2.50
Hdl Handle:
http://hdl.handle.net/10541/70055
Title:
IGF-I measurements in the monitoring of GH therapy.
Authors:
Higham, Claire E; Jostel, Andreas; Trainer, Peter J
Abstract:
Growth hormone replacement therapy has been used regularly in adult Growth hormone deficiency since the availability of recombinant GH in the 1980's. GH replacement improves quality of life, bone turnover markers, cardiovascular risk markers and adverse body composition. Originally, GH doses in replacement regimes were determined by weight and surface area and dose increases based on body composition outcomes analogous to pediatric practice. These regimens led to significant side effects related to excess GH, arthralgias, headaches and peripheral edema and IGF-I levels above the upper limit of the reference range. Newer treatment regimes therefore account for known factors affecting serum GH and IGF-I levels, i.e. age, gender, estrogen replacement and pre-treatment IGF-I levels. Monitoring is now via clinical symptomatology combined with serum total IGF-I levels, potentially this avoids excessive GH exposure and allows monitoring of compliance and dose titration. There is a lack of data relating IGF-I to biological endpoints, but analysis suggests that dose titration of IGF-I to the upper half of the age and gender related reference range is acceptable. The use of reliable IGF-I assays and extensive age and gender related reference ranges is necessary and centralized monitoring is preferable. Free IGF-I and bioavailable IGF-I measurements are available but their use in the monitoring of GH replacement remains to be determined.
Affiliation:
Department of Endocrinology, Christie Hospital, Manchester M20 4BX, UK.
Citation:
IGF-I measurements in the monitoring of GH therapy. 2007, 10 (2):159-63 Pituitary
Journal:
Pituitary
Issue Date:
2007
URI:
http://hdl.handle.net/10541/70055
DOI:
10.1007/s11102-007-0027-9
PubMed ID:
17410471
Type:
Article
Language:
en
ISSN:
1386-341X
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorHigham, Claire E-
dc.contributor.authorJostel, Andreas-
dc.contributor.authorTrainer, Peter J-
dc.date.accessioned2009-06-09T16:25:43Z-
dc.date.available2009-06-09T16:25:43Z-
dc.date.issued2007-
dc.identifier.citationIGF-I measurements in the monitoring of GH therapy. 2007, 10 (2):159-63 Pituitaryen
dc.identifier.issn1386-341X-
dc.identifier.pmid17410471-
dc.identifier.doi10.1007/s11102-007-0027-9-
dc.identifier.urihttp://hdl.handle.net/10541/70055-
dc.description.abstractGrowth hormone replacement therapy has been used regularly in adult Growth hormone deficiency since the availability of recombinant GH in the 1980's. GH replacement improves quality of life, bone turnover markers, cardiovascular risk markers and adverse body composition. Originally, GH doses in replacement regimes were determined by weight and surface area and dose increases based on body composition outcomes analogous to pediatric practice. These regimens led to significant side effects related to excess GH, arthralgias, headaches and peripheral edema and IGF-I levels above the upper limit of the reference range. Newer treatment regimes therefore account for known factors affecting serum GH and IGF-I levels, i.e. age, gender, estrogen replacement and pre-treatment IGF-I levels. Monitoring is now via clinical symptomatology combined with serum total IGF-I levels, potentially this avoids excessive GH exposure and allows monitoring of compliance and dose titration. There is a lack of data relating IGF-I to biological endpoints, but analysis suggests that dose titration of IGF-I to the upper half of the age and gender related reference range is acceptable. The use of reliable IGF-I assays and extensive age and gender related reference ranges is necessary and centralized monitoring is preferable. Free IGF-I and bioavailable IGF-I measurements are available but their use in the monitoring of GH replacement remains to be determined.en
dc.language.isoenen
dc.subject.meshDrug Monitoring-
dc.subject.meshFemale-
dc.subject.meshHormone Replacement Therapy-
dc.subject.meshHuman Growth Hormone-
dc.subject.meshHumans-
dc.subject.meshInsulin-Like Growth Factor I-
dc.subject.meshMale-
dc.subject.meshReference Values-
dc.titleIGF-I measurements in the monitoring of GH therapy.en
dc.typeArticleen
dc.contributor.departmentDepartment of Endocrinology, Christie Hospital, Manchester M20 4BX, UK.en
dc.identifier.journalPituitaryen
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