Insulin-like growth factor-1, growth hormone and disease outcomes in acromegaly: a population study.

Thomas, Melissa, Berni, Ellen, Jenkins-Jones, Sara, Wensley, Sarah, Poole, Chris D, Currie, Craig J, Brownrigg, Jack, Ayuk, John and Rees, D Aled (2021) Insulin-like growth factor-1, growth hormone and disease outcomes in acromegaly: a population study. Clinical endocrinology. ISSN 1365-2265. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Abstract

CONTEXT

A lack of consensus remains about the relative importance of insulin-like growth factor-1 (IGF-1) and growth hormone (GH) in predicting adverse outcomes in patients with acromegaly.

OBJECTIVE

To describe the differing association between IGF-1 and GH and major disease outcomes in acromegaly.

DESIGN

Retrospective cohort study.

PATIENTS

United Kingdom National Health Service patients with acromegaly who had an IGF-1 and/or a GH measurement recorded following diagnosis, prior to December 2019.

MEASUREMENTS

A composite endpoint including all-cause mortality (ACM), type 2 diabetes (DM), major adverse cardiovascular events (MACE) or cancer was the primary outcome. These outcomes were also analysed individually. Follow-up period was capped at 5 years.

RESULTS

A maximum of 417 cases and 332 cases were eligible for the IGF-1 and GH analyses, respectively, comprising 1041.5 and 938.9 years of follow-up. There was a direct association between increased IGF-1 concentration and adjusted event risk for the composite endpoint (hazard ratio [HR]=1.2; 95% confidence interval [CI]=1.02-1.5); in GH, the HR was 1.1 (1.0-1.2). For the individual endpoints in relation to IGF-1 level, the HRs were: ACM (1.2; 0.93-1.5), MACE (1.2; 0.64-2.1), DM (1.53; 1.09-2.2), and cancer (1.3; 0.95-1.7). For GH, the HRs were: ACM (1.1; 0.97-1.2), MACE (0.99; 0.73-1.3), DM (1.1; 0.99-1.2), and cancer (0.90; 0.66-1.2).

CONCLUSIONS

In this contemporary dataset with extended follow-up, IGF-1 and GH concentrations showed an association with major adverse outcomes from acromegaly.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: QV Pharmacology
WK Endocrine system. Endocrinology
WL Nervous system. Neurology
Divisions: Ambulatory Care > Endocrinology
Related URLs:
Depositing User: Jamie Edgar
Date Deposited: 31 Mar 2021 12:58
Last Modified: 31 Mar 2021 12:58
URI: http://www.repository.uhblibrary.co.uk/id/eprint/4157

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