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Nathan Goodyear

Insulin-like growth factor-I, its binding proteins (IGFBP-1 and IGFBP-3), and growth ho... - 0 views

erc.endocrinology-journals.org/...583.long

HGH GH IGF-1 IGFBP-1 IGFBP-3 breast cancer premenopause premenopausal women Nurses Health Study Nurses Health Study II

shared by Nathan Goodyear on 06 Jul 12 - No Cached
  • Nathan Goodyear on 06 Jul 12
     
    GH, IGF-1, IGFBP-1, and IGFBP-3 were not found to be associated with increased risk of breast cancer in premenopuasal women.
Nathan Goodyear

Reproducibility of Plasma Steroid Hormones, Prolactin, and Insulin-like Growth Factor L... - 0 views

cebp.aacrjournals.org/...972.long

hormone hormones androgens Testosterone DHEAS IGF-1 prolactin IGFBP-3 women female

shared by Nathan Goodyear on 21 Mar 14 - No Cached
  • Nathan Goodyear on 21 Mar 14
     
    Very interesting study finds that a single value assessment of androgens, DHEAS, prolactin, IGF-1 and IGFBP-3 can be used to assess 3 year average in pre-menopause women.  Estrogen and progesterone need to be assessed through the cycle.
Nathan Goodyear

Which Patients Do Not Require a GH Stimulation Test for the Diagnosis of Adult GH Defic... - 0 views

press.endocrine.org/...jcem.87.2.8216

HGH GH human growth hormone growth hormone IGF-1

shared by Nathan Goodyear on 04 Nov 14 - No Cached
  • Four studies have reported that the probability of GHD (peak GH criteria ranging from < 2.3 to < 5 μg/liter) in patients with three to four PHDs ranges from 91% to 100%
  • 95% accuracy by the presence of either three or more PHDs or a serum IGF-I concentration less than 84 μg/lite
  • adult GHD could be predicted with 95% accuracy by the presence of either three or four PHDs or a serum IGF-I concentration less than 84 μg/liter
  • ...5 more annotations...
  • Hypopituitary adults with GHD have been reported to have normal serum IGF-I levels in 37–70% of patients in various studies (5, 9, 18, 21, 22). This is owing in part to the fact that multiple factors regulate serum IGF-I concentrations including nutritional status; hepatic and renal function; and circulating concentrations of thyroid hormone, androgens, and estrogens
  • changes in concentrations of IGF-binding proteins (IGFBPs) influence the total concentration of IGF-I in plasma
  • Among patients with an IGF-I sd score above −1 in the present study, 46% had a peak GH less than 2.5 μg/liter and 67% had a peak GH less than 5 μg/liter.
  • In summary, adult GHD can be predicted with 95% accuracy by the presence of either three or four PHDs or a serum IGF-I concentration less than 84 μg/liter
  • We propose that adult patients with three or four PHDs (three or four of the following deficiencies: TSH, ACTH, gonadotropins [LH and/or FSH], and AVP [central diabetes insipidus]) do not require a GH stimulation test to make the diagnosis of adult GHD
  • Nathan Goodyear on 04 Nov 14
     
    Insulin Tolerance Test is the gold standard for HGH diagnosis, but this an unpopular test do to long list of side effects.  This study finds a 95% accuracy for IGF-1 less than 84 with 3 or more coexisting pituitary hormone deficiencies.
Nathan Goodyear

Diagnosing Growth Hormone Deficiency in Adults - 0 views

www.hindawi.com/...972617

HGH GH human growth hormone growth hormone IGF-1

shared by Nathan Goodyear on 04 Nov 14 - No Cached
  • it is clear that serum IGF-1 and or IGFBP-3 can be normal in patients with undisputed GHD
  • Various investigators have reported normal IGF-1 values in 37–70% of GH deficient adults
  • The co-administration of arginine and GHRH (the combined test) is a powerful stimulus for GH production and has gained increasing acceptance as a useful method of diagnosing GHD [34]. This test has been advocated as a suitable alternative to ITT
  • ...12 more annotations...
  • The glucagon stimulation test (GST) is a reliable, safe alternative to the ITT in the diagnosis of GHD
  • An intravenous infusion of arginine (0.5 g/kg body weight) together with an intravenous bolus of GHRH (1 mcg/kg body weight) is administered [30]. Serum samples for GH are then obtained every 15–30 minutes for two hours.
  • Obesity, particularly marked obesity, is associated with blunted GH secretion in response to provocative stimuli
  • It has also been suggested that that even mildly increased BMI (25–30 kg/m2) can result in diminished stimulated GH production in 13% of healthy subjects
  • Corneli et al. have defined BMI-specific cut-off points for diagnosing adult-onset GHD using GHRH + arginine—11.5 ng/mL for those with BMI < 25 kg/m2, 8.0 ng/mL for BMI 25–30 kg/m2, 4.2 ng/mL for those with BMI > 30 kg/m2
  • GH levels are higher during the luteal phase in comparison with the follicular phase of the cycle
  • Oral, in contrast to transdermal oestrogen, lowers IGF-1 levels and is associated with increased GH levels
  • Adequate pituitary replacement with thyroxine and hydrocortisone are needed for optimal GH production
  • one cannot rely on a low IGF-1 to diagnose GHD in women taking oral oestrogen preparations.
  • Numerous GH secretagogues are available with the insulin tolerance test being the gold standard and the glucagon stimulation test or the GHRH + arginine as acceptable alternatives
  • ain et al. found the GST to be at least as good as the ITT in provoking GH secretion
  • the GST is safe, with almost no contraindications, it causes nausea and sometimes vomiting in 15–20% of subjects
  • Nathan Goodyear on 04 Nov 14
     
    Nice, more recent analysis, of HGH testing.
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