Long-term monitoring of insulin-like growth factor I in adult growth hormone deficiency: a critical appraisal.

• Serum insulin-like growth factor I (IGF-I) levels predominantly reflect the hepatic effect of growth hormone (GH). Compared with serum GH levels, which reflect pulsatile GH secretion, serum IGF-I levels exhibit no major diurnal variation and thus provide a better estimate of integrated GH secretion in an individual patient. Measurement of serum IGF-I levels allows reliable identification of states of GH excess. In contrast, in a large proportion of adults with severe GH deficiency, serum IGF-I levels are within the normal range. Serum IGF-I levels increase markedly in response to GH administration and are often used as a surrogate variable for overall responsiveness to such treatment. Current data, however, suggest a poor relationship between changes in or levels of IGF-I and efficacy variables such as body composition, muscle function and well-being. The use of serum IGF-I as a guide during dose titration in the initial phase of treatment and during long-term monitoring of GH replacement therapy in adults, and its use as a safety marker or predictor of future morbidity and mortality are discussed here.

Nyckelord

Acromegaly

complications

Adult

Age of Onset

Carrier Proteins

blood

Female

Glycoproteins

blood

Human Growth Hormone

deficiency

therapeutic use

Humans

Insulin-Like Growth Factor Binding Protein 3

blood

Insulin-Like Growth Factor I

analysis

Male

Middle Aged

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)