discussion-presentation83

                        Acromegaly ???

                             Fatemeh Rahmani

Elevated IGF-1 with GH suppression after an oral glucose overload: incipient acromegaly ??


●Epidemiology of acromegaly (then and now )
●Discrepancies in GH /IGF1 levels
●Clinicaly silent somatotropin adenoma
●Micromegaly with apparent normal GH secration
●Utility of OGTT in Acromegaly

Over the years ,diagnostic criteria for acromegaly have changed dramatically, and the numbers of patients diagnosed with this disease have increased in parallel

Older studies have estimated an incidence of about 3–4 cases per million patient -years ,but the newest data found it to be 11cases per million patient-years

●in 1926, 62 % of acromegalic patients  had visual disturbances
●in 1975, the presence of visual field deficiets decreased to 27 %
●in 1996, it further dropped to 15.4 %
●in 2006, it decreased to only 5.2 %

Discrepancies in GH /IGF-1 levels

●sampling of GH /IGF-1
●Lack of assay standardization
●Hormone half life
●Pulsatility
●Age
●Gender
●Genetic differences
●Co-morbidity