scholarly journals Effect of Sex and Assay Method on Serum Concentrations of Growth Hormone in Patients with Acromegaly and in Healthy Controls

2006 ◽  
Vol 52 (3) ◽  
pp. 468-473 ◽  
Author(s):  
Helene Markkanen ◽  
Tuula Pekkarinen ◽  
Matti J Välimäki ◽  
Henrik Alfthan ◽  
Ritva Kauppinen-Mäkelin ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Tolerance Test ◽  
Reference Intervals ◽  
Assay Method ◽  
Specific Reference ◽  
Oral Glucose ◽  
Serum Samples ◽  
Serum Growth Hormone ◽  
The Difference

Abstract Background: Diagnosis and follow-up of acromegaly is based on measurements of serum growth hormone (GH) concentrations during an oral glucose tolerance test (OGTT). A nadir value <1 μg/L is commonly used to define a normal response, but some authors suggest lower cutoff values. Methods: To compare the results and subsequent patient classification obtained with 3 GH assays, we obtained basal serum samples from 78 apparently healthy adult controls (43 women and 35 men; median age, 32.5 years) and from 71 treated (44 women and 27 men; median age, 55.2 years) and 7 untreated acromegaly patients (4 women and 3 men; median age, 54.6 years), and OGTT was performed on all patients and on 72 of the 78 controls. GH was determined by 2 immunometric assays—a double monoclonal (AutoDELFIA; Wallac) and a monopolyclonal (Immulite 2000; DPC) assay—and in a limited set of samples by an RIA (Spectria RIA; Orion). Results: There was a strong correlation (r = 0.995; P <0.001) between the 2 immunometric methods, but the results obtained with the Immulite 2000 were, on average, 1.4-fold higher than those obtained with the AutoDELFIA. At concentrations around the cutoff (1 μg/L), however, the difference was ∼2-fold. Overall, the Orion RIA method also showed a good correlation (r = 0.951–0.959) with the other methods, but it did not measure concentrations <2 μg/L. Women had higher basal and OGTT nadir GH concentrations than men. Conclusion: Reference intervals should be determined separately for each method, and the need for establishing sex-specific reference values should be investigated.

scholarly journals Growth hormone after oral glucose overload: revision of reference values in normal subjects

2008 ◽  
Vol 52 (7) ◽  
pp. 1139-1144 ◽  
Author(s):  
Pedro W. S. Rosário ◽  
Mariana S. Furtado
Keyword(s):  
Growth Hormone ◽  
Reference Values ◽  
Glucose Tolerance Test ◽  
Normal Subjects ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Serum Samples ◽  
Gh Secretion ◽  
Test Repetition ◽  
Apparently Healthy

The evaluation of growth hormone (GH) secretion continues to be important in acromegaly and the nadir GH (n-GH) level in the oral glucose tolerance test (OGTT) is the gold standard for the demonstration of secretory autonomy of this hormone. n-GH levels < 1 µg/L are defined as normal suppression but, using current assays, n-GH < 1 µg/L is detected in patients with untreated acromegaly and this value seems to be much lower in normal subjects. The objective of the present study was to evaluate n-GH levels in the OGTT in normal subjects using three different assays (GH ICMA Immulite; GH IRMA DSL and GH IFMA AutoDelfia). Two-hundred apparently healthy subjects (120 women) ranging in age from 18 to 70 years and with a BMI > 18.5 and < 27 kg/m², who used no medications and presented normal glycemia, blood count, albumin, creatinine, TSH, SGOT, SGPT and bilirubin were studied. Serum samples were obtained before and 30,60,90 and 120 min after oral administration of 75 g glucose. The test was repeated after 4 weeks in 157 participants, with the same protocol being used in 79 and 78 receiving an overload of 100 g glucose. n-GH cut-off values (97.5th percentile) were higher in women than in men (GH-IFMA: 0.30 versus 0.11 µg/L; GH-ICMA: 0.60 versus 0.25 µg/L; GH-IRMA: 0.20 versus 0.10 µg/L, respectively). No correlation was observed between n-GH and age or BMI. A difference was only observed when comparing women < 35 years (n = 40) versus > 35 years (n = 80), with higher values in the former (n-GH cut-off in this subgroup: GH-IFMA 0.40 versus 0.26 µg/L, GH-ICMA 0.74 versus 0.50 µg/L, GH-IRMA 0.25 versus 0.15 µg/L). A good correlation was observed between the assays (r = 0.9-0.96), however, the highest values were always obtained with the Immulite assay. Test repetition with 75 g oral glucose showed a variation in n-GH < 10.2% (GH-IFMA), < 13.4% (GH-ICMA) and < 11% (GH-IRMA) in 95% of the subjects. This variation was similar when the test was repeated with 100 g glucose. A good correlation was observed between n-GH in the first and second test (r = 0.83-0.92). We suggest the following n-GH reference values: for men, 0.14 µg/L for the GH IRMA DSL and GH IFMA AutoDelfia kits and 0.25 µg/L for the GH ICMA Immulite kit; for women, 0.25 µg/L, 0.40 µg/L and 0.70 µg/L, respectively.

