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Horm Res. 2007;68 Suppl 5:166-72. doi: 10.1159/000110617. Epub 2007 Dec 10.

Excess mortality in acromegaly.

Author information

1
Department of Endocrinology, Greenlane Clinical Centre, Auckland City Hospital, Auckland, New Zealand. ian@adhb.govt.nz

Abstract

BACKGROUND:

Increased production of growth hormone (GH) and insulin-like growth factor-I (IGF-I) in patients with acromegaly is associated with a twofold increase in mortality compared with the general population. The range of standardised mortality rates in various studies ranges from 1.2 to 3.6.

PREDICTORS OF MORTALITY:

Multivariate analysis has indicated that post-treatment serum GH levels and, in a number of studies, serum IGF-I levels are the most powerful predictors of outcome. Normal IGF-I concentrations and random GH levels <2.5 microg/l measured by polyclonal radioimmunoassay result in optimal outcome. Other factors adversely influencing mortality include hypertension and a long interval between onset of the disorder and diagnosis.

CONCLUSIONS:

Analysis of recent reports suggests that adoption of treatment guidelines with appropriate post-treatment target ranges for GH and IGF-I, together with the availability of newer methods to control GH oversecretion, has significantly improved patient outcomes.

PMID:
18174739
DOI:
10.1159/000110617
[Indexed for MEDLINE]
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