Clinical Characteristics of Acromegalic Patients With Paradoxical GH Response to Oral Glucose Load
Abstract Context A paradoxical GH response to oral glucose (OG) is often found in acromegaly. However, the clinical characteristics of patients with acromegaly and a paradoxical GH response to OG (OG responders) remain unclear. Objective The aim of the present study was to define the clinical charac...
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| Veröffentlicht in: | The journal of clinical endocrinology and metabolism 2019-05, Vol.104 (5), p.1637-1644 |
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| creator | Mukai, Kosuke Otsuki, Michio Tamada, Daisuke Kitamura, Tetsuhiro Hayashi, Reiko Saiki, Aya Goto, Yuko Arita, Hideyuki Oshino, Satoru Morii, Eiichi Saitoh, Youichi Shimomura, Iichiro |
| description | Abstract
Context
A paradoxical GH response to oral glucose (OG) is often found in acromegaly. However, the clinical characteristics of patients with acromegaly and a paradoxical GH response to OG (OG responders) remain unclear.
Objective
The aim of the present study was to define the clinical characteristics of OG responders with acromegaly.
Design
Retrospective study.
Setting
Hospitalized care at Osaka University Hospital.
Patients and Methods
Of 63 patients with acromegaly admitted to our hospital from January 2006 to January 2017, 19 were classified as OG responders and 44 as nonresponders. The clinical characteristics of these groups were compared.
Results
Before surgery, OG responders had substantially greater IGF-1 SD scores than nonresponders (P < 0.05), although no difference was found in basal GH levels between the two groups (P = 0.46). Regarding glucose metabolism, 120-minute plasma glucose and immunoreactive insulin after OG administration and hemoglobin A1c were significantly greater in OG responders than in nonresponders (P < 0.01, P < 0.05, P < 0.05, respectively). GH levels during octreotide or bromocriptine testing were decreased more significantly in OG responders than in nonresponders (P < 0.05, P < 0.05, respectively). The proportion of pituitary tumors with hypointensity on T2-weighted MRI was significantly greater in OG responders than in nonresponders (P < 0.05). The difference in IGF-1 and parameters of glucose metabolism described disappeared between the two groups after surgery.
Conclusions
The paradoxical GH response reflected the clinical characteristics, especially IGF-I level, glucose metabolism, and drug efficacy in acromegaly. A paradoxical GH response, in addition to the nadir GH levels, to OG load is potentially useful for evaluation of the clinical characteristics of acromegaly.
Patients with acromegaly and a paradoxical GH response to oral glucose load had higher IGF-I levels, worse glucose metabolism, and better octreotide and bromocriptine efficacy compared with nonresponders. |
