Strasburger C J
Division of Clinical Endocrinology, Department of Medicine IV, Charité Universitätsmedizin Campus Mitte, Berlin, Germany.
J Endocrinol Invest. 2005;28(11 Suppl International):78-80.
There are several studies in the literature relating mortality in patients with acromegaly to GH levels either as random samples or as a mean of several spontaneous samples or GH nadir after oral glucose load. Fewer articles have been published until now on the relationship between IGF-I and mortality, with several of these studies reporting a clear association, while two databases did not find an association between mortality and IGF and have instead shown an interrelationship between mortality and GH levels. These latter studies report databases in which fewer individuals have been sampled for IGF-I than for GH. Moreover, reliable immunoassays for GH measurement have existed for almost 20 yr more than immunoassays for IGF-I. Since between-method results diverge for both GH and IGF-I, it appears desirable to have levels of both biochemical markers measured in the follow-up of acromegaly, preferably in a central laboratory setting. Only by this prospective effort, it will be possible in the future to evaluate the relative ability of IGF-I and GH in predicting the residual risk of patients with acromegaly in relation to mortality, but also to co-morbidities.
文献中有多项研究将肢端肥大症患者的死亡率与生长激素（GH）水平相关联，这些研究有的采用随机样本，有的采用多个自发样本的均值，还有的采用口服葡萄糖负荷后的GH最低点。迄今为止，关于胰岛素样生长因子-I（IGF-I）与死亡率之间关系的文章较少，其中一些研究报告了明确的关联，而两个数据库未发现死亡率与IGF之间存在关联，反而显示死亡率与GH水平之间存在相互关系。后一类研究报告的数据库中，对IGF-I进行采样的个体比GH少。此外，可靠的GH测量免疫测定法比IGF-I免疫测定法早存在近20年。由于GH和IGF-I的不同方法测量结果存在差异，在肢端肥大症的随访中，最好在中央实验室环境中测量这两种生化标志物的水平。只有通过这种前瞻性的努力，未来才有可能评估IGF-I和GH在预测肢端肥大症患者相对于死亡率以及合并症的残余风险方面的相对能力。
