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Published in: Pituitary 1/2017

01-02-2017

Biochemical investigations in diagnosis and follow up of acromegaly

Authors: Katharina Schilbach, Christian J. Strasburger, Martin Bidlingmaier

Published in: Pituitary | Issue 1/2017

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Abstract

Measurements of human growth hormone (GH) and insulin-like growth-factor I (IGF-I) are cornerstones in the diagnosis of acromegaly. Both hormones are also used as biochemical markers in the evaluation of disease activity during treatment. Management of acromegaly is particularly challenging in cases where discordant information is obtained from measurement of GH concentrations following oral glucose load and from measurement of IGF-I. While in some patients biological factors can explain the discrepancy, in many cases issues with the analytical methods seem to be responsible. Assays used by endocrine laboratories to determine concentrations of GH and IGF-I underwent significant changes during the last decades. While generally leading to more sensitive and reproducible methods, these changes also had considerable impact on absolute concentrations measured. This must be reflected by updated decision limits, cut-offs and reference intervals. Since different commercially available assays do not agree very well, method specific interpretation of GH and IGF-I concentrations is required. This complexity in the interpretation of hormone concentrations is not always appropriately reflected in laboratory reports, but also not in clinical guidelines reporting decision limits not related to a specific analytical method. The present review provides an overview about methodological and biological variables affecting the biochemical assessment of acromegaly in diagnosis and follow up.
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Metadata
Title
Biochemical investigations in diagnosis and follow up of acromegaly
Authors
Katharina Schilbach
Christian J. Strasburger
Martin Bidlingmaier
Publication date
01-02-2017
Publisher
Springer US
Published in
Pituitary / Issue 1/2017
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-017-0792-z

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