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

Artikel i vetenskaplig tidskrift
Författare Konstantina Kousoula
Katerina Farmaki
Thomas Skoglund
Daniel S Olsson
Gudmundur Johannsson
Penelope Trimpou
Oskar Ragnarsson
Publicerad i Growth Hormone and IGF Research
Volym 36
Sidor 16-21
ISSN 1096-6374
Publiceringsår 2017
Publicerad vid Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition
Sidor 16-21
Språk en
Länkar doi.org/10.1016/j.ghir.2017.08.003
Ämnesord Biochemical remission, Consensus guidelines, Growth hormone, Insulin-like growth factor I, Pituitary adenoma
Ämneskategorier Invärtesmedicin

Sammanfattning

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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