Usefulness of insulin-like growth factor binding protein-3 levels to determine acromegaly activity and effectiveness of transsphenoidal pituitary surgery

RESUMO

Background. Several series reported in the literature concerning the results of the treatment of acromegaly have difficult to evaluated because the indicators are inaccurate Methods. We investigated the usefulness of insulin. Like growth factor binding protein-3 (IGFBP) levels to determine disease activity after surgical treatment of acromegaly in 13 patients with confirmed somatotroph adenoma. Results. Before surgery, all 13 non-treated patients had levated serum levels of IGFBP-3 as well as total and free IGF-I. In addition, there was no overlap with the normal controls (p < 0.001). IGFBP-3 levels correlated significantly (0.91, p < 0.001) with GH suppressibility by glucose after surgery. Conclusions. These data confirm that IGFBP-3 is a better indicator of acromegalic activity than either total or free IGF-i. There was a high correlation with GH suppressibility by glucose after surgery; both free and total IGF-I could be considered sensitive markers only for diagnosis of active acromegaly but not for efficacy of surgery