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Does attainment of target levels of growth hormone and insulin-like growth factor I improve acromegaly prognosis?


For almost a decade, treatment goals for acromegaly have been those recommended by an expert group—achievement of serum growth hormone (GH) levels <2.5 µg/l and age-adjusted, normal levels of insulin-like growth factor I (IGF-I). This Practice Point commentary discusses a meta-analysis by Holdaway et al. that investigated the relationship between mortality and levels of GH and IGF-I in patients with acromegaly. The findings of the study confirm that the current criteria are adequate in terms of mortality, and that the prognosis of acromegaly has improved in the past 20 years. This improvement may be related to the comparatively aggressive treatment of the disease and management of comorbidities. Changes in the methods used by clinicians to measure GH levels probably require new criteria to be adopted, as good control of acromegaly is now more adequately defined as serum GH levels <1 µg/l and age-adjusted normal levels of IGF-I.

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  1. Giustina A et al. (2000) Criteria for cure of acromegaly: a consensus statement. J Clin Endocrinol Metab 85: 526–529

    CAS  PubMed  Google Scholar 

  2. Holdaway IM et al. (2008) A meta-analysis of the effect of lowering serum levels of GH and IGF-I on mortality in acromegaly. Eur J Endocrinol 159: 89–95

    Article  CAS  Google Scholar 

  3. Kauppinen-Makelin R et al. (2005) A nationwide survey of mortality in acromegaly. J Clin Endocrinol Metab 90: 4081–4086

    Article  Google Scholar 

  4. Colao A et al. (2004) Systemic complications of acromegaly: epidemiology, pathogenesis, and management. Endocr Rev 25: 102–152

    Article  CAS  Google Scholar 

  5. Nachtigall L et al. (2008) Changing patterns in diagnosis and therapy of acromegaly over two decades. J Clin Endocrinol Metab 93: 2035–2041

    Article  CAS  Google Scholar 

  6. Maison P and Chanson P (2006) Less is more risky? Growth hormone and insulin-like growth factor I levels and cardiovascular risk. Nat Clin Pract Endocrinol Metab 2: 650–651

    Article  Google Scholar 

  7. Cazabat L et al. (2008) Dynamic tests for the diagnosis and assessment of treatment efficacy in acromegaly. Pituitary 11: 129–139

    Article  CAS  Google Scholar 

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Correspondence to Philippe Chanson.

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Competing interests

Philippe Chanson received consulting and lecture fees and grant/research support from Novartis, Ipsen and Pfizer. Patrick Maison declared no competing interests.

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Chanson, P., Maison, P. Does attainment of target levels of growth hormone and insulin-like growth factor I improve acromegaly prognosis?. Nat Rev Endocrinol 5, 70–71 (2009).

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