Reduced disorderliness of growth hormone release in biochemically inactive acromegaly after pituitary surgery

Gerrit Van Den Berg, Steven M. Pincus, Marijke Frölich, Johannes D Veldhuis, Ferdinand Roelfsema

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

The episodicity of 24 h GH release was studied in 18 patients with active acromegaly, 12 patients 7-10 days after pituitary surgery, 14 patients long after operation (3-17 years), and 21 healthy gender- and age-matched control subjects, using a recently introduced scale- and model-independent regularity statistic, approximate entropy (ApEn). Blood samples were taken at 10-min intervals for 24 h, and plasma GH concentrations were measured by immunofluorometric assay (detection limit 11.5 ng/l). For this study we selected operated patients who were biochemically in remission, defined by normal circulating IGF-I and insulin-like growth factor-binding protein-3 (IGFBP-3) concentrations, normal glucose-suppressed plasma GH concentration (<0.38 μg/l), and the normalization of the paradoxical rise of GH to TRH or GnRH. In patients with active acromegaly ApEn was 1.23 ± 0.04, with no overlap with the control subjects (P = 1.2 x 10-16), who had an ApEn of 0.40 ± 0.04. ApEn in patients shortly after surgery was 0.71 ± 0.09 (P < 0.001 vs controls), and long after surgery 0.56 ± 0.05 (P < 0.011 vs controls). ApEn values in treated and untreated patients correlated significantly with the plasma concentration of IGF-I (r = 0.531) and IGFBP-3 (r = 0.598), and the log-transformed 24 h GH secretion rate (r = 0.749). Shortly after surgery only one-third of the patients had a normal ApEn value, whereas long after surgery about 70% of the patients had a normal ApEn value. Although ApEn eventually normalized in about 70% of the operated patients, the cause of the persistence of abnormal GH release in the remainder of the subjects is not known, and might reflect permanent hypothalamic-pituitary dysfunction or a very early recurrence of the somatotroph adenoma.

Original languageEnglish (US)
Pages (from-to)164-169
Number of pages6
JournalEuropean Journal of Endocrinology
Volume138
Issue number2
DOIs
StatePublished - Feb 1998
Externally publishedYes

Fingerprint

Acromegaly
Growth Hormone
Entropy
Insulin-Like Growth Factor Binding Protein 3
Insulin-Like Growth Factor I
Growth Hormone-Secreting Pituitary Adenoma
Fluoroimmunoassay
Gonadotropin-Releasing Hormone
Limit of Detection
Glucose
Recurrence

ASJC Scopus subject areas

  • Endocrinology

Cite this

Reduced disorderliness of growth hormone release in biochemically inactive acromegaly after pituitary surgery. / Van Den Berg, Gerrit; Pincus, Steven M.; Frölich, Marijke; Veldhuis, Johannes D; Roelfsema, Ferdinand.

In: European Journal of Endocrinology, Vol. 138, No. 2, 02.1998, p. 164-169.

Research output: Contribution to journalArticle

Van Den Berg, Gerrit ; Pincus, Steven M. ; Frölich, Marijke ; Veldhuis, Johannes D ; Roelfsema, Ferdinand. / Reduced disorderliness of growth hormone release in biochemically inactive acromegaly after pituitary surgery. In: European Journal of Endocrinology. 1998 ; Vol. 138, No. 2. pp. 164-169.
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