Seeking the optimal target range for insulin-like growth factor I during the treatment of adult human growth hormone HGH disorders.
Mukherjee A - J Clin Endocrinol Metab - 01-DEC-2003; 88(12): 5865-70
From NIH/NLM MEDLINE
NLM Citation ID:
14671182 (PubMed)
Full Source Title:
Journal of Clinical Endocrinology and Metabolism
Publication Type:
Journal Article
Language:
English
Author Affiliation:
Department of Endocrinology, Christie Hospital, Manchester M20 4BX, United Kingdom.
Authors:
Mukherjee A; Monson JP; Jönsson PJ; Trainer PJ; Shalet SM
KIMS International Board
Abstract:
Impaired HGH activity at target tissues, occurring when HGH action is blocked or during suboptimal HGH replacement therapy, may result in a pathological state associated with lowering of IGF-I, but not HGH levels. Such a state represents functional but not necessarily actual HGH deficiency (HGHD). The aim of this study was to identify a range of IGF-I values commensurate with HGHD, which could be used to determine the risk of functional HGHD during the treatment of adult HGH disorders. Centrally measured baseline IGF-I data from the Kabi International Metabolic Study European HGHD database were analyzed. Inclusion criteria were adult-onset HGHD and two or more additional anterior pituitary hormone deficits. Adults with childhood-onset HGHD and cured acromegaly were excluded. The cohort was stratified into six gender-based age ranges. Baseline IGF-I measurements from 376 females (median age, 48 yr; range, 21-77 yr) and 434 males (median age 52 yr; range 21-80 yr) were analyzed. Data were not normally distributed and are presented as medians (quartiles). The median serum IGF-I and IGF-I SDS in males were 94.0 microg/liter (64 and 141) and -1.52 (-2.53 and -0.456; n = 434). Both were significantly greater than the equivalent values of females, which were 73 microg/liter (46 and 103.5) and -2.30 (-3.28 and -1.328; n = 376; P < 0.0001 for both). Age and gender-related 90th and 95th percentiles for IGF-I SDS were determined to generate risk estimates for functional HGHD, which, in conjunction with the clinical status of the patient, may be used to aid dose titration during treatment of HGH disorders in adulthood.
Major Subjects:
- Growth Hormone / administration & dosage / * therapeutic use
- Human Growth Hormone / * deficiency
- Insulin-Like Growth Factor I / * metabolism
Additional Subjects:
- Adult
- Aged
- Aged, 80 and over
- Aging / blood
- Cohort Studies
- Dose-Response Relationship, Drug
- Female
- Humans
- Male
- Metabolism, Inborn Errors / blood / drug therapy
- Middle Aged
- Sex Characteristics
Chemical Compound Name:
12629-01-5(Human Growth Hormone); 67763-96-6(Insulin-Like Growth Factor I); 9002-72-6(Human Growth Hormone)