The influence of age on the GH–IGF1 axis in patients with acromegaly

Tanimoto, Keiji; Hizuka, Naomi; Izumi, Fujio; Takano, Kazue; Hanafusa, Toshiaki

doi:10.1530/eje-08-0243

Cited by 26 publications

(21 citation statements)

References 17 publications

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“…We have observed here an age dependence of GH secretion in acromegalic patients with obviously high GH values, similar to controls, suggesting that age dependence of the hypothalamic GHRH output might also be present in acromegalic patients. Our data are further supported by the recent study of Tanimoto et al (31), who found a gradual decline of mean GH concentrations in young, middle-aged, and elderly acromegalic patients from 18.5 to 8.8 and 6.7 g/L, respectively. However, to address the presence of age dependence in acromegaly, we had to exclude the disproportionate number of patients with mean 24-hour GH concentrations within the normal range, below 4.6 g/L.…”

Section: Discussionsupporting

confidence: 91%

Complex Rhythmicity and Age Dependence of Growth Hormone Secretion Are Preserved in Patients With Acromegaly: Further Evidence for a Present Hypothalamic Control of Pituitary Somatotropinomas

Ribeiro‐Oliveira

Abrantes

Barkan

2013

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context:Traditionally, acromegaly is viewed as a disease resulting from GH hypersecretion from an autonomous pituitary somatotropinoma.Objective: To test the hypothesis that GH secretion in acromegaly is still subjected to normal hypothalamic control, we studied the daily rhythmicity of GH secretion in normal controls and patients with newly diagnosed, untreated acromegaly. Design and Setting:This was an observational inpatient study in the General Clinical Research Center at the University of Michigan. Patients or Other Participants:One hundred four normal controls and 67 acromegalic patients were included in the study. Intervention:The intervention consisted of frequent blood sampling over 24 hours. Main Outcome Measure(s):We hypothesized that acromegalic patients would show rhythmicity, sexual dimorphism, and age-related decline of GH secretion similar to normal controls.Results: Both normal controls and the patients exhibited 3 major GH waves with the highest values at 12:00 PM, 5:00 PM, and 1:00 AM (P Ͻ .001 for all). Both controls and patients exhibited a clear appearance of the nocturnal GH waves, irrespective of the gender (P Ͻ .001 for all). The amplitude of the maximal (nocturnal) GH secretory wave (1:00 AM) as compared with the nadir GH secretion (9:00 AM) was clearly different between the 2 groups, with a significantly smaller magnitude in acromegaly (P Ͻ .001). A subsequent subanalysis of both groups was performed separately for both genders. Similar to the entire groups, both controls and patients exhibited a clear appearance of the nocturnal GH waves, irrespective of the gender (P Ͻ .001 for all). Patients with clearly elevated GH values have shown an age-related decline of GH secretion (r ϭ Ϫ0.35, P Ͻ .001), similar to controls. Conclusions:The analysis of GH profiles in multiple patients with untreated acromegaly discloses the persistence of the hallmarks of the central control of GH regulation, ie, nictohemeral rhythmicity, sexual dimorphism, and an age-related decline of GH output. (J Clin Endocrinol Metab 98: 2959 -2966, 2013)

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Section: Discussionsupporting

confidence: 91%

Complex Rhythmicity and Age Dependence of Growth Hormone Secretion Are Preserved in Patients With Acromegaly: Further Evidence for a Present Hypothalamic Control of Pituitary Somatotropinomas

Ribeiro‐Oliveira

Abrantes

Barkan

2013

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…On the basis of the present results (3/2,270), the number of cases of acromegaly is 264 in 200,000 adults with DM or GI. Considering that DM or GI occurs in 55% of patients with acromegaly [13][14][15][16][17][18][19], there would be 216 additional cases among the 800,000 adults without DM or GI, corresponding to 480 cases/1,000,000 adults (90% CI: 136-1,280).…”