| doi_str_mv | 10.1210/jc.2018-00975 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2138646886</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A688651962</galeid><oup_id>10.1210/jc.2018-00975</oup_id><sourcerecordid>A688651962</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5025-2bcefb6fabc54bb0ae97401868637e210fd4ff86a4656b16a5a6321525417f163</originalsourceid><addsrcrecordid>eNp1kcFv0zAUxi3ExMrgyBVF4sIlne3YTnKsKtiQKm2aQHCzHOeZujhxsR0N_nuctgMxgXyw_PR7n9_7PoReEbwklODLnV5STJoS47bmT9CCtIyXNWnrp2iBMSVlW9Mv5-h5jDuMCWO8eobOK8xqQTlfoG7t7Gi1csV6q4LSCYKNyepYeFOsdPADfFXO6uJWJQtjisVnm7b5FVTvfxwar66LO4h7P0Yoki9uwlxzk_b5vfGqf4HOjHIRXp7uC_Tp_buP6-tyc3P1Yb3alJpjykvaaTCdMKrTnHUdVtDWLG8mGlHVkFc1PTOmEYoJLjoiFFeiooRTzkhtiKgu0Nuj7j747xPEJAcbNTinRvBTlJRUjWCiaWb0zSN056cw5ukkrQSjvBKC_qGyAyDtaHzKDs2icjXLcNIeqOU_qHx6GKz2Ixib6381lMeG7G6MAYzcBzuo8FMSLOdM5U7LOVN5yDTzr0_DTt0A_W_6IcQMkCNw713OL35z0z0EuQXl0vaxaPkgejLLT_v__X9CfwFMkLVd</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2364253662</pqid></control><display><type>article</type><title>Clinical Characteristics of Acromegalic Patients With Paradoxical GH Response to Oral Glucose Load</title><source>ProQuest One Community College</source><source>MEDLINE</source><source>ProQuest Central (Alumni Edition)</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>ProQuest Central UK/Ireland</source><source>Alma/SFX Local Collection</source><source>ProQuest Central</source><creator>Mukai, Kosuke ; Otsuki, Michio ; Tamada, Daisuke ; Kitamura, Tetsuhiro ; Hayashi, Reiko ; Saiki, Aya ; Goto, Yuko ; Arita, Hideyuki ; Oshino, Satoru ; Morii, Eiichi ; Saitoh, Youichi ; Shimomura, Iichiro</creator><creatorcontrib>Mukai, Kosuke ; Otsuki, Michio ; Tamada, Daisuke ; Kitamura, Tetsuhiro ; Hayashi, Reiko ; Saiki, Aya ; Goto, Yuko ; Arita, Hideyuki ; Oshino, Satoru ; Morii, Eiichi ; Saitoh, Youichi ; Shimomura, Iichiro</creatorcontrib><description><![CDATA[Abstract
Context
A paradoxical GH response to oral glucose (OG) is often found in acromegaly. However, the clinical characteristics of patients with acromegaly and a paradoxical GH response to OG (OG responders) remain unclear.
Objective
The aim of the present study was to define the clinical characteristics of OG responders with acromegaly.
Design
Retrospective study.
Setting
Hospitalized care at Osaka University Hospital.
Patients and Methods
Of 63 patients with acromegaly admitted to our hospital from January 2006 to January 2017, 19 were classified as OG responders and 44 as nonresponders. The clinical characteristics of these groups were compared.
Results
Before surgery, OG responders had substantially greater IGF-1 SD scores than nonresponders (P < 0.05), although no difference was found in basal GH levels between the two groups (P = 0.46). Regarding glucose metabolism, 120-minute plasma glucose and immunoreactive insulin after OG administration and hemoglobin A1c were significantly greater in OG responders than in nonresponders (P < 0.01, P < 0.05, P < 0.05, respectively). GH levels during octreotide or bromocriptine testing were decreased more significantly in OG responders than in nonresponders (P < 0.05, P < 0.05, respectively). The proportion of pituitary tumors with hypointensity on T2-weighted MRI was significantly greater in OG responders than in nonresponders (P < 0.05). The difference in IGF-1 and parameters of glucose metabolism described disappeared between the two groups after surgery.
Conclusions
The paradoxical GH response reflected the clinical characteristics, especially IGF-I level, glucose metabolism, and drug efficacy in acromegaly. A paradoxical GH response, in addition to the nadir GH levels, to OG load is potentially useful for evaluation of the clinical characteristics of acromegaly.
