{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T10:38:43Z","timestamp":1788431923161,"version":"build-2803163510"},"reference-count":24,"publisher":"S. Karger AG","issue":"4","license":[{"start":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T00:00:00Z","timestamp":1622160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T00:00:00Z","timestamp":1622160000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neuroendocrinology"],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Introduction:&lt;\/i&gt;&lt;\/b&gt; Surgical remission for acromegaly is dependent on a number of factors including tumour size, invasiveness, and surgical expertise. We studied the value of early post-operative growth hormone (GH) level as a predictor of outcome and to guide early surgical re-exploration for residual disease in patients with acromegaly. &lt;b&gt;&lt;i&gt;Methods:&lt;\/i&gt;&lt;\/b&gt; Patients with acromegaly undergoing first-time endoscopic transsphenoidal surgery between 2005 and 2015, in 2 regional neurosurgical centres, were studied. Insulin-like growth factor-1 (IGF-1), basal GH (i.e., sample before oral glucose), and GH nadir on oral glucose tolerance test (OGTT) were tested at various time points, including 2\u20135 days post-operatively. Definition of disease remission was according to the 2010 consensus statement (i.e., GH nadir &amp;#x3c;0.4 \u03bcg\/L during an OGTT and normalized population-matched IGF-1). Forward stepwise logistic regression was used to determine factors associated with remission. &lt;b&gt;&lt;i&gt;Results:&lt;\/i&gt;&lt;\/b&gt; We investigated 81 consecutive patients with acromegaly, 67 (83%) of which had macroadenomas and 22 (27%) were noted to be invasive at surgery. Mean follow-up was 44 \u00b1 25 months. Overall, surgical remission was achieved in 55 (68%) patients at final follow-up. On univariate analysis, the remission rates at the end of the study period for patients with early post-operative GH nadir on OGTT of &amp;#x3c;0.4 (&lt;i&gt;N&lt;\/i&gt; = 43), between 0.4 and 1 (&lt;i&gt;N&lt;\/i&gt; = 28), and &amp;#x3e;1 \u03bcg\/L (&lt;i&gt;N&lt;\/i&gt; = 8) were 88, 54, and 20%, respectively. Similar results were seen with basal GH on early post-operative OGTT. On multivariate regression analysis, pre-operative IGF-1 (odds ratio of 13.1) and early post-operative basal GH (odds ratio of 5.0) and GH nadir on OGTT (odds ratio of 6.8) were significant predictors of residual disease. Based on a raised early GH nadir and post-operative MR findings, 10 patients underwent early surgical re-exploration. There was reduction in post-operative GH levels in 9 cases, of which 5 (50%) achieved long-term remission. There was an increased risk of new pituitary hormone deficiencies in patients having surgical re-exploration compared to those having a single operation (60 vs. 14%). &lt;b&gt;&lt;i&gt;Conclusions:&lt;\/i&gt;&lt;\/b&gt; An early post-operative basal GH and GH nadir on OGTT are reliable predictors of long-term disease remission. It can be used to guide patients for early surgical re-exploration for residual disease, although there is increased risk of hypopituitarism.<\/jats:p>","DOI":"10.1159\/000517476","type":"journal-article","created":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T17:03:32Z","timestamp":1622221412000},"page":"345-357","source":"Crossref","is-referenced-by-count":13,"title":["Value of Early Post-Operative Growth Hormone Testing in Predicting Long-Term Remission and Residual Disease after Transsphenoidal Surgery for Acromegaly"],"prefix":"10.1159","volume":"112","author":[{"given":"Yi Yuen","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mueez","family":"Waqar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Abou-Zeid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara","family":"Kearney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmela","family":"Caputo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Davis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Trainer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Higham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Roncaroli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanna K.","family":"Gnanalingham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2021,5,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.85.2.6363"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-2670"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.1996.8080817.x"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/92.12.741"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-010-0790-7"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e31823f5c16"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-014-2098-5"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ghir.2018.03.002"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-018-0058-5"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1530\/eje.1.02186"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1093\/neurosurgery\/16.cn_suppl_1.185"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-199310000-00008"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.3171\/2014.12.JNS141083"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e3181ef25c5"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.86.9.7819"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.1998.00581.x"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1023\/a:1012969719503"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1080\/00365510152567103"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.3171\/2010.7.FOCUS10164"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.4158\/EP.7.3.170"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1227\/01.neu.0000431480.87160.84"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-0901"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13129"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-2558"}],"container-title":["Neuroendocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/517476","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/517476","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T11:05:18Z","timestamp":1745406318000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000517476"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,28]]},"references-count":24,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,3,22]]},"published-print":{"date-parts":[[2022,3,29]]}},"URL":"https:\/\/doi.org\/10.1159\/000517476","archive":["Portico"],"relation":{},"ISSN":["0028-3835","1423-0194"],"issn-type":[{"value":"0028-3835","type":"print"},{"value":"1423-0194","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,28]]}}}