primary endpoint was achievement of full biochemical control, defined as growth hormone ≤2.5 µg/L and insulin-like growth factor I normalization at month 12. Results 76 patients were enrolled from 21 sites. 7/51 (13.7%) patients of the efficacy population had full biochemical control at baseline, 15/33 (45.5%) at month 12 and 10/26 (38.5%) at month 24 of treatment. At 12 months of treatment higher rates of biochemical control were observed in the following subgroups: older patients (>53 years [median]), females, treatment-naïve patients, and patients with a time since diagnosis of longer than 1.4 years (median). No clinically relevant differences in acromegaly symptoms or quality of life scores were observed. Median fasting blood glucose and glycated hemoglobin levels remained unchanged throughout the study. No new safety signals were observed. Overall tolerability of treatment with lanreotide autogel was judged by 80.8% of the enrolled patients at month 12 as ‘very good’ or ‘good’. Conclusion Treatment with lanreotide autogel in a real-world setting showed long-term effectiveness and good tolerability in patients with acromegaly.

The Role of Auxologic and Growth Factor Measurements in the Diagnosis of Growth Hormone Deficiency

PEDIATRICS ◽  
1998 ◽  
Vol 102 (Supplement_3) ◽  
pp. 524-526
Author(s):  
Raymond L. Hintz
Keyword(s):  
Growth Hormone ◽  
Growth Factor ◽  
Growth Hormone Deficiency ◽  
Short Stature ◽  
The Body ◽  
Hormone Deficiency ◽  
Insulin Like Growth Factor ◽  
Growth Study ◽  
Short Children ◽  
National Cooperative

The use of auxologic measurements in the diagnosis of short stature in children has a long history in pediatric endocrinology, and they have even been used as the primary criteria in selecting children for growth hormone (GH) therapy. Certainly, an abnormality in the control of growth is more likely in short children than in children of normal stature. However, most studies have shown little or no value of auxologic criteria in differentiating short children who have classic growth hormone deficiency (GHD) from short children who do not. In National Cooperative Growth Study Substudy VI, in more than 6000 children being assessed for short stature, the overall mean height SD score was −2.5 ± 1.1 and the body mass index standard deviation score was −0.5 ± 1.4. However, there were no significant differences in these measures between the patients who were found subsequently to have GHD and those who were not. There also was no consistent difference in the growth rates between the patients with classic GHD and those short children without a diagnosis of GHD. This probably reflects the fact that we are dealing with a selected population of children who were referred for short stature and are further selecting those who are the shortest for additional investigation. Growth factor measurements have been somewhat more useful in selecting patients with GHD and have been proposed as primary diagnostic criteria. However, in National Cooperative Growth Study Substudy VI, only small differences in the levels of insulin-like growth factor I and insulin-like growth factor binding protein 3 were seen between the patients who were selected for GH treatment and those who were not. Many studies indicate that the primary value of growth factor measurements is to exclude patients who are unlikely to have GHD or to identify those patients in whom an expedited work-up should be performed. The diagnosis of GHD remains difficult and must be based on all of the data possible and the best judgment of an experienced clinician. Even under ideal circumstances, errors of both overdiagnosis and underdiagnosis of GHD still are likely.

Restoration of gallbladder contractility after withdrawal of long-term octreotide therapy in acromegalic patients

1993 ◽  
Vol 129 (3) ◽  
pp. 207-212 ◽  
Author(s):  
Yi-Fan Shi ◽  
Xian-Feng Zhu ◽  
Alan G Harris ◽  
Jin-Xi Zhang ◽  
Jie-Ying Deng
Keyword(s):  
Growth Hormone ◽  
Growth Factor ◽  
Term Therapy ◽  
Serum Growth Hormone ◽  
Factor I ◽  
Gallbladder Contractility ◽  
Octreotide Therapy ◽  
Long Term Therapy ◽  
Growth Hormone Suppression

We sought to examine how the discontinuation of octreotide in long-term octreotide-treated acromegalic patients affects the well-documented side-effect of cholelithiasis. In 14 acromegalic patients, serum growth hormone levels, insulin-like growth factor I levels and percentage of relative gallbladder contractility were measured prior to and after the discontinuation of octreotide. Compared to pretreatment values, the basal growth hormone and 5-h growth hormone profiles were 36% and 24%, and 60% and 56% at the end of 1 and 2 weeks, respectively. Octreotide was found to be eliminated completely from the serum within 3 days after its withdrawal. In all of six patients who did not develop gallstones, the percentage relative gallbladder contractility normalized within 1 week. In eight patients who developed gallstones, four of them had restoration of normal contractility within 2 weeks. Our results show that upon withdrawal of octreotide, gallbladder contractility returns to normal while growth hormone suppression persists for a longer period of time. Therefore, discontinuation of octreotide therapy may allow for the clearance of stagnated bile and hence decrease the incidence of cholelithiasis in acromegalic patients receiving long-term therapy.

