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    Seeking the optimal target range for insulin-like growth factor I during the treatment of adult growth hormone disorders.

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    Authors
    Mukherjee, Annice
    Monson, John
    Jönsson, Peter J
    Trainer, Peter J
    Shalet, Stephen M
    Affiliation
    Department of Endocrinology, Christie Hospital, Manchester M20 4BX, United Kingdom.
    Issue Date
    2003-12
    
    Metadata
    Show full item record
    Abstract
    Impaired GH activity at target tissues, occurring when GH action is blocked or during suboptimal GH replacement therapy, may result in a pathological state associated with lowering of IGF-I, but not GH levels. Such a state represents functional but not necessarily actual GH deficiency (GHD). The aim of this study was to identify a range of IGF-I values commensurate with GHD, which could be used to determine the risk of functional GHD during the treatment of adult GH disorders. Centrally measured baseline IGF-I data from the Kabi International Metabolic Study European GHD database were analyzed. Inclusion criteria were adult-onset GHD and two or more additional anterior pituitary hormone deficits. Adults with childhood-onset GHD and cured acromegaly were excluded. The cohort was stratified into six gender-based age ranges. Baseline IGF-I measurements from 376 females (median age, 48 yr; range, 21-77 yr) and 434 males (median age 52 yr; range 21-80 yr) were analyzed. Data were not normally distributed and are presented as medians (quartiles). The median serum IGF-I and IGF-I SDS in males were 94.0 microg/liter (64 and 141) and -1.52 (-2.53 and -0.456; n = 434). Both were significantly greater than the equivalent values of females, which were 73 microg/liter (46 and 103.5) and -2.30 (-3.28 and -1.328; n = 376; P < 0.0001 for both). Age and gender-related 90th and 95th percentiles for IGF-I SDS were determined to generate risk estimates for functional GHD, which, in conjunction with the clinical status of the patient, may be used to aid dose titration during treatment of GH disorders in adulthood.
    Citation
    Seeking the optimal target range for insulin-like growth factor I during the treatment of adult growth hormone disorders. 2003, 88 (12):5865-70 J. Clin. Endocrinol. Metab.
    Journal
    The Journal of Clinical Endocrinology and Metabolism
    URI
    http://hdl.handle.net/10541/79038
    DOI
    10.1210/jc.2002-021741
    PubMed ID
    14671182
    Type
    Article
    Language
    en
    ISSN
    0021-972X
    ae974a485f413a2113503eed53cd6c53
    10.1210/jc.2002-021741
    Scopus Count
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