Patients with acromegaly and a paradoxical GH response to oral glucose load had higher IGF-I levels, worse glucose metabolism, and better octreotide and bromocriptine efficacy compared with nonresponders.]]></description><identifier>ISSN: 0021-972X</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/jc.2018-00975</identifier><identifier>PMID: 30476255</identifier><language>eng</language><publisher>Washington, DC: Endocrine Society</publisher><subject>Acromegaly ; Acromegaly - drug therapy ; Acromegaly - metabolism ; Acromegaly - pathology ; Adult ; Biomarkers - analysis ; Brain tumors ; Bromocriptine ; Bromocriptine - pharmacology ; Case-Control Studies ; Dextrose ; Drug efficacy ; Drug metabolism ; Female ; Follow-Up Studies ; Gastrointestinal Agents - pharmacology ; Glucose ; Glucose - administration & dosage ; Glucose - metabolism ; Glycosylated hemoglobin ; Growth hormones ; Hemoglobin ; Hormone Antagonists - pharmacology ; Human Growth Hormone - metabolism ; Humans ; Insulin ; Insulin-like growth factor I ; Insulin-Like Growth Factor I - metabolism ; Machinery industry ; Magnetic resonance imaging ; Male ; Metabolism ; Middle Aged ; Octreotide ; Octreotide - pharmacology ; Patients ; Physical growth ; Physiological aspects ; Pituitary ; Pituitary Neoplasms - drug therapy ; Pituitary Neoplasms - metabolism ; Pituitary Neoplasms - pathology ; Prognosis ; Retrospective Studies ; Surgery</subject><ispartof>The journal of clinical endocrinology and metabolism, 2019-05, Vol.104 (5), p.1637-1644</ispartof><rights>Copyright © 2019 Endocrine Society 2019</rights><rights>Copyright © Oxford University Press 2015</rights><rights>Copyright © 2019 Endocrine Society.</rights><rights>COPYRIGHT 2019 Oxford University Press</rights><rights>Copyright © 2019 Endocrine Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5025-2bcefb6fabc54bb0ae97401868637e210fd4ff86a4656b16a5a6321525417f163</citedby><cites>FETCH-LOGICAL-c5025-2bcefb6fabc54bb0ae97401868637e210fd4ff86a4656b16a5a6321525417f163</cites><orcidid>0000-0001-5947-8621</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2364253662?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,21388,21389,27924,27925,33530,33531,33744,33745,43659,43805,64385,64387,64389,72469,73123,73128,73129,73131</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30476255$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mukai, Kosuke</creatorcontrib><creatorcontrib>Otsuki, Michio</creatorcontrib><creatorcontrib>Tamada, Daisuke</creatorcontrib><creatorcontrib>Kitamura, Tetsuhiro</creatorcontrib><creatorcontrib>Hayashi, Reiko</creatorcontrib><creatorcontrib>Saiki, Aya</creatorcontrib><creatorcontrib>Goto, Yuko</creatorcontrib><creatorcontrib>Arita, Hideyuki</creatorcontrib><creatorcontrib>Oshino, Satoru</creatorcontrib><creatorcontrib>Morii, Eiichi</creatorcontrib><creatorcontrib>Saitoh, Youichi</creatorcontrib><creatorcontrib>Shimomura, Iichiro</creatorcontrib><title>Clinical Characteristics of Acromegalic Patients With Paradoxical GH Response to Oral Glucose Load</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><description><![CDATA[Abstract
Context
A paradoxical GH response to oral glucose (OG) is often found in acromegaly. However, the clinical characteristics of patients with acromegaly and a paradoxical GH response to OG (OG responders) remain unclear.
Objective
The aim of the present study was to define the clinical characteristics of OG responders with acromegaly.
Design
Retrospective study.
Setting
Hospitalized care at Osaka University Hospital.
Patients and Methods
Of 63 patients with acromegaly admitted to our hospital from January 2006 to January 2017, 19 were classified as OG responders and 44 as nonresponders. The clinical characteristics of these groups were compared.
Results
Before surgery, OG responders had substantially greater IGF-1 SD scores than nonresponders (P < 0.05), although no difference was found in basal GH levels between the two groups (P = 0.46). Regarding glucose metabolism, 120-minute plasma glucose and immunoreactive insulin after OG administration and hemoglobin A1c were significantly greater in OG responders than in nonresponders (P < 0.01, P < 0.05, P < 0.05, respectively). GH levels during octreotide or bromocriptine testing were decreased more significantly in OG responders than in nonresponders (P < 0.05, P < 0.05, respectively). The proportion of pituitary tumors with hypointensity on T2-weighted MRI was significantly greater in OG responders than in nonresponders (P < 0.05). The difference in IGF-1 and parameters of glucose metabolism described disappeared between the two groups after surgery.
