Affiliation:
1. 1Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
2. 2Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
3. 3Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
Abstract
Objective
Growth hormone (GH) nadir (GHnadir) during oral glucose tolerance test (OGTT) is an important tool in diagnosing acromegaly, but data evaluating the need to adjust cut-offs to biological variables utilizing today's assay methods are scarce. We therefore investigated large cohorts of healthy subjects of both sexes to define normal GHnadir concentrations for a modern, sensitive, 22 kD-GH-specific assay.
Design
Multicenter study with prospective and retrospective cohorts (525 healthy adults: 405 females and 120 males).
Methods
GH concentrations were measured by the IDS-iSYS immunoassay after oral application of 75 g glucose.
Results
GHnadir concentrations (µg/L) were significantly higher in lean and normal weight subjects (group A) compared to overweight and obese subjects (group B); (males (M): A vs B, mean: 0.124 vs 0.065, P = 0.0317; premenopausal females without estradiol-containing OC (OC-EE) (FPRE): A vs B, mean: 0.179 vs 0.092, P < 0.0001; postmenopausal women (FPOST): A vs B, mean: 0.173 vs 0.078, P < 0.0061). Age, glucose metabolism and menstrual cycle had no impact on GHnadir. However, premenopausal females on OC-EE (FPREOC) exhibited significantly higher GHnadir compared to all other groups (all P < 0.0001). BMI had no impact on GHnadir in FPREOC (A vs B, mean: 0.624 vs 0.274, P = 0.1228).
Conclusions
BMI, sex and OC-EE intake are the major determinants for the GHnadir during OGTT in healthy adults. Using a modern sensitive GH assay, GHnadir concentrations in healthy subjects are distinctly lower than cut-offs used in previous guidelines for diagnosis and monitoring of acromegaly.
Subject
Endocrinology,General Medicine,Endocrinology, Diabetes and Metabolism
Cited by
39 articles.
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