SERUM GROWTH HORMONE RESPONSF TO BROMOCRIPTINE DURING A GLUCOSE TOLERANCE TEST IN ACROMEGALY

1976 ◽  
Vol 82 (1) ◽  
pp. 39-46 ◽  
Author(s):  
J. Cassar ◽  
K. Mashiter ◽  
G. Sullivan ◽  
G. F. Joplin
Keyword(s):  
Growth Hormone ◽  
Glucose Tolerance ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Term Treatment ◽  
Distinct Pattern ◽  
Oral Glucose ◽  
Serum Growth Hormone ◽  
Long Term Treatment

ABSTRACT Serum growth hormone was assayed in eighteen acromegalic patients during an oral glucose tolerance test with and without 2.5 mg bromocriptine. The serum growth hormone levels during the glucose tolerance test with bromocriptine, although significantly lower at two sampling times, do not show any distinct pattern. We conclude that such an acute test will not distinguish the patient who might respond to long term treatment with bromocriptine.

THE EFFECT OF THE PROGESTOGEN ETHYNODIOL DIACETATE ON GLUCOSE, INSULIN, AND GROWTH HORMONE AFTER SIX MONTHS TREATMENT

1972 ◽  
Vol 70 (2) ◽  
pp. 373-384 ◽  
Author(s):  
W. N. Spellacy ◽  
W. C. Buhi ◽  
S. A. Birk
Keyword(s):  
Growth Hormone ◽  
Blood Glucose ◽  
Plasma Insulin ◽  
Tolerance Test ◽  
Metabolic Effects ◽  
Oral Glucose ◽  
Hormone Levels ◽  
Glucose Levels ◽  
Ethynodiol Diacetate ◽  
Tolerance Curve

ABSTRACT Seventy-one women were treated with a daily dose of 0.25 mg of the progestogen ethynodiol diacetate. They were all tested with a three-hour oral glucose tolerance test before beginning the steroid and then again during the sixth month of use. Measurements were made of blood glucose and plasma insulin and growth hormone levels. There was a significant elevation of the blood glucose levels after steroid treatment as well as a deterioration in the tolerance curve in 12.9% of the women. The plasma insulin values were also elevated after drug treatment whereas the fasting ambulatory growth hormone levels did not significantly change. There was a significant association between the changes in glucose and insulin levels and the subject's age, control weight, or weight gain during treatment. The importance of considering the metabolic effects of the progestogen component of oral contraceptives is stressed.

Gestational diabetes mellitus: are mothers being followed-up? A retrospective study

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697469
Author(s):  
Rebecca Ward ◽  
Fahmy W Hanna ◽  
Ann Shelley-Hitchen ◽  
Ellen Hodgson ◽  
Adrian Heald ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Median Time ◽  
Post Partum ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Tertiary Referral Centre ◽  
Alternative Approach ◽  
Nice Guidance ◽  
History Of

BackgroundWomen with gestational diabetes (GDM) have an elevated risk of developing type 2 diabetes (T2DM). NICE Guidance recommends women who develop GDM are screened 6 weeks post-partum and annually thereafter.AimTo evaluate conformity to guidance of screening in women with GDM by 6-week post-partum fasting plasma glucose (FPG) and annual FPG and determine time between delivery and development of T2DM.MethodRecords at a tertiary referral centre were used to identify women (n = 54) diagnosed with GDM by antenatal oral glucose tolerance test between July 1999 and January 2007. Data from laboratory records were used to collect investigations of glycaemic status during the follow-up period (median follow-up 12.4 years, range 9.5–17.1 years).ResultsOf 252 women, 102 (40.2%) did not have a FPG at 6 weeks (+/−2 weeks). Of these, median time to first test was 1.2 years (range 0.04–10.8 years), with only 43.1% followed-up within 1 year. In those who had a 6-week FPG, 17 (11.3%) women had no further tests. A total of 84 (33% of those with gestational diabetes in the index pregnancy) women were diagnosed with T2DM; median time from delivery to diagnosis was 5.2 years (range 0.35–15.95). We found the only significant factor for a follow-up test at 1-year post-partum was the use of insulin.ConclusionOur data suggest an alternative approach is needed for monitoring women with a history of GDM. This needs to be appropriate for a generally healthy group in which traditional screening mechanisms may not be adequate or sufficient.

