Endocrine Abstracts

Growth hormone (GH) and insulin like growth factor 1 (IGF-I) modulate and stimulate angiogenesis and endothelial function. Excess of GH, as in acromegaly, is associated with cardiovascular morbidity and mortality, which is reversible after normalization of IGF-I and GH. Diabetes mellitus (DM) is a common comorbidity in acromegaly, but the prevalence of diabetes retinopathy in patients with acromegaly is unknown. Also, the roles of GH and IGF-I in diabetes retinopathy are not f...

Background: Growth Hormone (GH) and insulin-like growth factor 1 (IGF-1) are the biomarkers used to assess disease activity in acromegaly. Consensus guidelines from the Endocrine Society (2014) recommend a normal (age/sex-adjusted) IGF-1 in combination with a suppressed random GH<1 μg/l for biochemical remission. However, these results are discordant in some patients. The clinical significance of the IGF-1/GH dichotomy in the follow-up of these patients is unclear and...

Background: In the core phase of the PAPE study until 24 weeks we have shown that switching to pasireotide LAR (PAS-LAR) in well-controlled acromegaly patients receiving combination therapy of somatostatin analogues and pegvisomant (PEGV), normalizes IGF1 levels in the majority of patients. PAS-LAR induced a significant PEGV sparing effect, but this was at the expense of a higher incidence of diabetes. This extension study until 48-weeks assesses the efficacy, safety and quali...

Introduction: Pituitary adenomas (PAs) that occur in a familial setting account for no more than 5%, which can be part of familial tumor syndromes such as Multiple Endocrine Neoplasia type 1 (MEN1) and type 4 (MEN4), Carney Complex (CNC) or Familial Isolated Pituitary Adenoma (FIPA). The presence of two or more cases of PAs without MEN1 or CNC characteristics in the same family, enable FIPA diagnosis. Heterozygous germline inactivating mutations in the aryl hydrocarbon rec...

Background: The response to first-generation long-acting somatostatin analogues (LA-SSA) treatment in acromegaly depends on the expression of the somatostatin receptor (SSTR) subtypes. In contrast to octreotide and lanreotide which preferentially bind to SSTR2, pasireotide targets multiple SSTRs, with the highest binding affinity for SSTR5. It has previously been suggested that SSTR5 expression could predict the response to pasireotide LAR (PAS-LAR) treatment in acromegaly.</p...

Objective: People are at higher risk for malignancy as they get older or have a strong family history of cancer.Aim: To collect family history of cancer in a large cohort of patients with pituitary adenomas (PA) in Outpatient clinic from years 2005–2017.Results: Overall 46% of 1100 patients with PA had a family member affected with cancer. Breast cancer in family members was reported in 15.3% of patients with prolactinomas whi...

Acromegaly is a morbid condition mainly caused by overproduction of growth-hormone (GH) from a pituitary adenoma leading to excessive growth. Normalisation of insulin-like growth factor-1 (IGF1) is an important goal for the treatment of acromegaly. The second-generation somatostatin analog (SSA) long acting pasireotide (la-PAS) has recently been introduced for the management of patients uncontrolled by first-generation SSA. The ACRONIS study (CSOM230CIC05) will provide real-wo...

Acromegaly is a rare disease characterised by excessive Growth hormone (GH) production from a pituitary adenoma. Subfertility is common in acromegaly and has various aetiologies, therefore pregnancy in acromegaly is rare. We present a case series of 19 pregnancies in 13 women with acromegaly from the newly formed Irish National Pituitary Registry. Twelve women had pituitary macroadenomas, one woman had a microadenoma. The age of the women ranged from 28 to 40 years with a medi...

GH consists of various molecular isoforms. Most abundant is 22 kDa-GH (80–90% of total GH), followed by 20 kDa-GH (5–15% of total GH). The biological significance of 20 kDa-GH remains unclear, but its effects appear comparable to those of 22 kDa-GH. Acromegaly is characterized by chronic GH excess. Data on GH isoforms in acromegaly are scarce, but an increased 20 kDa-/22 kDa-GH-ratio (20k-ratio) has been described. Our aims were to compare the 20k-ratio in a larger c...

Background: Acromegaly is usually caused by a benign pituitary tumour, with increased production of growth hormone (GH) and insulin-like growth factor 1 (IGF-1). Treatment options include surgery, followed by pharmacological treatment with dopamine agonists, somatostatin analogues, GH receptor antagonists or radiotherapy. Treatment optimization is important to decrease the burden of this often-chronic disease on the patient.Objectives: To evaluate the ef...

Background: Acromegaly is characterised by growth hormone (GH) and insulin-like growth factor (IGF-1) hypersecretion. The disease is associated with increased cardiovascular, cerebrovascular and metabolic co-morbidities, resulting in excess mortality. A target GH <1 μg/l and normalised IGF-1 values correlate with mortality risk reduction. However, there is lack of consensus over which biomarker, GH or IGF-1, better predicts increased morbidity and/ or mortality.<p...