Grottoli S, Razzore P, Gaia D, Gasperi M, Giusti M, Colao A, Ciccarelli E, Gasco V, Martino E, Ghigo E, Camanni F
Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Turin, Turin, Italy.
J Endocrinol Invest. 2003 Feb;26(2):123-7. doi: 10.1007/BF03345139.
The diagnosis of acromegaly, in an appropriate clinical context, usually relies on lack of GH suppression below 1 microg/l during OGTT coupled with elevated IGF-I levels. On the other hand, in normal subjects glucose-induced inhibition of GH secretory bursts without any further decrease of interpulse GH levels had already been shown. Based on the foregoing, we aimed to compare the diagnostic reliability of OGTT-induced GH nadir with that recorded during 3-h spontaneous GH secretion. In 59 acromegalic patients (17 male and 42 female, age, mean +/- SE 51.5 +/- 1.9, range 21-76 yr) and in 82 normal subjects (43 male and 39 female, age, mean +/- SE 35.7 +/- 1.5, range 15-72 yr) GH secretion was evaluated every 30 min from 0 to 180 min during slow saline infusion or OGTT (75 g at 0 min). A nadir GH concentration below 1 microg/l was recorded in all normal subjects either during OGTT or saline infusion if GH secretion was evaluated over 180 min. In contrast in acromegalic patients a nadir GH concentration below 1 microg/l never occurred in both conditions. This study shows that a 3-h spontaneous GH profile is as reliable as OGTT in the diagnosis of active acromegaly.
在适当的临床背景下，肢端肥大症的诊断通常依赖于口服葡萄糖耐量试验（OGTT）期间生长激素（GH）抑制水平未降至1μg/L以下，同时伴有胰岛素样生长因子-I（IGF-I）水平升高。另一方面，在正常受试者中，已证实葡萄糖可抑制GH分泌脉冲，但脉冲间期GH水平无进一步下降。基于上述情况，我们旨在比较OGTT诱导的GH最低点与3小时自发性GH分泌记录的诊断可靠性。对59例肢端肥大症患者（男17例，女42例，年龄平均±标准误51.5±1.9岁，范围21 - 76岁）和82例正常受试者（男43例，女39例，年龄平均±标准误35.7±1.5岁，范围15 - 72岁）在缓慢输注生理盐水或OGTT（0分钟时给予75g葡萄糖）期间，每隔30分钟评估一次GH分泌，持续0至180分钟。如果对GH分泌进行180分钟以上的评估，在所有正常受试者的OGTT或生理盐水输注期间，均记录到GH最低点浓度低于1μg/L。相反，在肢端肥大症患者中，在这两种情况下均未出现GH最低点浓度低于1μg/L的情况。本研究表明，3小时自发性GH谱在诊断活动性肢端肥大症方面与OGTT一样可靠。
