Long-term changes in serum IGF-1 levels after successful surgical treatment of growth hormone-secreting pituitary adenoma
- Authors
- Shin M.-S.; Yu J.H.; Choi J.H.; Jung C.H.; Hwang J.Y.; Cho Y.H.; Kim C.J.; Kim M.-S.
- Issue Date
- 2013
- Keywords
- Acromegaly; Growth hormone; Insulin-like growth factor 1; Pituitary tumor; Surgery
- Citation
- Neurosurgery, v.73, no.3, pp 473 - 479
- Pages
- 7
- Indexed
- SCI
SCIE
SCOPUS
- Journal Title
- Neurosurgery
- Volume
- 73
- Number
- 3
- Start Page
- 473
- End Page
- 479
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/11373
- DOI
- 10.1227/01.neu.0000431480.87160.84
- ISSN
- 0148-396X
1524-4040
- Abstract
- Background: Successful treatment of acromegaly is known to normalize serum insulin-like growth factor 1 (IGF-1) levels within days after surgery. However, our clinical observations indicate that many cases of acromegaly show delayed normalization of serum IGF-1 levels after complete tumor resection. Objective: To study long-term changes of the serum IGF-1 levels in acromegalic patients for whom surgical treatment was thought to be successful. Methods: A retrospective observational study was performed with 46 acromegalic patients with no residual tumor on sellar magnetic resonance imaging, and a nadir growth hormone of less than 0.4 μg/L on a postoperative oral glucose tolerance test. Results: In all patients, serum IGF-1 levels returned to the normal reference values for age and sex during the observational period (12-132 months). The mean duration from the time of surgery until IGF-1 normalization was 10 months (range, 3 days-57 months). Twenty-seven patients (59%) reached normal IGF-1 ranges within 3 months of surgery, whereas 19 patients (41%) experienced delayed (>3 months) IGF-1 normalization. Eleven patients (24%) recovered normal IGF-1 levels 12 to 57 months after surgery. The possibility of delayed IGF-1 cure was increased 8.8-fold with an immediate postoperative IGF-1 level increase of 100 μg/L. Conclusion: Satisfactory remission of acromegaly by IGF-1 criteria was delayed in a large proportion of acromegalic patients, especially those with high postoperative IGF-1 levels. Hence, additional treatment can be delayed in clinically stable acromegalic patients who show no evidence of residual tumors on postoperative magnetic resonance imaging and a normal growth hormone suppressive response to a glucose load. © 2013 by the Congress of Neurological Surgeons.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - 2. Clinical Science > Department of Endocrinology and Metabolism > 1. Journal Articles
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.