Repeat Transsphenoidal Surgery for the Treatment of Remaining or Recurring Pituitary Tumors in Acromegaly

Neurosurgery ◽  
2010 ◽  
Vol 67 (4) ◽  
pp. 949-956 ◽  
Author(s):  
Shozo Yamada ◽  
Noriaki Fukuhara ◽  
Kenichi Oyama ◽  
Akira Takeshita ◽  
Yasuharu Takeuchi
Keyword(s):  
Growth Hormone ◽  
Growth Factor ◽  
Adjuvant Therapy ◽  
Surgical Outcome ◽  
Transsphenoidal Surgery ◽  
Hazard Ratio ◽  
Insulin Like Growth Factor ◽  
Cure Rate ◽  
Factor I

Abstract BACKGROUND: Acromegaly is a disorder characterized by hypersecretion of growth hormone caused by a growth hormone–secreting pituitary adenoma. OBJECTIVE: To evaluate the long-term efficacy and safety of repeat transsphenoidal surgery for persistent or recurrent acromegaly. METHODS: We retrospectively reviewed records for 53 acromegalic patients who underwent repeat transsphenoidal surgery for persistent or progressive acromegaly at Toranomon Hospital between 1987 and 2006. Multivariate logistic regression was performed to evaluate preoperative factors influencing the surgical outcome. RESULTS: Thirty-one patients (58.5%) met the criteria for cure on long-term follow-up endocrine findings. Furthermore, 17 patients were well controlled with normal insulin-like growth factor I levels without (2 patients) or with medication (15 patients), whereas insulin-like growth factor I levels were still above normal in 5 patients after postoperative adjuvant therapy. Only 1 patient was undergoing additional hormonal replacement after surgery, although transient cerebrospinal fluid leak, transient abducens nerve palsy, severe nasal bleeding, and pituitary abscess occurred in each patient, respectively. Multivariate analysis clarified that a favorable surgical outcome was achieved in patients without cavernous sinus invasion (hazard ratio 12.56), tumor segmentation (hazard ratio 5.82), or in those older than 40 years old (hazard ratio 3.21). CONCLUSION: Repeat surgery can be performed safely with an approximately 60% long-term cure rate in this series. Reoperation should therefore be considered for persistent or recurrent disease in acromegalic patients in whom adjuvant therapy is not effective enough or cannot be accepted. The careful study of initial or preoperative magnetic resonance imaging and the use of micro-Doppler, endoscope, and eye movement monitoring device during surgery can help increase cure rate with a lower complication rate.

The Research Progress of Heavy Metals in PM2.5

2014 ◽  
Vol 955-959 ◽  
pp. 1397-1404 ◽  
Author(s):  
Li Na Shi ◽  
Xun Xu ◽  
Xiao Yan Dou ◽  
Xu Dong Zhao
Keyword(s):  
Heavy Metals ◽  
Air Pollution ◽  
Human Health ◽  
Human Body ◽  
Chemical Form ◽  
The Body ◽  
Detection Methods ◽  
Research Progress ◽  
Depth Study

PM2.5 is one of the most important components in air pollution. It is also the focus of the most closely watched at home and abroad. Based on its small size, complex components, and strongenvironmental activity, it can be used as a carrier for chemicals, heavy metals, bacteria, toxins and carcinogens into the body. Then, as a result, it will affect Human Body Health. Heavy metals are important components of PM2.5, and the long-term accumulation of heavy metals in PM2.5 poses a great threat on human health and the environment. This paper reviewed the sources, distribution methods,chemical form, detection methods, disposal way, research progress of heavy metals in PM2.5. As a result, it provided a reference for in-depth study on the future.

Long-term results of gamma knife surgery for growth hormone—producing pituitary adenoma: is the disease difficult to cure?

2005 ◽  
Vol 102 (Special_Supplement) ◽  
pp. 119-123 ◽  
Author(s):  
Tatsuya Kobayashi ◽  
Yoshimasa Mori ◽  
Yukio Uchiyama ◽  
Yoshihisa Kida ◽  
Shigeru Fujitani
Keyword(s):  
Growth Hormone ◽  
Gamma Knife ◽  
Pituitary Adenomas ◽  
Gamma Knife Surgery ◽  
Long Term Results ◽  
Content Type ◽  
The Mean ◽  
Dose Radiation ◽  
Fine Print

Object. The authors conducted a study to determine the long-term results of gamma knife surgery for residual or recurrent growth hormine (GH)—producing pituitary adenomas and to compare the results with those after treatment of other pituitary adenomas. Methods. The series consisted of 67 patients. The mean tumor diameter was 19.2 mm and volume was 5.4 cm3. The mean maximum dose was 35.3 Gy and the mean margin dose was 18.9 Gy. The mean follow-up duration was 63.3 months (range 13–142 months). The tumor resolution rate was 2%, the response rate 68.3%, and the control rate 100%. Growth hormone normalization (GH < 1.0 ng/ml) was found in 4.8%, nearly normal (< 2.0 ng/ml) in 11.9%, significantly decreased (< 5.0 ng/ml) in 23.8%, decreased in 21.4%, unchanged in 21.4%, and increased in 16.7%. Serum insulin-like growth factor (IGF)—1 was significantly decreased (IGF-1 < 400 ng/ml) in 40.7%, decreased in 29.6%, unchanged in 18.5%, and increased in 11.1%, which was almost parallel to the GH changes. Conclusions. Gamma knife surgery was effective and safe for the control of tumors; however, normalization of GH and IGF-1 secretion was difficult to achieve in cases with large tumors and low-dose radiation. Gamma knife radiosurgery is thus indicated for small tumors after surgery or medication therapy when a relatively high-dose radiation is required.

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