Preoperative growth hormone (GH) peak values during a GH releasing peptide-2 test reflect the severity of hypopituitarism and the postoperative recovery of GH secretion in patients with non-functioning pituitary adenomas
Non-functioning pituitary adenoma (NFPA) is one common cause of adult growth hormone deficiency (AGHD). In Japan, a GH-releasing peptide (GHRP)-2 test is used to evaluate GH secretion. Although the cut-off for peak GH during a GHRP-2 test for severe AGHD is ≤9 ng/mL, severe AGHD may further diminish...
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| Veröffentlicht in: | Endocrine Journal 2020, Vol.67(2), pp.167-175 |
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| creator | Soga, Akimi Fukuda, Izumi Kobayashi, Shunsuke Tahara, Shigeyuki Morita, Akio Sugihara, Hitoshi |
| description | Non-functioning pituitary adenoma (NFPA) is one common cause of adult growth hormone deficiency (AGHD). In Japan, a GH-releasing peptide (GHRP)-2 test is used to evaluate GH secretion. Although the cut-off for peak GH during a GHRP-2 test for severe AGHD is ≤9 ng/mL, severe AGHD may further diminish responses (range, nearly no-response to ≤9 ng/mL). We studied whether the peak GH responses during a GHRP-2 test could be predicted based on clinical characteristics of patients with NFPA. We compared patients with almost no-response during a GHRP-2 test with other patients considered as severe AGHD. Among the 76 patients with NFPA who were admitted to our institution, 36 patients (mean age, 61 years; male/female, n = 23/n = 13) were diagnosed with severe AGHD based on a preoperative GHRP-2 test. Based on the preoperative median peak GH concentration (2.83 ng/mL), patients were divided into two groups ( |
| doi_str_mv | 10.1507/endocrj.EJ19-0288 |
| format | Article |
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In Japan, a GH-releasing peptide (GHRP)-2 test is used to evaluate GH secretion. Although the cut-off for peak GH during a GHRP-2 test for severe AGHD is ≤9 ng/mL, severe AGHD may further diminish responses (range, nearly no-response to ≤9 ng/mL). We studied whether the peak GH responses during a GHRP-2 test could be predicted based on clinical characteristics of patients with NFPA. We compared patients with almost no-response during a GHRP-2 test with other patients considered as severe AGHD. Among the 76 patients with NFPA who were admitted to our institution, 36 patients (mean age, 61 years; male/female, n = 23/n = 13) were diagnosed with severe AGHD based on a preoperative GHRP-2 test. Based on the preoperative median peak GH concentration (2.83 ng/mL), patients were divided into two groups (<median = low or group L, n = 18; ≥median = moderate or group M, n = 18). Clinical manifestations, body mass index, severity of hypopituitarism and tumor size, volume, and extension were analyzed retrospectively. Compared with group M, group L patients were significantly older and more gonadotropin and ACTH deficient. A lower peak GH release during a GHRP-2 test was associated with a higher number of anterior pituitary hormone deficiencies across all 76 patients. Postoperatively, seven in group M and no patient in group L were assessed as having no longer severe AGHD, respectively. Preoperative peak GH concentrations assessed during a GHRP-2 test reflected the severity of hypopituitarism and the recovery of postoperative GH secretion.</description><identifier>ISSN: 0918-8959</identifier><identifier>EISSN: 1348-4540</identifier><identifier>DOI: 10.1507/endocrj.EJ19-0288</identifier><identifier>PMID: 31776295</identifier><language>eng</language><publisher>Japan: The Japan Endocrine Society</publisher><subject>Adenoma ; Adenoma - complications ; Adenoma - diagnostic imaging ; Adenoma - surgery ; Adrenocorticotropic hormone ; Adrenocorticotropic Hormone - deficiency ; Adult ; Adult growth hormone deficiency ; Aged ; Aged, 80 and over ; Body mass index ; Female ; GH releasing peptide (GHRP)-2 test ; Gonadotropins ; Growth hormones ; Growth Substances ; Human Growth Hormone - deficiency ; Human Growth Hormone - metabolism ; Humans ; Hypogonadism ; Hypopituitarism ; Hypopituitarism - etiology ; Hypopituitarism - metabolism ; Insulin-Like Growth Factor I - metabolism ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Non-functioning pituitary adenomas (NFPA) ; Oligopeptides ; Peptides ; Pituitary (anterior) ; Pituitary Function Tests ; Pituitary hormones ; Pituitary Neoplasms - complications ; Pituitary Neoplasms - diagnostic imaging ; Pituitary Neoplasms - surgery ; Postoperative Period ; Preoperative Period ; Prognosis ; Recovery of Function ; Retrospective Studies ; Secretion ; Severity of Illness Index ; Young Adult</subject><ispartof>Endocrine Journal, 2020, Vol.67(2), pp.167-175</ispartof><rights>The Japan Endocrine Society</rights><rights>Copyright Japan Science and Technology Agency 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-5c078b143971c5d6c5913b7a411decfd888f15a53d0cd18546db85003215c073</citedby><cites>FETCH-LOGICAL-c526t-5c078b143971c5d6c5913b7a411decfd888f15a53d0cd18546db85003215c073</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1883,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31776295$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Soga, Akimi</creatorcontrib><creatorcontrib>Fukuda, Izumi</creatorcontrib><creatorcontrib>Kobayashi, Shunsuke</creatorcontrib><creatorcontrib>Tahara, Shigeyuki</creatorcontrib><creatorcontrib>Morita, Akio</creatorcontrib><creatorcontrib>Sugihara, Hitoshi</creatorcontrib><title>Preoperative growth hormone (GH) peak values during a GH releasing peptide-2 test reflect the severity of hypopituitarism and the postoperative recovery of GH secretion in patients with non-functioning pituitary adenomas</title><title>Endocrine Journal</title><addtitle>Endocr J</addtitle><description>Non-functioning pituitary adenoma (NFPA) is one common cause of adult growth hormone deficiency (AGHD). In Japan, a GH-releasing peptide (GHRP)-2 test is used to evaluate GH secretion. Although the cut-off for peak GH during a GHRP-2 test for severe AGHD is ≤9 ng/mL, severe AGHD may further diminish responses (range, nearly no-response to ≤9 ng/mL). We studied whether the peak GH responses during a GHRP-2 test could be predicted based on clinical characteristics of patients with NFPA. We compared patients with almost no-response during a GHRP-2 test with other patients considered as severe AGHD. Among the 76 patients with NFPA who were admitted to our institution, 36 patients (mean age, 61 years; male/female, n = 23/n = 13) were diagnosed with severe AGHD based on a preoperative GHRP-2 test. Based on the preoperative median peak GH concentration (2.83 ng/mL), patients were divided into two groups (<median = low or group L, n = 18; ≥median = moderate or group M, n = 18). Clinical manifestations, body mass index, severity of hypopituitarism and tumor size, volume, and extension were analyzed retrospectively. Compared with group M, group L patients were significantly older and more gonadotropin and ACTH deficient. A lower peak GH release during a GHRP-2 test was associated with a higher number of anterior pituitary hormone deficiencies across all 76 patients. Postoperatively, seven in group M and no patient in group L were assessed as having no longer severe AGHD, respectively. Preoperative peak GH concentrations assessed during a GHRP-2 test reflected the severity of hypopituitarism and the recovery of postoperative GH secretion.</description><subject>Adenoma</subject><subject>Adenoma - complications</subject><subject>Adenoma - diagnostic imaging</subject><subject>Adenoma - surgery</subject><subject>Adrenocorticotropic hormone</subject><subject>Adrenocorticotropic Hormone - deficiency</subject><subject>Adult</subject><subject>Adult growth hormone deficiency</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Body mass index</subject><subject>Female</subject><subject>GH releasing peptide (GHRP)-2 test</subject><subject>Gonadotropins</subject><subject>Growth hormones</subject><subject>Growth Substances</subject><subject>Human Growth Hormone - deficiency</subject><subject>Human Growth Hormone - metabolism</subject><subject>Humans</subject><subject>Hypogonadism</subject><subject>Hypopituitarism</subject><subject>Hypopituitarism - etiology</subject><subject>Hypopituitarism - metabolism</subject><subject>Insulin-Like Growth Factor I - metabolism</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Non-functioning pituitary adenomas (NFPA)</subject><subject>Oligopeptides</subject><subject>Peptides</subject><subject>Pituitary (anterior)</subject><subject>Pituitary Function Tests</subject><subject>Pituitary hormones</subject><subject>Pituitary Neoplasms - complications</subject><subject>Pituitary Neoplasms - diagnostic imaging</subject><subject>Pituitary Neoplasms - surgery</subject><subject>Postoperative Period</subject><subject>Preoperative Period</subject><subject>Prognosis</subject><subject>Recovery of Function</subject><subject>Retrospective