Conclusions
The paradoxical GH response reflected the clinical characteristics, especially IGF-I level, glucose metabolism, and drug efficacy in acromegaly. A paradoxical GH response, in addition to the nadir GH levels, to OG load is potentially useful for evaluation of the clinical characteristics of acromegaly.
Patients with acromegaly and a paradoxical GH response to oral glucose load had higher IGF-I levels, worse glucose metabolism, and better octreotide and bromocriptine efficacy compared with nonresponders.]]></description><subject>Acromegaly</subject><subject>Acromegaly - drug therapy</subject><subject>Acromegaly - metabolism</subject><subject>Acromegaly - pathology</subject><subject>Adult</subject><subject>Biomarkers - analysis</subject><subject>Brain tumors</subject><subject>Bromocriptine</subject><subject>Bromocriptine - pharmacology</subject><subject>Case-Control Studies</subject><subject>Dextrose</subject><subject>Drug efficacy</subject><subject>Drug metabolism</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastrointestinal Agents - pharmacology</subject><subject>Glucose</subject><subject>Glucose - administration & dosage</subject><subject>Glucose - metabolism</subject><subject>Glycosylated hemoglobin</subject><subject>Growth hormones</subject><subject>Hemoglobin</subject><subject>Hormone Antagonists - pharmacology</subject><subject>Human Growth Hormone - metabolism</subject><subject>Humans</subject><subject>Insulin</subject><subject>Insulin-like growth factor I</subject><subject>Insulin-Like Growth Factor I - metabolism</subject><subject>Machinery industry</subject><subject>Magnetic resonance imaging</subject><subject>Male</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Octreotide</subject><subject>Octreotide - pharmacology</subject><subject>Patients</subject><subject>Physical growth</subject><subject>Physiological aspects</subject><subject>Pituitary</subject><subject>Pituitary Neoplasms - drug therapy</subject><subject>Pituitary Neoplasms - metabolism</subject><subject>Pituitary Neoplasms - pathology</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><issn>0021-972X</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kcFv0zAUxi3ExMrgyBVF4sIlne3YTnKsKtiQKm2aQHCzHOeZujhxsR0N_nuctgMxgXyw_PR7n9_7PoReEbwklODLnV5STJoS47bmT9CCtIyXNWnrp2iBMSVlW9Mv5-h5jDuMCWO8eobOK8xqQTlfoG7t7Gi1csV6q4LSCYKNyepYeFOsdPADfFXO6uJWJQtjisVnm7b5FVTvfxwar66LO4h7P0Yoki9uwlxzk_b5vfGqf4HOjHIRXp7uC_Tp_buP6-tyc3P1Yb3alJpjykvaaTCdMKrTnHUdVtDWLG8mGlHVkFc1PTOmEYoJLjoiFFeiooRTzkhtiKgu0Nuj7j747xPEJAcbNTinRvBTlJRUjWCiaWb0zSN056cw5ukkrQSjvBKC_qGyAyDtaHzKDs2icjXLcNIeqOU_qHx6GKz2Ixib6381lMeG7G6MAYzcBzuo8FMSLOdM5U7LOVN5yDTzr0_DTt0A_W_6IcQMkCNw713OL35z0z0EuQXl0vaxaPkgejLLT_v__X9CfwFMkLVd</recordid><startdate>201905</startdate><enddate>201905</enddate><creator>Mukai, Kosuke</creator><creator>Otsuki, Michio</creator><creator>Tamada, Daisuke</creator><creator>Kitamura, Tetsuhiro</creator><creator>Hayashi, Reiko</creator><creator>Saiki, Aya</creator><creator>Goto, Yuko</creator><creator>Arita, Hideyuki</creator><creator>Oshino, Satoru</creator><creator>Morii, Eiichi</creator><creator>Saitoh, Youichi</creator><creator>Shimomura, Iichiro</creator><general>Endocrine Society</general><general>Copyright Oxford University Press</general><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7T5</scope><scope>7TM</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5947-8621</orcidid></search><sort><creationdate>201905</creationdate><title>Clinical Characteristics of Acromegalic Patients With Paradoxical GH Response to Oral Glucose