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Postoperative plasma GH levels and restoration of GH dynamics in acromegalic patients surgically treated by the transsphenoidal approach.

Abstract：

:In 44 patients with acromegaly treated by transsphenoidal pituitary microsurgery, the relationship between changes in pre- and post-operative GH dynamics and postoperative fasting plasma GH levels was examined to clarify which is the optimal approach for evaluating postoperative removal of the tumour. TRH, LHRH and bromocriptine tests, which act directly on the pituitary somatotroph, and the oral glucose tolerance test (oGTT) and insulin tolerance test (ITT), which act via hypothalamus, were carried out pre- and post-operatively. Abnormal responses postoperatively were found in most patients with fasting postoperative plasma GH over 5 ng/ml. In 24 patients with postoperative fasting plasma GH level of 5 ng/ml or below, 7 of 17 (41%) showed abnormal responses in the TRH test, 2 of 5 (40%) in the LHRH test and 3 of 13 (23%) patients in the bromocriptine test. All patients with a fasting plasma GH level less than 10 ng/ml, except for those with panhypopituitarism, showed normal responses to ITT and the paradoxical increases with the oGTT were absent. These results indicate that abnormal responses caused by a direct action on adenoma cells do not necessarily disappear even when the fasting plasma GH level is below 5 ng/ml. Abnormal responses caused by indirect actions, through the hypothalamus, disappear when the level is less than 10 ng/ml.

journal_name

Clin Endocrinol (Oxf)

journal_title

Clinical endocrinology

authors

Karashima T,Kato K,Nawata H,Ikuyama S,Ibayashi H,Nakagaki H,Kitamura K

doi

10.1111/j.1365-2265.1986.tb01677.x

subject

Has Abstract

pub_date

1986-08-01 00:00:00

pages

157-63

issue

2

eissn

0300-0664

issn

1365-2265

journal_volume

25

pub_type

杂志文章

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