{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:47:00Z","timestamp":1787021220525,"version":"build-2736575974"},"reference-count":38,"publisher":"The Endocrine Society","issue":"7","license":[{"start":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T00:00:00Z","timestamp":1616112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100008005","name":"Yonsei University College of Medicine","doi-asserted-by":"publisher","award":["6-2020-0224"],"award-info":[{"award-number":["6-2020-0224"]}],"id":[{"id":"10.13039\/501100008005","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Team Science Award Grant of Yonsei University College of Medicine","award":["6-2021-0009"],"award-info":[{"award-number":["6-2021-0009"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>In the management of growth hormone (GH)\u2013secreting pituitary adenomas, the oral glucose tolerance test (OGTT) has been the gold standard not only for diagnoses but also for the determination of biochemical remission. Insulin-like growth factor-1 (IGF-1) is an essential biomarker, although it should be adjusted for both age and sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We evaluated whether IGF-1 levels could serve as a reliable alternative to an OGTT for disease monitoring after the surgical treatment of acromegaly. We retrospectively reviewed the medical records of 320 patients who underwent surgical resection of their GH-secreting pituitary tumors at the Severance hospital. Receiver operator characteristic (ROC) analyses were performed to validate the accuracy of IGF-1 levels for the assessment of remission. In addition, regression analyses were performed to identify factors associated with discrepancy between OGTT and IGF-1 levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Except for 1 week after surgery, ROC analyses showed an area under the curve of greater than 0.8 for IGF-1 at all time points. Of 320 patients, 270 achieved endocrine remission after surgery alone. Among these patients, IGF-1 levels were normalized in 250 patients. The mean duration from surgery to IGF-1 normalization was 4.7 months. Regression analyses demonstrated that risk of failed IGF-1 normalization was increased by 3.1-fold when the tumor invaded the cavernous sinus and increased by 9.0-fold in patients with incomplete tumor removal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>IGF-1 level is a reliable alternative to OGTT and plays a valuable role in monitoring acromegaly status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgab186","type":"journal-article","created":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T00:13:15Z","timestamp":1616112795000},"page":"e2589-e2599","source":"Crossref","is-referenced-by-count":9,"title":["Revisiting the Role of Insulin-like Growth Factor-1 Measurement After Surgical Treatment of Acromegaly"],"prefix":"10.1210","volume":"106","author":[{"given":"In-Ho","family":"Jung","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Yonsei University College of Medicine, Seoul,Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seonah","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yonsei University College of Medicine, Seoul,Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8693-9630","authenticated-orcid":false,"given":"Cheol Ryong","family":"Ku","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea"},{"name":"Pituitary Tumor Center, Severance Hospital, Seoul, Republic of Korea"},{"name":"Yonsei Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Guk","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9876-8370","authenticated-orcid":false,"given":"Eun Jig","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea"},{"name":"Pituitary Tumor Center, Severance Hospital, Seoul, Republic of Korea"},{"name":"Yonsei Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun Ho","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yonsei University College of Medicine, Seoul,Republic of Korea"},{"name":"Department of Neurosurgery, Ewha Woman\u2019s University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2523-7122","authenticated-orcid":false,"given":"Eui Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yonsei University College of Medicine, Seoul,Republic of Korea"},{"name":"Pituitary Tumor Center, Severance Hospital, Seoul, Republic of Korea"},{"name":"Yonsei Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2021,3,19]]},"reference":[{"issue":"1","key":"2021122203523077200_OP-B1","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1210\/jc.2007-1191","article-title":"Mortality in acromegaly: a metaanalysis","volume":"93","author":"Dekkers","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2021122203523077200_OP-B2","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1038\/nrendo.2014.21","article-title":"Expert consensus document: a consensus on the medical treatment of acromegaly","volume":"10","author":"Giustina","year":"2014","journal-title":"Nat Rev Endocrinol"},{"issue":"11","key":"2021122203523077200_OP-B3","doi-asserted-by":"crossref","first-page":"3189","DOI":"10.1172\/JCI39375","article-title":"Acromegaly pathogenesis and treatment","volume":"119","author":"Melmed","year":"2009","journal-title":"J Clin Invest"},{"issue":"1","key":"2021122203523077200_OP-B4","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/1750-1172-3-17","article-title":"Acromegaly","volume":"3","author":"Chanson","year":"2008","journal-title":"Orphanet J Rare Dis"},{"key":"2021122203523077200_OP-B5","volume-title":"Youmans and Winn Neurological Surgery","author":"Wenya Linda Bi","year":"2017","edition":"7th ed"},{"issue":"4","key":"2021122203523077200_OP-B6","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1007\/s11154-020-09588-z","article-title":"Multidisciplinary