Biochemical evaluation of disease activity after pituitary surgery in acromegaly: a critical analysis of patients who spontaneously change disease status

Abstract

A significant proportion of acromegalic patients change biochemical status upon long-term follow-up after surgery. Most of these changes occur within the first postoperative year and are more likely to take place if the initial GH postglucose and IGF-1 levels are discordant.

Limited utility of oral glucose tolerance test in biochemically active acromegaly

“…Therefore, although the 120 min has been advocated as the sole point in OGTT to be measured (12,22), our data suggest that adherence to this recommendation or the use of relatively infrequent GH sampling may actually miss the time of maximal GHn. Perhaps, this might at least in part explain the combination of normal IGF1 and incompletely suppressed GH described by other investigators (5,(22)(23)(24).…”

Low insulin resistance after surgery predicts poor GH suppression one year after complete resection for acromegaly: a retrospective study

“…In contrast, the biochemical status of some postoperative patients changed upon follow-up. Espinosa-de-los-Monteros et al indicated that, in most cases, such changes of biochemical status occur within the first postoperative year after surgery [29]. Therefore, it is possible that there is some clinical significance in cases demonstrating divergence between the GH nadir and IGF-1 at the first postoperative year evaluation.…”

Acromegaly: a Latin American perspective

“…With increasing frequency, multidisciplinary groups from these centers publish their experience in the diagnosis and management of acromegaly. Several important Latin American publications have appeared in the medical literature, covering the oncogenesis of somatotrophinomas [14, 15], the clinical aspects of acromegaly [16] and its complications [17, 18], as well as the results of the surgical [19, 20], pharmacological [21–24] and radiotherapeutical management of the disease [25]. Interestingly, the outcomes of transsphenoidal surgery, radiotherapy and therapy with somatostatin analogs described in these publications are comparable to those reached in academic institutions from Europe and the United States [19–25].…”