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    IGF-I measurements in the monitoring of GH therapy.

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    Authors
    Higham, Claire E
    Jostel, Andreas
    Trainer, Peter J
    Affiliation
    Department of Endocrinology, Christie Hospital, Manchester M20 4BX, UK.
    Issue Date
    2007
    
    Metadata
    Show full item record
    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.
    Citation
    IGF-I measurements in the monitoring of GH therapy. 2007, 10 (2):159-63 Pituitary
    Journal
    Pituitary
    URI
    http://hdl.handle.net/10541/70055
    DOI
    10.1007/s11102-007-0027-9
    PubMed ID
    17410471
    Type
    Article
    Language
    en
    ISSN
    1386-341X
    ae974a485f413a2113503eed53cd6c53
    10.1007/s11102-007-0027-9
    Scopus Count
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