Clinical characteristics of acromegalic patients with paradoxical growth hormone response to oral glucose load.

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Clinical characteristics of acromegalic patients with paradoxical growth hormone response to oral glucose load.

J Clin Endocrinol Metab. 2018 Nov 23;:

Authors: Mukai K, Otsuki M, Tamada D, Kitamura T, Hayashi R, Saiki A, Goto Y, Arita H, Oshino S, Morii E, Saitoh Y, Shimomura I

Abstract
Context: Paradoxical GH response to oral glucose (OG) is often found in acromegaly. However, the clinical characteristics of acromegalic patients with paradoxical GH response to OG (OG responders) remains unclear.
Objective: The aim of the present study was to define the clinical characteristics of OG responders with acromegaly.
Design: Retrospective study.
Setting: Hospitalized care at Osaka University Hospital.
Patients and methods: Sixty-three acromegalic patients admitted to our hospital between January 2006 and January 2017 were classified into OG responders (n=19) and non-responders (n=44). The clinical characteristics of these groups were compared.
Results: Before surgery, OG responders had significantly higher IGF-1 SD scores than non-responders although there was no difference in basal GH levels between the two groups. With regard to glucose metabolism, 120-min PG and IRI after OG administration, and HbA1c were significantly higher in OG responders than non-responders. GH levels during octreotide or bromocriptine tests were decreased more significantly in OG responders than non-responders. The proportion of pituitary tumors with hypointensity on T2-weighted MRI was significantly higher in OG responders than non-responders. The difference in IGF-1 and parameters of glucose metabolism described above disappeared between the two groups after surgery.
Conclusions: Paradoxical GH response reflected the clinical characteristics, especially IGF-I levels, glucose metabolism and drug efficacy in acromegaly. Paradoxical GH response, in addition to the nadir GH levels, to OG load can be potentially useful for evaluation of the clinical characteristics of acromegaly.

PMID: 30476255 [PubMed - as supplied by publisher]

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