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dc.contributor.authorMukherjee, Annice
dc.contributor.authorShalet, Stephen M
dc.date.accessioned2010-02-09T11:01:49Z
dc.date.available2010-02-09T11:01:49Z
dc.date.issued2009-11
dc.identifier.citationThe value of IGF1 estimation in adults with GH deficiency. 2009, 161 Suppl 1:S33-9 Eur. J. Endocrinol.en
dc.identifier.issn1479-683X
dc.identifier.pmid19684059
dc.identifier.doi10.1530/EJE-09-0247
dc.identifier.urihttp://hdl.handle.net/10541/91476
dc.description.abstractThe 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.
dc.language.isoenen
dc.subjectOestrogen Replacement Therapyen
dc.subject.meshAdult
dc.subject.meshAge Factors
dc.subject.meshBiological Markers
dc.subject.meshDrug Administration Schedule
dc.subject.meshEstrogen Replacement Therapy
dc.subject.meshFemale
dc.subject.meshHuman Growth Hormone
dc.subject.meshHumans
dc.subject.meshHypopituitarism
dc.subject.meshImmunoassay
dc.subject.meshInsulin-Like Growth Factor Binding Protein 3
dc.subject.meshInsulin-Like Growth Factor I
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshPredictive Value of Tests
dc.subject.meshSeverity of Illness Index
dc.subject.meshSex Factors
dc.titleThe value of IGF1 estimation in adults with GH deficiency.en
dc.typeArticleen
dc.contributor.departmentDepartment of Endocrinology, Salford Royal NHS Foundation Trust, UK. annice.mukherjee@srft.nhs.uken
dc.identifier.journalEuropean Journal of Endocrinologyen
html.description.abstractThe 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.


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