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Probl Endokrinol (Mosk) ; 70(2): 4-10, 2023 Sep 18.
Artículo en Ruso | MEDLINE | ID: mdl-38796756

RESUMEN

BACKGROUND: Hyperprolactinemia accompanies growth hormone hypersecretion in approximately 25-39% of cases. There is a recommendation to determine the level of prolactin in clinical guidelines for diagnosis and treatment of acromegaly. However, there is no understanding of the necessity to investigate the IGF-1 level in patients with hyperprolactinemia and a pituitary adenoma. AIM: Determining the proportion of patients with hyperprolactinemia and pituitary adenoma, who were examined for IGF-1 levels, and identifying the proportion of patients with acromegaly among this cohort. MATERIALS AND METHODS: Between December 2019 and December 2022 a single-center observational single-stage single-sample uncontrolled study was conducted. At the first stage of the study, the proportion of patients with pituitary adenoma and hyperprolactinemia with studied IGF-1 levels was determined, according to medical records. At the second stage of the study, patients without known indicators of IGF-1 were determined. The concentration of growth hormone was studied during the oral glucose load in the case of increased IGF-1 levels. RESULTS: At the first stage, 105 patients were included in the study. The level of IGF-1 was determined in 41/105 (39%) cases. There were 22/41 (53.7%) cases in the subgroup with pituitary incidentalomas and 19/64 (29.7%) cases in the subgroup with hyperprolactinemia among them. At the second stage, the IGF-1 level was additionally determined in 53 patients with hyperprolactinemia and pituitary adenoma (total 94 patients). The level of IGF-1 was elevated in 11/94 patients, further acromegaly was confirmed in 3/94 patients (3.2%). CONCLUSION: In real clinical practice the level of IGF-1 is studied only in 39% of cases in patients with pituitary adenoma and hyperprolactinemia. The disease was detected in 3 cases (3.2%) out of 94 people with hyperprolactinemia and pituitary adenoma without clinical manifestations of acromegaly. We consider the study of IGF-1 levels justified as a screening for acromegaly in patients with hyperprolactinemia and pituitary adenoma.


Asunto(s)
Acromegalia , Hiperprolactinemia , Factor I del Crecimiento Similar a la Insulina , Neoplasias Hipofisarias , Humanos , Hiperprolactinemia/sangre , Hiperprolactinemia/diagnóstico , Femenino , Acromegalia/sangre , Acromegalia/diagnóstico , Acromegalia/complicaciones , Masculino , Neoplasias Hipofisarias/sangre , Neoplasias Hipofisarias/diagnóstico , Neoplasias Hipofisarias/complicaciones , Adulto , Factor I del Crecimiento Similar a la Insulina/análisis , Factor I del Crecimiento Similar a la Insulina/metabolismo , Persona de Mediana Edad , Adenoma/sangre , Adenoma/diagnóstico , Adenoma/complicaciones , Hormona de Crecimiento Humana/sangre
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