management of acromegaly: a consensus","volume":"21","author":"Giustina","year":"2020","journal-title":"Rev Endocr Metab Disord"},{"issue":"7","key":"2021122203523077200_OP-B7","doi-asserted-by":"crossref","first-page":"3141","DOI":"10.1210\/jc.2009-2670","article-title":"A consensus on criteria for cure of acromegaly","volume":"95","author":"Giustina","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2021122203523077200_OP-B8","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1210\/jc.2008-1371","article-title":"The utility of oral glucose tolerance testing for diagnosis and assessment of treatment outcomes in 166 patients with acromegaly","volume":"94","author":"Carmichael","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2021122203523077200_OP-B9","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1007\/s11102-015-0657-2","article-title":"IGF-1 levels across the spectrum of normal to elevated in acromegaly: relationship to insulin sensitivity, markers of cardiovascular risk and body composition","volume":"18","author":"Reid","year":"2015","journal-title":"Pituitary"},{"issue":"5","key":"2021122203523077200_OP-B10","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1055\/a-0594-2404","article-title":"Impact of glucose metabolism disorders on IGF-1 levels in patients with acromegaly","volume":"50","author":"Dogansen","year":"2018","journal-title":"Horm Metab Res"},{"issue":"8","key":"2021122203523077200_OP-B11","doi-asserted-by":"crossref","first-page":"2844","DOI":"10.1210\/jc.2017-00202","article-title":"Classification of patients with GH disorders may vary according to the IGF-I assay","volume":"102","author":"Mavromati","year":"2017","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2021122203523077200_OP-B12","doi-asserted-by":"crossref","first-page":"287","DOI":"10.3171\/jns.2002.97.2.0287","article-title":"Changing patterns of insulin-like growth factor-I and glucose-suppressed growth hormone levels after pituitary surgery in patients with acromegaly","volume":"97","author":"Espinosa-de-los-Monteros","year":"2002","journal-title":"J Neurosurg"},{"issue":"3","key":"2021122203523077200_OP-B13","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1111\/j.1365-2265.2006.02430.x","article-title":"Biochemical evaluation of disease activity after pituitary surgery in acromegaly: a critical analysis of patients who spontaneously change disease status","volume":"64","author":"Espinosa-de-Los-Monteros","year":"2006","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"12","key":"2021122203523077200_OP-B14","doi-asserted-by":"crossref","first-page":"6480","DOI":"10.1210\/jc.2005-0901","article-title":"Postoperative evaluation of patients with acromegaly: clinical significance and timing of oral glucose tolerance testing and measurement of (free) insulin-like growth factor I, acid-labile subunit, and growth hormone-binding protein levels","volume":"90","author":"Feelders","year":"2005","journal-title":"J Clin Endocrinol Metab"},{"issue":"9","key":"2021122203523077200_OP-B15","doi-asserted-by":"crossref","first-page":"4072","DOI":"10.1210\/jcem.86.9.7819","article-title":"Surgical management of GH-secreting pituitary adenomas: an outcome study using modern remission criteria","volume":"86","author":"Kreutzer","year":"2001","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2021122203523077200_OP-B16","first-page":"41","article-title":"Biochemical assessment and long-term monitoring in patients with acromegaly: statement from a joint consensus conference of the Growth Hormone Research Society and the Pituitary Society","volume":"26","author":"Lim","year":"2005","journal-title":"Clin Biochem Rev"},{"key":"2021122203523077200_OP-B17","volume-title":"Harrison\u2019s Principle of Internal Medicine","author":"Longo","year":"2011","edition":"18th ed"},{"issue":"3","key":"2021122203523077200_OP-B18","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1046\/j.1365-2265.2003.01900.x","article-title":"Early postoperative indicators of late outcome in acromegalic patients","volume":"60","author":"Takahashi","year":"2004","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"6","key":"2021122203523077200_OP-B19","doi-asserted-by":"crossref","first-page":"1959","DOI":"10.3171\/2016.8.JNS161123","article-title":"Correlation between GH and IGF-1 during treatment for acromegaly","volume":"126","author":"Oldfield","year":"2017","journal-title":"J Neurosurg"},{"issue":"4","key":"2021122203523077200_OP-B20","doi-asserted-by":"crossref","first-page":"960","DOI":"10.3803\/EnM.2020.732","article-title":"Establishment of reference intervals for serum insulin-like growth factor I in Korean adult population","volume":"35","author":"Kim","year":"2020","journal-title":"Endocrinol Metab (Seoul)"},{"issue":"3","key":"2021122203523077200_OP-B21","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1530\/EJE-14-0304","article-title":"Clinical predictors of GH deficiency in surgically cured acromegalic patients","volume":"171","author":"Ku","year":"2014","journal-title":"Eur J Endocrinol"},{"issue":"2 Suppl Operative","key":"2021122203523077200_OP-B22","first-page":"ons192","article-title":"Surgical and endocrinological outcomes in the treatment of growth hormone-secreting pituitary adenomas according to the shift of surgical paradigm","volume":"71","author":"Ku","year":"2012","journal-title":"Neurosurgery"},{"issue":"5","key":"2021122203523077200_OP-B23","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1227\/NEU.0b013e31823f5c16","article-title":"Predicting long-term remission by measuring immediate postoperative growth hormone levels and oral glucose tolerance test in acromegaly","volume":"70","author":"Kim","year":"2012","journal-title":"Neurosurgery"},{"issue":"3","key":"2021122203523077200_OP-B24","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1210\/jcem.85.3.6464","article-title":"Octreotide