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The impact of adjustments to the diagnostic criteria for biochemical remission in surgically treated patients with acromegaly

Journal article
Authors Konstantina Kousoula
Katerina Farmaki
Thomas Skoglund
Daniel S Olsson
Gudmundur Johannsson
Penelope Trimpou
Oskar Ragnarsson
Published in Growth Hormone and IGF Research
Volume 36
Pages 16-21
ISSN 1096-6374
Publication year 2017
Published at Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Pages 16-21
Language en
Links doi.org/10.1016/j.ghir.2017.08.003
Keywords Biochemical remission, Consensus guidelines, Growth hormone, Insulin-like growth factor I, Pituitary adenoma
Subject categories Internal medicine

Abstract

Background The suggested criteria for biochemical remission in patients treated for acromegaly were recently modified. The aim of this project was to study to what extent this modification influences remission rates. Design, patients and methods This was a retrospective study of 55 consecutive patients [29 men; median age 47 years (interquartile range 38–68)] diagnosed with acromegaly between 2003 and 2014. After treatment serum IGF-I and/or GH was measured according to a standardized protocol. The biochemical remission status was defined according to the clinical guidelines from 2010 and2014. Results Out of 55 patients, 44 patients were primarily operated. Of these, 33 (75%) were evaluated 3–12 months postoperatively by measuring serum IGF-I and GH during an oral glucose tolerance test. According to the 2010 guidelines, 11 patients (33%) were in biochemical remission, 15 patients (46%) were not and 7 patients (21%) had discordant results (normal IGF-I and high GH or vice versa). Applying the 2014 guidelines in the same group, 16 patients (49%) were in biochemical remission, 7 patients (21%) were not and 10 patients (30%) had discordant results. Thus, by using the most recent criteria for biochemical control, more patients were considered to be in remission, or with discordant results, and fewer patients not in remission (P < 0.05). Conclusion An apparently minor adjustment of the criteria for biochemical control has a significant impact on remission status in patients treated for acromegaly, eventually affecting follow-up and treatment strategies. © 2017 Elsevier Ltd

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