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Insulin‐like growth factor‐1, growth hormone and disease outcomes in acromegaly: a population study

Thomas, Melissa, Berni, Ellen, Jenkins-Jones, Sara, Wensley, Sarah, Poole, Chris D., Currie, Craig J., Brownrigg, Jack, Ayuk, John and Rees, D. Aled 2021. Insulin‐like growth factor‐1, growth hormone and disease outcomes in acromegaly: a population study. Clinical Endocrinology 95 (1) , pp. 143-152. 10.1111/cen.14468

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Abstract

ContextA lack of consensus remains about the relative importance of insulin‐like growth factor‐1 (IGF‐1) and growth hormone (GH) in predicting adverse outcomes in patients with acromegaly.ObjectiveTo describe the differing association between IGF‐1 and GH and major disease outcomes in acromegaly.DesignRetrospective cohort study.PatientsUnited Kingdom National Health Service patients with acromegaly who had an IGF‐1 and/or a GH measurement recorded following diagnosis, prior to December 2019.MeasurementsA composite endpoint including all‐cause mortality (ACM), type 2 diabetes (DM), major adverse cardiovascular events (MACE) or cancer was the primary outcome. These outcomes were also analysed individually. Follow‐up period was capped at 5 years.ResultsA maximum of 417 cases and 332 cases were eligible for the IGF‐1 and GH analyses, respectively, comprising 1041.5 and 938.9 years of follow‐up. There was a direct association between increased IGF‐1 concentration and adjusted event risk for the composite endpoint (hazard ratio [HR]=1.2; 95% confidence interval [CI]=1.02–1.5); in GH, the HR was 1.1 (1.0–1.2). For the individual endpoints in relation to IGF‐1 level, the HRs were: ACM (1.2; 0.93–1.5), MACE (1.2; 0.64–2.1), DM (1.53; 1.09–2.2), and cancer (1.3; 0.95–1.7). For GH, the HRs were: ACM (1.1; 0.97–1.2), MACE (0.99; 0.73–1.3), DM (1.1; 0.99‐1.2), and cancer (0.90; 0.66–1.2).ConclusionsIn this contemporary dataset with extended follow‐up, IGF‐1 and GH concentrations showed an association with major adverse outcomes from acromegaly.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Neuroscience and Mental Health Research Institute (NMHRI)
Medicine
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Publisher: Wiley
ISSN: 0300-0664
Date of First Compliant Deposit: 24 March 2021
Date of Acceptance: 17 March 2021
Last Modified: 29 Apr 2022 06:51
URI: https://orca.cardiff.ac.uk/id/eprint/140080

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