{Reference Type}: Observational Study
{Title}: Paradoxical GH increase after oral glucose load in subjects with and without acromegaly.
{Author}: Ceccato F;Vedolin CK;Voltan G;Antonelli G;Barbot M;Basso D;Regazzo D;Scaroni C;Occhi G;
{Journal}: J Endocrinol Invest
{Volume}: 47
{Issue}: 1
{Year}: 2024 Jan 21
{Factor}: 5.467
{DOI}: 10.1007/s40618-023-02138-9
{Abstract}: <B>OBJECTIVE: </B>A paradoxical GH rise after the glucose load (GH-Par) is described in about one-third of acromegalic patients. Here, we evaluated the GH profile in subjects with and without acromegaly aiming to refine the definition of GH-Par.<BR><B>METHODS: </B>Observational case-control study.<BR><B>METHODS: </B>Our cohort consisted of 60 acromegalic patients, and two groups of subjects presenting suppressed GH (< 0.4 µg/L) and high (non-acro↑IGF-1, n = 116) or normal IGF-1 levels (non-acro, n = 55). The distribution of GH peaks ≥ 120% from baseline, insulin, and glucose levels were evaluated over a 180-min time interval after glucose intake.<BR><B>RESULTS: </B>A similar proportion of subjects in all three groups shows a GH ratio of ≥ 120% starting from 120 min. Re-considering the definition of paradoxical increase of GH within 90 min, we observed that the prevalence of GH peaks ≥ 120% was higher in acromegaly than in non-acro↑IGF-1 and non-acro (respectively 42%, 16%, and 7%, both p < 0.001). In patients without GH-Par, a late GH rebound was observed in the second part of the curve. Higher glucose peak (p = 0.038), slower decline after load, 20% higher glucose exposure (p = 0.015), and a higher prevalence of diabetes (p = 0.003) characterized acromegalic patients with GH-Par (with respect to those without).<BR><B>CONCLUSIONS: </B>GH-Par response may be defined as a 20% increase in the first 90 min after glucose challenge. GH-Par, common in acromegaly and associated with an increased prevalence of glucose metabolism abnormalities, is found also in a subset of non-acromegalic subjects with high IGF-1 levels, suggesting its possible involvement in the early phase of the disease.