Studies</subject><subject>Secretion</subject><subject>Severity of Illness Index</subject><subject>Young Adult</subject><issn>0918-8959</issn><issn>1348-4540</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkUGP1CAcxRujccfVD-DFkHhZD12hlBaOZrPOaDbRw94bBv6dMrZQgc5mvut-GOnMWBMvEMLvPR7_l2XvCb4lDNefwWqn_P72_jsROS44f5GtCC15XrISv8xWWBCec8HEVfYmhD3GlLKSvs6uKKnrqhBslT3_9OBG8DKaA6Cdd0-xQ53zg7OAbtabT2gE-QsdZD9BQHryxu6QROsN8tCDDPNxhDEaDXmBIoSYLtoeVESxAxTgAN7EI3It6o6jG02cTJTehAFJq0_M6EL8F8GDcklzUqRXAigP0TiLjEVjQsDGgJ5MSmmdzdvJqvn2FOPifURSg3WDDG-zV63sA7y77NfZ49f7x7tN_vBj_e3uy0OuWFHFnClc8y0pqaiJYrpSTBC6rWVJiAbVas55S5hkVGOlCWdlpbecpWkWZJbS6-zmbDt69zuNKTaDCQr6XlpwU2gKSkTJay5EQj_-h-7d5G0Kl6hKlGVR1FWiyJlS3oWQ5tmM3gzpZw3Bzdx8c2m-mZtv5uaT5sPFedoOoBfF36oTsD4D-xDlDhZA-mhUD4tlVTfFvCzWC6E66RNG_wD2dMpp</recordid><startdate>20200101</startdate><enddate>20200101</enddate><creator>Soga, Akimi</creator><creator>Fukuda, Izumi</creator><creator>Kobayashi, Shunsuke</creator><creator>Tahara, Shigeyuki</creator><creator>Morita, Akio</creator><creator>Sugihara, Hitoshi</creator><general>The Japan Endocrine Society</general><general>Japan Science and Technology Agency</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>7QP</scope><scope>7T5</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20200101</creationdate><title>Preoperative growth hormone (GH) peak values during a GH releasing peptide-2 test reflect the severity of hypopituitarism and the postoperative recovery of GH secretion in patients with non-functioning pituitary adenomas</title><author>Soga, Akimi ; 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In Japan, a GH-releasing peptide (GHRP)-2 test is used to evaluate GH secretion. Although the cut-off for peak GH during a GHRP-2 test for severe AGHD is ≤9 ng/mL, severe AGHD may further diminish responses (range, nearly no-response to ≤9 ng/mL). We studied whether the peak GH responses during a GHRP-2 test could be predicted based on clinical characteristics of patients with NFPA. We compared patients with almost no-response during a GHRP-2 test with other patients considered as severe AGHD. Among the 76 patients with NFPA who were admitted to our institution, 36 patients (mean age, 61 years; male/female, n = 23/n = 13) were diagnosed with severe AGHD based on a preoperative GHRP-2 test. Based on the preoperative median peak GH concentration (2.83 ng/mL), patients were divided into two groups (<median = low or group L, n = 18; ≥median = moderate or group M, n = 18). Clinical manifestations, body mass index, severity of hypopituitarism and tumor size, volume, and extension were analyzed retrospectively. Compared with group M, group L patients were significantly older and more gonadotropin and ACTH deficient. A lower peak GH release during a GHRP-2 test was associated with a higher number of anterior pituitary hormone deficiencies across all 76 patients. Postoperatively, seven in group M and no patient in group L were assessed as having no longer severe AGHD, respectively. Preoperative peak GH concentrations assessed during a GHRP-2 test reflected the severity of hypopituitarism and the recovery of postoperative GH secretion.</abstract><cop>Japan</cop><pub>The Japan Endocrine Society</pub><pmid>31776295</pmid><doi>10.1507/endocrj.EJ19-0288</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adenoma Adenoma - complications Adenoma - diagnostic imaging Adenoma - surgery Adrenocorticotropic hormone Adrenocorticotropic Hormone - deficiency Adult Adult growth hormone deficiency Aged Aged, 80 and over Body mass index Female GH releasing peptide (GHRP)-2 test Gonadotropins Growth hormones Growth Substances Human Growth Hormone - deficiency Human Growth Hormone - metabolism Humans Hypogonadism Hypopituitarism Hypopituitarism - etiology Hypopituitarism - metabolism Insulin-Like Growth Factor I - metabolism Magnetic Resonance Imaging Male Middle Aged Non-functioning pituitary adenomas (NFPA) Oligopeptides Peptides Pituitary (anterior) Pituitary Function Tests Pituitary hormones Pituitary Neoplasms - complications Pituitary Neoplasms - diagnostic imaging Pituitary Neoplasms - surgery Postoperative Period Preoperative Period Prognosis Recovery of Function Retrospective Studies Secretion Severity of Illness Index Young Adult |
| title | Preoperative growth hormone (GH) peak values during a GH releasing peptide-2 test reflect the severity of hypopituitarism and the postoperative recovery of GH secretion in patients with non-functioning pituitary adenomas |
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