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- Title
Insulin‐like growth factor‐1, growth hormone and disease outcomes in acromegaly: A population study.
- Authors
Thomas, Melissa; Berni, Ellen; Jenkins‐Jones, Sara; Wensley, Sarah; Poole, Chris D.; Currie, Craig J.; Brownrigg, Jack; Ayuk, John; Rees, D. Aled
- 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 data set with extended follow‐up, IGF‐1 and GH concentrations showed an association with major adverse outcomes from acromegaly.
- Subjects
UNITED Kingdom; GREAT Britain. National Health Service; SOMATOTROPIN; TYPE 2 diabetes; ACROMEGALY; SOMATOMEDIN C; MORTALITY; CARDIOVASCULAR diseases
- Publication
Clinical Endocrinology, 2021, Vol 95, Issue 1, p143
- ISSN
0300-0664
- Publication type
Article
- DOI
10.1111/cen.14468