Section: Resultsmentioning

confidence: 99%

“…On the basis of the prevalence of DM and GI in acromegaly (approximately 55% [13][14][15][16][17][18][19]) and in the general adult population (approximately 20% [20][21][22]) and of the result of the present study (3 cases of acromegaly/2,270 subjects with DM or GI), we estimated a prevalence of 480 cases/1,000,000 adults (90% CI: 136-1,280). A surprising difference exists between the prevalence of GH-producing pituitary adenomas in autopsy studies [2][3][4][5] and disease diagnosed spontaneously in population studies.…”

Section: Discussionmentioning

confidence: 99%

“…Diabetes mellitus (DM) or glucose intolerance (GI) are observed in about 55% of patients with acromegaly [13][14][15][16][17][18][19], a rate much higher than that found in the general adult population [approximately 15-20% in the Brazilian population [20][21][22]. This difference makes these conditions attractives for the investigation of the presence of acromegaly and to estimate the prevalence of the disease in the general population.…”

Section: Introductionmentioning

confidence: 99%

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Frequency of acromegaly in adults with diabetes or glucose intolerance and estimated prevalence in the general population

Rosário

2010

Pituitary

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The objective of this study was to evaluate the frequency of acromegaly in adults with diabetes mellitus (DM) or glucose intolerance (GI) and to estimate its prevalence in the general population. A total of 2,270 patients with DM or GI and age from 20 to 70 years were studied. Patients with known pituitary disease and pregnant women were excluded. Serum IGF-1 was measured in all subjects and, if elevated, a new measurement was obtained together with the measurement of GH in the oral glucose tolerance test (OGTT). Patients with persistently elevated IGF-1 and inadequate suppression of GH were submitted to magnetic resonance imaging (MRI). Acromegaly was not suspected by the assistant physician in any of the patients. Six patients had persistently elevated IGF-1 and inadequate suppression of GH in the OGTT (without other conditions associated with GH or IGF-1 elevation). Pituitary adenoma was detected by MRI in three patients, and two subjects presented an acromegalic phenotype. Two patients were submitted to transsphenoidal surgery, with immunohistochemistry confirming immunoreactivity for GH. Another patient was treated with octreotide LAR which resulted in the normalization of IGF-1 and GH. Considering a prevalence of DM or GI of 20% in adults and the occurrence of these co-morbidities in 55% of patients with acromegaly, the frequency of 3/2,270 found in this study permits to estimate 480 cases/1,000,000 adults. The present results suggest that the prevalence of acromegaly is underestimated and further studies are needed to evaluate the cost-effectiveness of biochemical screening in certain groups of patients.

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“…Decreased GH and IGF-1 may be involved with aging-associated changes in body composition, structural function, and metabolism [4].…”

Section: Introductionmentioning

confidence: 99%

Growth Hormone Replacement Therapy in Patients without Adult Growth Hormone Deficiency: What Answers Do We Have So Far?

Rucker¹,

Sá²,

Arbex³

2017

Health

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Growth hormone (GH) and insulin-like growth factor 1 (IGF-1) have been suggested as "anti-aging" therapies, or for improving quality of life with aging. In this study, we focus on the actions of GH in the main organs and organ systems of the human body, like skeletal muscle, bones and brain, particularly in regard to data and research on the use of GH replacement therapy in adults without growth hormone deficiency, especially elderly patients. Several different studies have been carried out to show what the effects and side effects of GH replacement in healthy people and what would be the impact in quality of life and life span. In this review, we demonstrate what answers we have so far about the effects of GH replacement in many organs and systems in healthy people.

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The influence of age on the GH–IGF1 axis in patients with acromegaly

Cited by 26 publications

References 17 publications

Complex Rhythmicity and Age Dependence of Growth Hormone Secretion Are Preserved in Patients With Acromegaly: Further Evidence for a Present Hypothalamic Control of Pituitary Somatotropinomas

Complex Rhythmicity and Age Dependence of Growth Hormone Secretion Are Preserved in Patients With Acromegaly: Further Evidence for a Present Hypothalamic Control of Pituitary Somatotropinomas

Frequency of acromegaly in adults with diabetes or glucose intolerance and estimated prevalence in the general population

Growth Hormone Replacement Therapy in Patients without Adult Growth Hormone Deficiency: What Answers Do We Have So Far?

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