Endocrine Abstracts

Introduction: Active acromegaly is diagnosed based on clinical symptoms and biochemical tests, such as elevated GH concentration, IGF-1 concentration above the reference range for sex and age. However, due to certain limitations associated with IGF-1 measurements, alternative biomarkers are being sought that may be useful at various stages of the diagnostic and therapeutic process.

Purpose: Evaluation of the usefulness of serum soluble α-klotho protein, nesfatin-1 and IGFBP-3 determination in the biochemical diagnosis and treatment monitoring in patients with acromegaly.

Materials and Methods: The concentrations of soluble α-klotho protein, nesfatin-1 and IGFBP-3 were determined in patients at the time of acromegaly diagnosis, as well as after 3 and 12 months following the removal of the pituitary adenoma. The examined biomarkers were measured in 35 patients at the time of diagnosis and in 25 patients after 3 and 12 months post-surgery. Measurements of soluble α-klotho protein and nesfatin-1 were conducted using the ELISA immunoassay, while IGFBP-3 was determined using the isotopic method (RIA immunoassay).

Results: The concentration of soluble α-klotho protein was higher (P=0.0001) at the time of disease diagnosis compared to the control group. However, no difference was observed in the soluble α-klotho protein concentration at 3 and 12 months after surgery in the study group (P=0.214) vs the control group (P=0.407). The concentration of soluble α-klotho protein was lower (P=0.0001) 3 months after surgery than at the time of disease diagnosis. No difference was observed in the concentration of soluble α-klotho protein at 3 and 12 months after surgery (P=0.802). The IGFBP-3 concentration was lower (P=0.0001) at 3 and 12 months after surgery than at the time of disease diagnosis (P=0.0001). No differences were observed in the IGFBP-3 concentration at 3 and 12 months after surgery (P=0.122).

Conclusion: Determination of concentrations of the biomarkers tested: soluble α-klotho protein and IGFBP-3, may be useful in the diagnosis of patients with acromegaly. The concentration of nesfatin-1 did not show discriminatory properties in patients with acromegaly.