Premium
Elevated insulin‐like growth factor‐1 in Cushing’s disease
Author(s) -
English Katherine,
Chikani Viral,
Dimeski Goce,
Inder Warrick J.
Publication year - 2019
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13974
Subject(s) - medicine , cushing's disease , endocrinology , acromegaly , insulin like growth factor , endocrine system , adenoma , pituitary adenoma , body mass index , endocrine disease , case control study , hormone , cushing syndrome , growth factor , growth hormone , gastroenterology , disease , receptor
Summary Objective To determine if patients with untreated Cushing's disease have higher serum insulin‐like growth factor‐1 (IGF‐1) compared to matched controls, and if IGF‐1 decreases following remission of Cushing's disease. Design Retrospective case‐control study matching Cushing's disease cases to control patients for adenoma size, age, sex, diabetic and gonadal status, body mass index and serum IGF‐1 measured within one year. Paired analysis of pre‐operative (untreated) and >3 months post‐operative (remission) serum IGF‐1 for cases. Patients and measurements All patients were investigated at the Princess Alexandra Hospital Endocrine Unit between 2005 and 2017. Serum IGF‐1 was measured in 25 cases and 49 controls, 23 case‐control pairs and 13 cases pre‐ and post‐operatively. Results Mean serum IGF‐1 in cases was significantly higher compared to controls—32 ± 12 nmol/L compared to 25 ± 8 nmol/L, ( P = 0.005). The proportion of cases with elevated serum IGF‐1 above an age‐adjusted reference range was higher compared to 1:1 matched controls (8/23 (35%) vs 1/23 (4%), P = 0.02). In 13 cases in remission post‐operatively, serum IGF‐1 decreased significantly from 31 (IQR 29‐40.5) nmol/L to 23 (IQR 15‐28.5) nmol/L, ( P < 0.001), despite no difference in the prevalence of pre‐ vs post‐operative pituitary hormone dysfunction ( P = 0.47). Conclusion Patients with untreated Cushing's disease may have elevated IGF‐1, which decreases following remission. Mildly elevated IGF‐1 in Cushing's disease does not imply pathological growth hormone (GH) excess.