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Insulin‐like growth factor‐1, growth hormone and disease outcomes in acromegaly: A population study
Author(s) -
Thomas Melissa,
Berni Ellen,
JenkinsJones Sara,
Wensley Sarah,
Poole Chris D.,
Currie Craig J.,
Brownrigg Jack,
Ayuk John,
Rees D. Aled
Publication year - 2021
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.14468
Subject(s) - mace , medicine , acromegaly , hazard ratio , endocrinology , population , clinical endpoint , proportional hazards model , confidence interval , cohort , insulin like growth factor , cohort study , hormone , growth hormone , growth factor , myocardial infarction , clinical trial , environmental health , conventional pci , receptor
Context A lack of consensus remains about the relative importance of insulin‐like growth factor‐1 (IGF‐1) and growth hormone (GH) in predicting adverse outcomes in patients with acromegaly. Objective To describe the differing association between IGF‐1 and GH and major disease outcomes in acromegaly. Design Retrospective cohort study. Patients United Kingdom National Health Service patients with acromegaly who had an IGF‐1 and/or a GH measurement recorded following diagnosis, prior to December 2019. Measurements A composite endpoint including all‐cause mortality (ACM), type 2 diabetes (DM), major adverse cardiovascular events (MACE) or cancer was the primary outcome. These outcomes were also analysed individually. Follow‐up period was capped at 5 years. Results A maximum of 417 cases and 332 cases were eligible for the IGF‐1 and GH analyses, respectively, comprising 1041.5 and 938.9 years of follow‐up. There was a direct association between increased IGF‐1 concentration and adjusted event risk for the composite endpoint (hazard ratio [HR] = 1.2; 95% confidence interval [CI] = 1.02‐1.5); in GH, the HR was 1.1 (1.0‐1.2). For the individual endpoints in relation to IGF‐1 level, the HRs were ACM (1.2; 0.93‐1.5), MACE (1.2; 0.64‐2.1), DM (1.53; 1.09‐2.2) and cancer (1.3; 0.95‐1.7). For GH, the HRs were ACM (1.1; 0.97‐1.2), MACE (0.99; 0.73‐1.3), DM (1.1; 0.99‐1.2) and cancer (0.90; 0.66‐1.2). Conclusions In this contemporary data set with extended follow‐up, IGF‐1 and GH concentrations showed an association with major adverse outcomes from acromegaly.