may act as a radioprotective agent in acromegaly","volume":"85","author":"Landolt","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2021122203523077200_OP-B25","doi-asserted-by":"crossref","first-page":"833","DOI":"10.3171\/jns.2007.106.5.833","article-title":"Radiosurgery of growth hormone-producing pituitary adenomas: factors associated with biochemical remission","volume":"106","author":"Pollock","year":"2007","journal-title":"J Neurosurg"},{"issue":"2","key":"2021122203523077200_OP-B26","first-page":"526","article-title":"Criteria for cure of acromegaly: a consensus statement","volume":"85","author":"Giustina","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"issue":"9","key":"2021122203523077200_OP-B27","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1038\/s41574-018-0058-5","article-title":"A consensus statement on acromegaly therapeutic outcomes","volume":"14","author":"Melmed","year":"2018","journal-title":"Nat Rev Endocrinol"},{"issue":"2","key":"2021122203523077200_OP-B28","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1093\/neuros\/nyx020","article-title":"Long-term endocrine outcomes following endoscopic endonasal transsphenoidal surgery for acromegaly and associated prognostic factors","volume":"81","author":"Babu","year":"2017","journal-title":"Neurosurgery"},{"issue":"24","key":"2021122203523077200_OP-B29","doi-asserted-by":"crossref","first-page":"e3808","DOI":"10.1097\/MD.0000000000003808","article-title":"No differences in metabolic outcomes between nadir GH 0.4 and 1.0 ng\/mL during OGTT in surgically cured acromegalic patients (observational study)","volume":"95","author":"Ku","year":"2016","journal-title":"Medicine (Baltimore)"},{"issue":"5","key":"2021122203523077200_OP-B30","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.ghir.2008.02.001","article-title":"Prevalence of discordant GH and IGF-I levels in acromegalics at diagnosis, after surgical treatment and during treatment with octreotide LAR","volume":"18","author":"Machado","year":"2008","journal-title":"Growth Horm IGF Res"},{"issue":"8","key":"2021122203523077200_OP-B31","doi-asserted-by":"crossref","first-page":"3190","DOI":"10.1210\/jc.2013-1036","article-title":"Endoscopic vs microsurgical transsphenoidal surgery for acromegaly: outcomes in a concurrent series of patients using modern criteria for remission","volume":"98","author":"Starke","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2021122203523077200_OP-B32","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1210\/jc.2007-2084","article-title":"Growth hormone response during oral glucose tolerance test: the impact of assay method on the estimation of reference values in patients with acromegaly and in healthy controls, and the role of gender, age, and body mass index","volume":"93","author":"Arafat","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2021122203523077200_OP-B33","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1210\/jc.2008-2421","article-title":"Guidelines for acromegaly management: an update","volume":"94","author":"Melmed","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2021122203523077200_OP-B34","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1227\/01.neu.0000431480.87160.84","article-title":"Long-term changes in serum IGF-1 levels after successful surgical treatment of growth hormone-secreting pituitary adenoma","volume":"73","author":"Shin","year":"2013","journal-title":"Neurosurgery"},{"issue":"3","key":"2021122203523077200_OP-B35","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1007\/s12020-015-0619-5","article-title":"Impact of pre-treatment with somatostatin analogs on surgical management of acromegalic patients referred to a single center","volume":"51","author":"Bacigaluppi","year":"2016","journal-title":"Endocrine"},{"issue":"4","key":"2021122203523077200_OP-B36","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1007\/s11102-011-0369-1","article-title":"Discordant growth hormone and IGF-1 levels post pituitary surgery in patients with acromegaly na\u00efve to medical therapy and radiation: what to follow, GH or IGF-1 values?","volume":"15","author":"Brzana","year":"2012","journal-title":"Pituitary"},{"issue":"1","key":"2021122203523077200_OP-B37","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.jfma.2017.02.014","article-title":"Body mass index and insulin-like growth factor 1 as risk factors for discordant growth hormone and insulin-like growth factor 1 levels following pituitary surgery in acromegaly","volume":"117","author":"Zhang","year":"2018","journal-title":"J Formos Med Assoc"},{"issue":"2","key":"2021122203523077200_OP-B38","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1111\/j.1365-2265.2009.03556.x","article-title":"Monitoring of acromegaly: what should be performed when GH and IGF-1 levels are discrepant?","volume":"71","author":"Freda","year":"2009","journal-title":"Clin Endocrinol (Oxf)"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgab186\/38036285\/dgab186.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/106\/7\/e2589\/41848115\/dgab186.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/106\/7\/e2589\/41848115\/dgab186.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T22:54:01Z","timestamp":1640127241000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/106\/7\/e2589\/6178519"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,19]]},"references-count":38,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,3,19]]},"published-print":{"date-parts":[[2021,6,16]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgab186","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,7,1]]},"published":{"date-parts":[[2021,3,19]]}}}