Session: SUN 88-129-Acromegaly & Prolactinoma
Poster Board SUN-105
Research Design and Methods: Age- and sex-matched normal IGF-1 and a nadir serum GH level less than 0.4 ng/mL in the 75g oral glucose tolerance test (OGTT) were considered representative of biochemical remission. GHD was defined when the peak serum GH level was less than 3.0 ng/mL in insulin tolerance test (ITT) which was conducted at least 2 times at 1.5 years intervals. Nadir serum GH level in preoperative and postoperative OGTTs, random serum GH/IGF-1 level after 1, 6, 12, 18, 24, 48, and 72 hour after TSA were analyzed.
Results: One hundred and twenty three patients had been followed up for 4.91±2.49 years with OGTTs and the axis of GH had been evaluated 2.64±0.86 times with ITT for 4.44±2.13 years. Among them, 12 (9.8%) patients developed GHD after TSA. GHD patients were older (43.75±10.37 vs. 49.50±9.63; P=0.047) and female sex dominant (51% vs. 75%; P=0.084). Furthermore, GHD patients had significantly lower serum GH level at 72 hr and IGF-1 level at 6 months after TSA (0.74±0.89 vs. 0.34±0.33; P=0.019 and 358.34±158.46 vs. 208.19±123.99; P=0.008, respectively). There were no differences in Hardy classification, number of ITT and follow up duration between two groups. Although 8 of 12 GHD patients had appropriate GH response at first ITT (1.22±0.45 years), they developed delayed GHD at 3.08±0.70 years after TSA. The incidences of GHD were significantly accelerated across decreasing GH level at 72 hours after TSA quartile categories (P=0.044). Correlation analyses after adjustment for multivariable confounders showed that lower GH level at 72 hours after TSA were correlated with accelerated GHD (OR=0.466, P=0.016, 95% CI 0.250-0.866).
Conclusions: These data provide the first clinical evidence that severely decreased immediate-postoperative serum GH level at 72 hours after TSA could be an independent risk factor for accelerated GHD in acromegalic patients.
Nothing to Disclose: CRK, JWH, EHK, SHK, EJL
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