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    The value of IGF1 estimation in adults with GH deficiency.

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    Authors
    Mukherjee, Annice
    Shalet, Stephen M
    Affiliation
    Department of Endocrinology, Salford Royal NHS Foundation Trust, UK. annice.mukherjee@srft.nhs.uk
    Issue Date
    2009-11
    
    Metadata
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    Abstract
    The GH/IGF1 system, like other endocrine systems, is dynamic and its activity changes with age and sexual maturation, and is influenced by body composition and other factors. A normal level of IGF1 does not exclude a diagnosis of GH deficiency (GHD) in adults, and the usefulness of IGF1 in the diagnosis of adult GHD has historically been confusing and contentious. The regulation of IGF1 secretion in adults is complex, and is not solely dependent on GH status with factors recognized to influence IGF1 status in patients with GHD including age, gender, exogenous estrogen therapy, prolactin status, and severity of GHD. The usefulness of IGF1 for monitoring treatment of GH disorders in adulthood is now widely accepted, especially as GH-dosing regimens for GHD have evolved from weight-based dosing (associated with overtreatment and side effects) to individualized dose-titration strategies, which maintain IGF1 within target limits. Sub-optimal replacement therapy may be associated with morbidity and mortality risk from a continuing state of functional GHD. Conversely, avoiding iatrogenic biochemical acromegaly is clearly important and other potential safety issues may be associated with a persistently high IGF1. Analysis and interpretation of IGF1 status therefore represent a useful diagnostic tool especially in the younger adult patients with severe GHD and an essential measurement for monitoring GH replacement in all adults with GHD. High-quality, method-specific reference ranges for IGF1 and a high degree of methodological consistency in the assay are essential for reliable comparison of results.
    Citation
    The value of IGF1 estimation in adults with GH deficiency. 2009, 161 Suppl 1:S33-9 Eur. J. Endocrinol.
    Journal
    European Journal of Endocrinology
    URI
    http://hdl.handle.net/10541/91476
    DOI
    10.1530/EJE-09-0247
    PubMed ID
    19684059
    Type
    Article
    Language
    en
    ISSN
    1479-683X
    ae974a485f413a2113503eed53cd6c53
    10.1530/EJE-09-0247
    Scopus Count
    Collections
    All Christie Publications
    Endocrinology

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