GH levels higher for postmenopausal women vs. men with controlled acromegaly
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Among adults with controlled acromegaly, postmenopausal women had higher growth hormone levels than men despite similar insulin-like growth factor I levels, according to study data.
Jakob Dal, MD, senior registrar in the department of endocrinology and associate professor in the department of clinical medicine at Aalborg University Hospital in Denmark, and colleagues wrote that active acromegaly is subject to sex differences in GH and IGF‐I patterns, and clinical features, but whether this pertains to controlled disease as well remains unclear.
“Discordantly elevated GH levels with normalized IGF‐I in female patients across all age groups are reported,” the researchers wrote. “This could indicate that the relationship between GH and IGF‐I persists in postmenopausal females during treatment.”
For the cross-sectional, multicenter study, the researchers enrolled 84 patients (51.2% women) with acromegaly. Patients were deemed controlled after surgery alone (n = 23) or during continued somatostatin receptor ligand therapy (n = 61).
Researchers measured serum concentrations of GH, insulin, glucose and free fatty acids during an oral glucose tolerance test and performed a baseline serum IGF-I measurement. Patients completed two health-related quality of life questionnaires — Acromegaly Quality of Life Questionnaire (AcroQoL) and Patient‐Assessed Acromegaly Symptom Questionnaire (PASQ).
Overall, mean patient age was 57 years and most women were postmenopausal. Demographic and clinical variables were similar between men and women.
Women had significantly higher fasting GH but similar IGF‐I standard deviation scores compared with men. Researchers used a fasting GH of less than 1 µg/L as cutoff and determined that disease control was decreased among women (56% vs. 83%; P = .007), although a comparable rate was reported when using IGF‐I standard deviation scores less than 2 (women, 79% vs. men, 76%; P = .71).
Additionally, women had an impaired AcroQoL physical score (P = .05) and higher fasting free fatty acids (P = .03) and insulin concentrations during the OGTT (P = .04) compared with men.
“Postmenopausal female patients with acromegaly exhibit increased GH concentrations despite normalized IGF‐I levels,” researchers wrote. “Female sex was also associated with slightly impaired quality of health, higher free fatty acid levels despite higher insulin levels suggesting that disease‐specific sex differences prevailed after treatment. Our findings support the relevance of including GH measurements in the routine assessment of disease control in acromegaly.”
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