EXPRESS: Method dependent variation in TSH and FT4 reference intervals in pregnancy: a systematic review

2021 ◽  
pp. 000456322110269
Author(s):  
O E Okosieme ◽  
Medha Agrawal ◽  
Danyal Usman ◽  
Carol Evans
Keyword(s):  
Systematic Review ◽  
Reference Interval ◽  
First Trimester ◽  
Reference Intervals ◽  
Assay Method ◽  
Specific Reference ◽  
Upper Limits ◽  
Wide Range ◽  
Assay Methods ◽  
In Pregnancy

Background: Gestational TSH and FT4 reference intervals may differ according to assay method but the extent of variation is unclear and has not been systematically evaluated. We conducted a systematic review of published studies on TSH and FT4 reference intervals in pregnancy. Our aim was to quantify method-related differences in gestation reference intervals, across four commonly used assay methods, Abbott, Beckman, Roche, and Siemens. Methods: We searched the literature for relevant studies, published between January 2000 and December 2020, in healthy pregnant women without thyroid antibodies or disease. For each study, we extracted trimester-specific reference intervals (2.5–97.5 percentiles) for TSH and FT4 as well as the manufacturer provided reference interval for the corresponding non-pregnant population. Results: TSH reference intervals showed a wide range of study-to-study differences with upper limits ranging from 2.33 to 8.30 mU/L. FT4 lower limits ranged from 4.40–13.93 pmol/L, with consistently lower reference intervals observed with the Beckman method. Differences between non-pregnant and first trimester reference intervals were highly variable, and for most studies the TSH upper limit in the first trimester could not be predicted or extrapolated from non-pregnant values. Conclusions: Our study confirms significant intra and inter-method disparities in gestational thyroid hormone reference intervals. The relationship between pregnant and non-pregnant values is inconsistent and does not support the existing practice in some laboratories of extrapolating gestation references from non-pregnant values. Laboratories should invest in deriving method-specific gestation reference intervals for their population.

scholarly journals Years of potential life lost in pre-diabetes and diabetes mellitus: data from a 40-year follow-up of the Israel study on Glucose intolerance, Obesity and Hypertension

2021 ◽  
Vol 9 (1) ◽  
pp. e001981
Author(s):  
Micha Rapoport ◽  
Angela Chetrit ◽  
Dror Cantrell ◽  
Ilya Novikov ◽  
Jesse Roth ◽  
...  
Keyword(s):  
Glucose Intolerance ◽  
Lifestyle Modification ◽  
Smoking Status ◽  
Age Groups ◽  
Tolerance Test ◽  
High Risk Group ◽  
Oral Glucose ◽  
Average Difference ◽  
Using Data

IntroductionWe examined years of potential life lost (YPLL) associated with pre-diabetes as compared with either normoglycemia or diabetes, using data of the Israel cohort of Glucose intolerance, Obesity and Hypertension 40-year follow-up.Research design and methodsMen and women (N=2844, mean age 52.0±8.2 years) who underwent oral glucose tolerance test and anthropometric measurements, during 1976–1982, were followed for mortality until May 2019. Multiple imputation procedures for missing mortality dates and multivariable regression mixed models were applied.ResultsAt baseline, 35.8%, 48.8% and 15.4% individuals were found with normoglycemia, pre-diabetes, and diabetes, respectively. The average difference in YPLL associated with pre-diabetes as compared with normoglycemia was 4.3 years (95% CI 3.3 to 5.2; p<0.001). YPLL were 1 year higher in women with pre-diabetes than in men with pre-diabetes. These differences persisted mainly in individuals younger than 60 years, and those with body mass index (BMI) <25 kg/m2, at baseline. Adjusting for age, sex, country of origin, smoking status, BMI, and blood pressure, the average difference in YPLL associated with pre-diabetes as compared with normoglycemia was 2.0 years (95% CI 1.2 to 2.8; p<0.001). Significant reductions of 5.9 years (95% CI 4.8 to 7.0) on average were observed for diabetes as compared with pre-diabetes and 7.9 years (95% CI 6.7 to 9.1) as compared with individuals with normoglycemia.ConclusionsThis study reveals that life expectancy of middle-aged individuals with pre-diabetes is shorter than of normoglycemic ones. These findings are especially relevant in view of the rising worldwide prevalence of pre-diabetes within younger age groups and underscore the crucial importance of interventions by either lifestyle modification or drug therapy capable of delaying progression from pre-diabetes to diabetes to reduce the YPLL in this high-risk group.

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