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.

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.

scholarly journals Activin-Induced Inhibin α-Subunit Production by Rat Granulosa Cells Requires Endogenous Insulin-Like Growth Factor-I1

1998 ◽  
Vol 58 (3) ◽  
pp. 712-718 ◽  
Author(s):  
Toshihide Kubo ◽  
Shunichi Shimasaki ◽  
Holly Kim ◽  
Danmei Li ◽  
Gregory F. Erickson
Keyword(s):  
Growth Factor ◽  
Granulosa Cells ◽  
Insulin Like Growth Factor ◽  
Α Subunit ◽  
Endogenous Insulin

scholarly journals The Effect of Oral Glucose on Serum Free Insulin-Like Growth Factor-I and -II in Healthy Adults*

1997 ◽  
Vol 82 (9) ◽  
pp. 3124-3127 ◽  
Author(s):  
Jan Frystyk ◽  
Thorbjørn Grøfte ◽  
Christian Skjærbæk ◽  
Hans Ørskov
Keyword(s):  
Growth Factor ◽  
Healthy Subjects ◽  
Time Course ◽  
Oral Glucose ◽  
Insulin Like Growth Factor ◽  
Serum Samples ◽  
Cross Sectional ◽  
Igf System ◽  
Igf I ◽  
The Impact

Abstract Insulin-like growth factor (IGF) binding protein-I (IGFBP-1) has been suggested to regulate the availability of free IGF and the glucose lowering activity of the IGF-system in relation to fuel supply. Our recent observations of significant inverse correlations between free IGF-I and IGFBP-1 in cross-sectionally collected fasting serum samples support a possible physiological association between the peptides. To further study the impact of IGFBP-1 on free IGF levels and the possible participation of the IGF-system in glucose homeostasis, we studied the time course of changes in IGFBP-1 and free IGFs in 13 healthy subjects undergoing an oral glucose tolerance test (OGTT). Serum was collected every 30 min for 330 min. Glucose, insulin, and GH followed the expected patterns and had regained baseline levels at 270 min. Total IGF-I and free and total IGF-II remained unaltered. IGFBP-1 decreased significantly by 37–52% (P < 0.05) from 150 to 210 min, whereafter the concentration gradually increased by 75% to a level that tended to be above baseline (P = 0.052). Free IGF-I decreased by 29–38% (P < 0.05) at the end of the study (270–330 min). IGFBP-1 was inversely correlated to free IGF-I at baseline (r = −0.57; P < 0.05), as well as during the OGTT (r = 0.66; P < 0.0001). In contrast, free IGF-II was not correlated to IGFBP-1. Insulin, but not free IGF-I, correlated significantly with serum glucose (P < 0.05). These results extend our previous findings of an inverse correlation between free IGF-I and IGFBP-1 in cross-sectional studies to include longitudinal observations, and thus further substantiates the hypothesis that IGFBP-1 is an important determinant of free IGF-I in vivo. Significant changes in free IGF-I were observed only in the late postprandial phase, when glucose and insulin were fully normalized, demonstrating that free IGFs probably do not participate in glucoregulation to any significant degree during an oral glucose load in healthy subjects.

scholarly journals Insulin-like growth factor binding protein-1 as a predictor of glucose-stimulated hyperinsulinemia in prepubertal obese children

1999 ◽  
pp. 231-234 ◽  
Author(s):  
H Saitoh ◽  
T Kamoda ◽  
S Nakahara ◽  
T Hirano ◽  
A Matsui
Keyword(s):  
Growth Factor ◽  
Serum Level ◽  
Binding Protein ◽  
Serum Insulin ◽  
Insulin Response ◽  
Oral Glucose ◽  
Insulin Like Growth Factor ◽  
Fasting Insulin ◽  
Obese Children ◽  
Factor Binding

OBJECTIVE: The present study was undertaken to examine the association of a glucose-stimulated insulin response with the fasting insulin-like growth factor-binding protein (IGFBP)-1 concentration in prepubertal obese children. SUBJECTS AND METHODS: The fasting levels of serum insulin and IGFBP-1 were measured in 17 obese and 16 control children. Furthermore, we performed an oral glucose tolerance test in obese children and examined the association of the area under the curve (AUC) for insulin with the fasting IGFBP-1 level. RESULTS: The mean serum level of IGFBP-1 was significantly lower in obese children (41.0 +/- 4.8 micrograms/l. P < 0.005) than in controls (91.2 +/- 9.9 micrograms/l). Although there was an inverse relationship between the fasting levels of serum insulin and IGFBP-1 in all subjects (r = -0.42, P < 0.05), no significant correlation between these two parameters was observed in the obese group alone. In obese children, the fasting IGFBP-1 level correlated inversely with AUC-insulin (r = -0.70, P < 0.005), whereas there was no significant relationship between the fasting insulin level and AUC-insulin. CONCLUSION: The present study suggests that the serum level of IGFBP-1 may be an early predictor of insulin resistance in prepubertal obesity.

scholarly journals SAT-276 Co-Secreting TSH and Growth Hormone Pituitary Adenoma

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Hatem Eid
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenoma ◽  
Pituitary Adenomas ◽  
Case Reports ◽  
Somatostatin Analogs ◽  
Signs And Symptoms ◽  
Pituitary Hormones ◽  
Oral Glucose ◽  
Pituitary Macroadenoma ◽  
Α Subunit

Abstract Introduction: Secreting pituitary adenoma is exceedingly rare. Less than 15 cases having been reported. Its clinical presentation and diagnosis is challenging. We report a case of pituitary macroadenoma, with features of acromegaly and hyperthyroidism. Case report: A 75 years’ old man presented with new onset atrial fibrillation. He had high FT4 with normal TSH. His ultrasound scan of the neck showed a solitary nodule. He had ablation twice and was started on bisoprolol and anticoagulant. He had MRI scan for headaches and this showed a pituitary macroadenoma. He had high IGF-1. His oral glucose tolerance showed failure of GH suppression. His FT4 was persistently high with normal TSH and he had high a subunits. This suggested the diagnosis of TSH and GH secreting pituitary adenoma. Discussion: TSH-secreting pituitary adenomas are rare and not uncommonly, they co-secrete other pituitary hormones including growth hormones. Somatotrophs and lactotrops share common transcription factors with thyrotrophs. TSH-secreting adenomas are benign but 60% of them are locally invasive. TSH-secreting pituitary adenomas typically present with either symptoms of tumor growth like headache or visual field disturbance or symptoms of hyperthyroidism. Thyroid nodules are common in patients with TSHomas. In patients with TSH-secreting pituitary adenomas, majority will need only surgery and radiation. The medical treatment used to normalize TSH and FT4 levels is somatostatin analogs. This is effective in about 90% of patients with TSH secreting pituitary adenomas TSHoma should be differentiated from resistance to thyroid (RTH). The main difference between TSHoma and RTH is the presence of signs and symptoms of hyperthyroidism in patients with TSHoma, absence of a family history, normal thyroid hormone levels in family members, and the presence of an elevated glycoprotein α-subunit in patients with pituitary tumor. Reference: H Adams and D Adams. A case of a co-secreting TSH and growth hormone pituitary adenoma presenting with a thyroid nodule. EDM case reports 2018 [email protected]

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