Sakhnova E E, Przhiyalkovskaya E G, Belaya Zh E, Melnichenko G A
Endocrinology Research Centre.
Probl Endokrinol (Mosk). 2021 Dec 17;68(1):40-48. doi: 10.14341/probl12791.
Acromegaly is a rare endocrine disorder associated with multiple complications and increased mortality. Timely diagnosis and adequate treatment can bring the life expectancy of patients with acromegaly closer to the general population level. The tests for the diagnosis of acromegaly are measurement of both serum GH, and GH after oral glucose administration; serum insulin-like growth factor-1 (IGF-1). However, in clinical practice, up to 39% of patients with discordant results are found. The patients with discordant GH and IGF-1levels, are the most difficult to manage. This review discusses the prevalence of discordant GH and IGF-1 outcomes in patients with acromegaly; factors causing this discrepancy; the impact of hormone levels on treatment outcomes. Although endocrinologists are used to dealing with this discrepancy in clinical practice for many years, discordant patients'outcome remains uncertain and undefined The optimal treatment should be individually tailored for each patient, taking into account all clinical parameters.
肢端肥大症是一种罕见的内分泌疾病，伴有多种并发症且死亡率增加。及时诊断和充分治疗可使肢端肥大症患者的预期寿命更接近普通人群水平。诊断肢端肥大症的检查包括测定血清生长激素（GH）以及口服葡萄糖后的GH，还有血清胰岛素样生长因子-1（IGF-1）。然而，在临床实践中，发现高达39%的患者结果不一致。生长激素和胰岛素样生长因子-1水平不一致的患者最难管理。本综述讨论了肢端肥大症患者生长激素和胰岛素样生长因子-1结果不一致的发生率；导致这种差异的因素；激素水平对治疗结果的影响。尽管内分泌学家多年来在临床实践中习惯了处理这种差异，但结果不一致的患者情况仍不确定且不明确。最佳治疗应根据每个患者的所有临床参数进行个体化定制。
