Fluctuation analysis of postoperative secretory status in patients operated for acromegaly.
Acromegaly
/ diagnosis
Adenoma
/ diagnosis
Adult
Aged
Female
Follow-Up Studies
Glucose Tolerance Test
Growth Hormone-Secreting Pituitary Adenoma
/ diagnosis
Human Growth Hormone
/ blood
Humans
Insulin-Like Growth Factor I
/ metabolism
Male
Middle Aged
Postoperative Period
Prognosis
Recurrence
Retrospective Studies
Secretory Pathway
/ physiology
Treatment Outcome
Acromegaly
Acromégalie
Classification
GH
Hormone de croissance
IGF-1
Outcome
Pronostic
Recurrence
Récidive
Journal
Annales d'endocrinologie
ISSN: 2213-3941
Titre abrégé: Ann Endocrinol (Paris)
Pays: France
ID NLM: 0116744
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
11
09
2019
revised:
29
10
2019
accepted:
06
11
2019
pubmed:
27
1
2020
medline:
9
9
2020
entrez:
27
1
2020
Statut:
ppublish
Résumé
The aim of this study was to describe endocrinological outcome in patients operated on for acromegaly. A retrospective study included 167 patients. Patients were assessed in the early postoperative period (EPP), at 3 months (M3), at 1 year (Y1), and then annually. They were classified as grade I (IGF-1 level normal-for-age and positive GH response on oral glucose tolerance test [nadir <0.4ng/L]); grade II (discordant); or grade III or IV (acromegaly, controlled or uncontrolled under medical therapy, respectively). Taking all patients with all grades, 35% changed grades between EPP and M3, 26% between M3 and Y1 and 9% after Y1. In grade I, respectively 22%, 15% and 2% of patients changed grades between EPP and M3, between M3 and Y1, and after Y1, compared to 31%, 6% and 6% in grade IV. Respectively 57%, 67%, and 47% of grade II patients changed grades between EPP and M3, between M3 and Y1, and after Y1; between EPP or M3 and last follow-up (>1 year), respectively 74% and 75% of grade II patients changed grades. Knosp category, resection quality and abnormal GH response (vs. abnormal IGF-1) significantly impacted grade II patients' outcome. Whereas outcome in grades I and III-IV seems to be determined by 1 year, grade II discordant patients' outcome remains uncertain even after 1 year.
Identifiants
pubmed: 31982107
pii: S0003-4266(19)30236-7
doi: 10.1016/j.ando.2019.11.002
pii:
doi:
Substances chimiques
IGF1 protein, human
0
Human Growth Hormone
12629-01-5
Insulin-Like Growth Factor I
67763-96-6
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
11-17Informations de copyright
Copyright © 2019 Elsevier Masson SAS. All rights reserved.