Load</title><author>Mukai, Kosuke ; Otsuki, Michio ; Tamada, Daisuke ; Kitamura, Tetsuhiro ; Hayashi, Reiko ; Saiki, Aya ; Goto, Yuko ; Arita, Hideyuki ; Oshino, Satoru ; Morii, Eiichi ; Saitoh, Youichi ; Shimomura, Iichiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5025-2bcefb6fabc54bb0ae97401868637e210fd4ff86a4656b16a5a6321525417f163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Acromegaly</topic><topic>Acromegaly - drug therapy</topic><topic>Acromegaly - metabolism</topic><topic>Acromegaly - pathology</topic><topic>Adult</topic><topic>Biomarkers - analysis</topic><topic>Brain tumors</topic><topic>Bromocriptine</topic><topic>Bromocriptine - pharmacology</topic><topic>Case-Control Studies</topic><topic>Dextrose</topic><topic>Drug efficacy</topic><topic>Drug metabolism</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastrointestinal Agents - pharmacology</topic><topic>Glucose</topic><topic>Glucose - administration & dosage</topic><topic>Glucose - metabolism</topic><topic>Glycosylated hemoglobin</topic><topic>Growth hormones</topic><topic>Hemoglobin</topic><topic>Hormone Antagonists - pharmacology</topic><topic>Human Growth Hormone - metabolism</topic><topic>Humans</topic><topic>Insulin</topic><topic>Insulin-like growth factor I</topic><topic>Insulin-Like Growth Factor I - metabolism</topic><topic>Machinery industry</topic><topic>Magnetic resonance imaging</topic><topic>Male</topic><topic>Metabolism</topic><topic>Middle Aged</topic><topic>Octreotide</topic><topic>Octreotide - pharmacology</topic><topic>Patients</topic><topic>Physical growth</topic><topic>Physiological aspects</topic><topic>Pituitary</topic><topic>Pituitary Neoplasms - drug therapy</topic><topic>Pituitary Neoplasms - metabolism</topic><topic>Pituitary Neoplasms - pathology</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mukai, Kosuke</creatorcontrib><creatorcontrib>Otsuki, Michio</creatorcontrib><creatorcontrib>Tamada, Daisuke</creatorcontrib><creatorcontrib>Kitamura, Tetsuhiro</creatorcontrib><creatorcontrib>Hayashi, Reiko</creatorcontrib><creatorcontrib>Saiki, Aya</creatorcontrib><creatorcontrib>Goto, Yuko</creatorcontrib><creatorcontrib>Arita, Hideyuki</creatorcontrib><creatorcontrib>Oshino, Satoru</creatorcontrib><creatorcontrib>Morii, Eiichi</creatorcontrib><creatorcontrib>Saitoh, Youichi</creatorcontrib><creatorcontrib>Shimomura, Iichiro</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of clinical endocrinology and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mukai, Kosuke</au><au>Otsuki, Michio</au><au>Tamada, Daisuke</au><au>Kitamura, Tetsuhiro</au><au>Hayashi, Reiko</au><au>Saiki, Aya</au><au>Goto, Yuko</au><au>Arita, Hideyuki</au><au>Oshino, Satoru</au><au>Morii, Eiichi</au><au>Saitoh, Youichi</au><au>Shimomura, Iichiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Characteristics of Acromegalic Patients With Paradoxical GH Response to Oral Glucose Load</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>2019-05</date><risdate>2019</risdate><volume>104</volume><issue>5</issue><spage>1637</spage><epage>1644</epage><pages>1637-1644</pages><issn>0021-972X</issn><eissn>1945-7197</eissn><abstract><![CDATA[Abstract
Context
A paradoxical GH response to oral glucose (OG) is often found in acromegaly. However, the clinical characteristics of patients with acromegaly and a paradoxical GH response to OG (OG responders) remain unclear.
Objective
The aim of the present study was to define the clinical characteristics of OG responders with acromegaly.
Design
Retrospective study.
Setting
Hospitalized care at Osaka University Hospital.
