ECE2016 Eposter Presentations Pituitary - Clinical (83 abstracts)
Discrepant GH and IGF-I values in the evaluation of treated acromegalic patients; an ongoing challenge. A meta-analysis
George Kanakis 1 , Alexandra Chrisoulidou 2 , Alexandra Bargiota 3 , Zoe Efstathiadou 4 , Lamprini Papanastasiou 5 , Anastasia Theodoropoulou 6 , Stylianos Tigas 7 , Dimitra Vassiliadi 8 , Stylianos Tsagarakis 9 & Maria Alevizaki 10
1Athens Naval & VA Hospital, Athens, Greece; 2Theagenio Cancer Hospital, Thessaloniki, Greece; 3University of Thessaly, Larissa, Greece; 4Hippokration General Hospital, Thessaloniki, Greece; 5Athens General Hospital G. Gennimatas, Athens, Greece; 6University Hospital of Patras, Patras, Greece; 7University of Ioannina, Ioannina, Greece; 8Attikon University Hospital, Athens, Greece; 9Evangelismos Hospital, Athens, Greece; 10Medical School of Athens, Athens, Greece.
Purpose: Growth Hormone (GH) and Insulin-like Growth Factor 1 (IGF-I) are currently the principal biomarkers used to assess disease activity in acromegaly and any discrepancy between them renders interpretation of results inconclusive. The purpose of this study was to assess the frequency of discrepant results and identify parameters that might affect the emergence of this phenomenon.
Methods: A systematic review of Medline and Scopus was performed (1987–2013) followed by a meta-analysis to address the frequency of discrepant results between GH and IGF-I levels. Meta-regression was performed using the year of publication as a continuous variable and subgroup analyses included the different types of GH testing and GH assays used, as well as the results of patients treated with Somatostatin Analogues (SSAs) compared to those treated with non-pharmaceutical modalities.
Results: The analysis retrieved 39 eligible studies totaling 7071 patients. The pooled discordance rate between GH and IGF-I was 25.7% (95% CI: 22.3–29.4) and the predominant format was that of elevated IGF-I with normal GH levels [15.3% (95% CI: 12.5–18.7)]. No significant correlation between the discordance rate and the year of publication was shown, whereas, the use of ultrasensitive GH assays resulted in higher discordance rates (30.7%, 95% CI: 25.9–35.9 vs. 19.8%, 95% CI: 14.1–27.2, P=0.04). Patients receiving SSAs presented a discordance rate significantly higher than those not on SSA treatment (32.5%, 95% CI: 27.8–37.4) vs. (21.6%, 95% CI: 17.8–25.6, P=0.001)
Conclusions: Discrepancy between GH and IGF-I results is encountered in a quarter of treated patients with acromegaly, especially when using ultrasensitive GH assays or in patients receiving SSAs, a fact that the clinician should take into consideration when making clinical decisions.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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