2006, Number 2
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An Med Asoc Med Hosp ABC 2006; 51 (2)
Level of growth hormone supression with glucose by an ultrasensitive assay in 30 healthy subjects
Stempa BO, Díaz OE, Diez CLF, Martínez EG, Joya GJ
Language: Spanish
References: 13
Page: 58-64
PDF size: 95.53 Kb.
ABSTRACT
Since the sixties, the determination of serum concentrations of growth hormone (GH) has been possible. New techniques have been developed that enjoy great sensitivity and measure concentrations of GH that before were considered undetectable. Those tests are named ultrasensitive assays. So it is the case of chemiluminiscence and immunoradiometric assay (IRMA). In this study, GH suppression tests with glucose were performed to 30 healthy subjects in order to assess the nadir value of GH with said stimulus.
Using chemiluminiscent assay, a nadir average of 0.11 ±
0.09 ng/mL was obtained, hence making possible to propose an
upper normal limit of 0.29 ng/mL of GH after the suppression
with glucose. The results of our study confirm previous publications of studies made in major medical centers of the USA and Europe. Also, they support the use of ultrasensitive assays for determination of GH in blood. Establishing lower cut values for GH has demonstrated a correlation with smaller morbidity and mortality in acromegalic patients under treatment.
REFERENCES
Kacsoh B. Endocrine physiology. New York, NY: Mc GrawHill, 2000; 251-274.
Giustina A, Barkan A, Casanueva F, Cavagnini F, Frohman L, Ho K, Veldhuis J, Wass J, Von Perder K, Melmed S. Criteria for cure of acromegaly: A consensus statement. J Clin Endocrinol Metab 2000; 85: 526–529.
Peacy SR, Shalet SM. IGF-1 measurement in diagnosis and management of acromegaly. Ann Clin Biochem 2001; 38: 297-303.
Freda P. Current concepts in the biochemical assessment of the patient with acromegaly. Growth Horm IGF Res 2003; 13: 171-184.
Chapman IM, Hartman MI, Straume M, Johnson ML, Veldhuis JD, Thorner MO. Enhanced sensitivity growth hormone chemiluminiscence assay reveals lower post-glucose GH concentrations in men than women. J Clin Endocrinol Metab 1994; 78: 1312-1319.
Dimaraki EV, Jaffe CA, Demott-Friberg R, William F, Barkan AL. Acromegaly with apparently normal GH secretion. Implications for diagnosis and follow up. J Clin Endocrinol Metab 2002; 87: 3537-3542
Arellano S, Domínguez B, Espinoza de los Monteros AL, Gómez Cruz JR, Gómez MG, Guinto G et al. Consenso Nacional de Acromegalia: Guía para su diagnóstico, tratamiento y seguimiento. Posición de la Sociedad Mexicana de Endocrinología y Metabolismo. Rev Endocrinol Nutr 2004; 1 (supl): S63-S72.
Costa A, Rossi A, Martinelli C, Machado HR, Moreira AC Assessment of disease activity in treated acromegalic patients using a sensitive assay: Should we achieve strict normal GH levels for a biochemical cure? J Clin Endocrinol Metab 2000; 87: 3142-3147.
Freda UP, Post KD, Powell JS, Wardlaw SL. Evaluation of disease with sensitive measures of growth hormone secretion in 60 postoperative patients with acromegaly. J Clin Endocrinol Metab 1998; 83: 3808-3816.
Abosch A, Tyrrel B, Lanborn K, Hannegan LT, Applebury CB, Wilson CB. Transsphenoidal microsurgery for growth hormone secreting pituitary adenomas: Initial outcome and long term results. J Clin Endocrinol Metab 1998; 83: 3411-3418.
Melmed S, Jackson I, Kleinberg D, Klibanski A. Current treatment guidelines for acromegaly. J Clin Endocrinol Metab. 1998; 83: 2646-2652.
Hattori N, Shimatsu A, Kato Y. Growth hormone responses to oral glucose loading measured by highly sensitive enzyme immunoassay in normal subjects and patients with glucose intolerance and acromegaly. J Clin Endocrinol Metab 1990; 70: 771-776.
Sheaves R, Jenkins P, Blackburn P. Outcome of transsphenoidal surgery for acromegaly using strict criteria for surgical cure. Clin Endocrinol 45: 407-413.