Patients and Methods
Of 63 patients with acromegaly admitted to our hospital from January 2006 to January 2017, 19 were classified as OG responders and 44 as nonresponders. The clinical characteristics of these groups were compared.
Results
Before surgery, OG responders had substantially greater IGF-1 SD scores than nonresponders (P < 0.05), although no difference was found in basal GH levels between the two groups (P = 0.46). Regarding glucose metabolism, 120-minute plasma glucose and immunoreactive insulin after OG administration and hemoglobin A1c were significantly greater in OG responders than in nonresponders (P < 0.01, P < 0.05, P < 0.05, respectively). GH levels during octreotide or bromocriptine testing were decreased more significantly in OG responders than in nonresponders (P < 0.05, P < 0.05, respectively). The proportion of pituitary tumors with hypointensity on T2-weighted MRI was significantly greater in OG responders than in nonresponders (P < 0.05). The difference in IGF-1 and parameters of glucose metabolism described disappeared between the two groups after surgery.
Conclusions
The paradoxical GH response reflected the clinical characteristics, especially IGF-I level, glucose metabolism, and drug efficacy in acromegaly. A paradoxical GH response, in addition to the nadir GH levels, to OG load is potentially useful for evaluation of the clinical characteristics of acromegaly.
Patients with acromegaly and a paradoxical GH response to oral glucose load had higher IGF-I levels, worse glucose metabolism, and better octreotide and bromocriptine efficacy compared with nonresponders.]]></abstract><cop>Washington, DC</cop><pub>Endocrine Society</pub><pmid>30476255</pmid><doi>10.1210/jc.2018-00975</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-5947-8621</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0021-972X |
| ispartof | The journal of clinical endocrinology and metabolism, 2019-05, Vol.104 (5), p.1637-1644 |
| issn | 0021-972X 1945-7197 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2138646886 |
| source | ProQuest One Community College; MEDLINE; ProQuest Central (Alumni Edition); Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford University Press Journals All Titles (1996-Current); ProQuest Central UK/Ireland; Alma/SFX Local Collection; ProQuest Central |
| subjects | Acromegaly Acromegaly - drug therapy Acromegaly - metabolism Acromegaly - pathology Adult Biomarkers - analysis Brain tumors Bromocriptine Bromocriptine - pharmacology Case-Control Studies Dextrose Drug efficacy Drug metabolism Female Follow-Up Studies Gastrointestinal Agents - pharmacology Glucose Glucose - administration & dosage Glucose - metabolism Glycosylated hemoglobin Growth hormones Hemoglobin Hormone Antagonists - pharmacology Human Growth Hormone - metabolism Humans Insulin Insulin-like growth factor I Insulin-Like Growth Factor I - metabolism Machinery industry Magnetic resonance imaging Male Metabolism Middle Aged Octreotide Octreotide - pharmacology Patients Physical growth Physiological aspects Pituitary Pituitary Neoplasms - drug therapy Pituitary Neoplasms - metabolism Pituitary Neoplasms - pathology Prognosis Retrospective Studies Surgery |
| title | Clinical Characteristics of Acromegalic Patients With Paradoxical GH Response to Oral Glucose Load |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-04T15%3A59%3A44IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Clinical%20Characteristics%20of%20Acromegalic%20Patients%20With%20Paradoxical%20GH%20Response%20to%20Oral%20Glucose%20Load&rft.jtitle=The%20journal%20of%20clinical%20endocrinology%20and%20metabolism&rft.au=Mukai,%20Kosuke&rft.date=2019-05&rft.volume=104&rft.issue=5&rft.spage=1637&rft.epage=1644&rft.pages=1637-1644&rft.issn=0021-972X&rft.eissn=1945-7197&rft_id=info:doi/10.1210/jc.2018-00975&rft_dat=%3Cgale_proqu%3EA688651962%3C/gale_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2364253662&rft_id=info:pmid/30476255&rft_galeid=A688651962&rft_oup_id=10.1210/jc.2018-00975&rfr_iscdi=true |