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First but not second postoperative day growth hormone assessments as early predictive tests for long-term acromegaly persistence
PURPOSE: Postoperative assessment of acromegaly activity is typically performed at least 3 months after neurosurgery (NS). Few studies have evaluated the use of early postoperative growth hormone (GH) levels as a test to predict short- and long-term remission of acromegaly. Our objective was to eval...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8502138/ https://www.ncbi.nlm.nih.gov/pubmed/33837920 http://dx.doi.org/10.1007/s40618-021-01553-0 |
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author | Cambria, V. Beccuti, G. Prencipe, N. Penner, F. Gasco, V. Gatti, F. Romanisio, M. Caputo, M. Ghigo, E. Zenga, F. Grottoli, S. |
author_facet | Cambria, V. Beccuti, G. Prencipe, N. Penner, F. Gasco, V. Gatti, F. Romanisio, M. Caputo, M. Ghigo, E. Zenga, F. Grottoli, S. |
author_sort | Cambria, V. |
collection | PubMed |
description | PURPOSE: Postoperative assessment of acromegaly activity is typically performed at least 3 months after neurosurgery (NS). Few studies have evaluated the use of early postoperative growth hormone (GH) levels as a test to predict short- and long-term remission of acromegaly. Our objective was to evaluate the diagnostic performance of serum random GH on a postoperative day one (D1-rGH) and two (D2-rGH), particularly in predicting long-term disease persistence. MATERIALS AND METHODS: Forty-one subjects with acromegaly who were undergoing NS were enrolled (mean age ± SD 47.4 ± 13.1 years at diagnosis; women 54%; macroadenomas 71%). The final assessment of disease activity was performed one year after NS. ROC curves were used to evaluate the diagnostic performance of D1-rGH and D2-rGH. RESULTS: After a 1-year follow-up, the overall remission rate was 55%. ROC analysis identified an optimal D1-rGH cut-off value of 2.1 ng/mL for diagnosing long-term disease persistence (55.6% SE; 90.9% SP). The cut-off point became 2.5 ng/mL after maximizing specificity for disease persistence (yielding a 100% positive predictive value) and 0.3 ng/mL after maximizing sensitivity for disease remission. The optimal D2-rGH cut-off value was 0.6 ng/mL (81.8% SE; 50% SP); the cut-off point became 2.9 ng/mL after maximizing specificity and 0.1 ng/mL after maximizing sensitivity, with no clinical utility. CONCLUSIONS: D1-rGH could be a highly specific test for the early diagnosis of long-term acromegaly persistence, which is predicted by a value > 2.5 ng/mL with a great degree of certainty. The diagnostic performance of D2-rGH was insufficient. Further research is required to validate these preliminary results prior to modifying the postoperative management of acromegaly. |
format | Online Article Text |
id | pubmed-8502138 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-85021382021-10-22 First but not second postoperative day growth hormone assessments as early predictive tests for long-term acromegaly persistence Cambria, V. Beccuti, G. Prencipe, N. Penner, F. Gasco, V. Gatti, F. Romanisio, M. Caputo, M. Ghigo, E. Zenga, F. Grottoli, S. J Endocrinol Invest Original Article PURPOSE: Postoperative assessment of acromegaly activity is typically performed at least 3 months after neurosurgery (NS). Few studies have evaluated the use of early postoperative growth hormone (GH) levels as a test to predict short- and long-term remission of acromegaly. Our objective was to evaluate the diagnostic performance of serum random GH on a postoperative day one (D1-rGH) and two (D2-rGH), particularly in predicting long-term disease persistence. MATERIALS AND METHODS: Forty-one subjects with acromegaly who were undergoing NS were enrolled (mean age ± SD 47.4 ± 13.1 years at diagnosis; women 54%; macroadenomas 71%). The final assessment of disease activity was performed one year after NS. ROC curves were used to evaluate the diagnostic performance of D1-rGH and D2-rGH. RESULTS: After a 1-year follow-up, the overall remission rate was 55%. ROC analysis identified an optimal D1-rGH cut-off value of 2.1 ng/mL for diagnosing long-term disease persistence (55.6% SE; 90.9% SP). The cut-off point became 2.5 ng/mL after maximizing specificity for disease persistence (yielding a 100% positive predictive value) and 0.3 ng/mL after maximizing sensitivity for disease remission. The optimal D2-rGH cut-off value was 0.6 ng/mL (81.8% SE; 50% SP); the cut-off point became 2.9 ng/mL after maximizing specificity and 0.1 ng/mL after maximizing sensitivity, with no clinical utility. CONCLUSIONS: D1-rGH could be a highly specific test for the early diagnosis of long-term acromegaly persistence, which is predicted by a value > 2.5 ng/mL with a great degree of certainty. The diagnostic performance of D2-rGH was insufficient. Further research is required to validate these preliminary results prior to modifying the postoperative management of acromegaly. Springer International Publishing 2021-04-10 2021 /pmc/articles/PMC8502138/ /pubmed/33837920 http://dx.doi.org/10.1007/s40618-021-01553-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Cambria, V. Beccuti, G. Prencipe, N. Penner, F. Gasco, V. Gatti, F. Romanisio, M. Caputo, M. Ghigo, E. Zenga, F. Grottoli, S. First but not second postoperative day growth hormone assessments as early predictive tests for long-term acromegaly persistence |
title | First but not second postoperative day growth hormone assessments as early predictive tests for long-term acromegaly persistence |
title_full | First but not second postoperative day growth hormone assessments as early predictive tests for long-term acromegaly persistence |
title_fullStr | First but not second postoperative day growth hormone assessments as early predictive tests for long-term acromegaly persistence |
title_full_unstemmed | First but not second postoperative day growth hormone assessments as early predictive tests for long-term acromegaly persistence |
title_short | First but not second postoperative day growth hormone assessments as early predictive tests for long-term acromegaly persistence |
title_sort | first but not second postoperative day growth hormone assessments as early predictive tests for long-term acromegaly persistence |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8502138/ https://www.ncbi.nlm.nih.gov/pubmed/33837920 http://dx.doi.org/10.1007/s40618-021-01553-0 |
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