{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T21:32:39Z","timestamp":1783632759593,"version":"3.55.0"},"reference-count":28,"publisher":"The Endocrine Society","issue":"5","license":[{"start":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T00:00:00Z","timestamp":1718409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>A paradoxical growth hormone (GH) response to oral glucose load (oral glucose tolerance test [OGTT]) in acromegaly is associated with a milder phenotype.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To study whether the GH response to the OGTT predicts the risk of recurrence after initial surgical cure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Retrospective, observational study at 2 tertiary care centers. We investigated 254 patients with acromegaly who were cured by surgery. All patients underwent an OGTT at diagnosis before pituitary surgery. A peak to basal GH ratio \u2265120% within 90 minutes was used to distinguish paradoxical (GH-Par) from nonparadoxical responses (GH-NPar) in patients with acromegaly. Cox analysis was used to investigate whether the paradoxical GH response to OGTT was associated with the risk of disease recurrence<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A paradoxical GH response to OGTT occurred in 87 patients (34.3%, termed GH-Par group). Recurrence of acromegaly occurred in 3 patients in the GH-Par group (3.4%) and in 20 patients in the GH-NPar group (12.0%). In the multivariate analysis, the paradoxical GH response to OGTT was significantly associated with a low risk of recurrence (HR 0.18, 95% CI 0.05-0.63; P = .007). Basal GH level at diagnosis was the only other variable associated with the risk of disease recurrence (HR 1.58, 95% CI 1.01-2.47; P = .04).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Our study demonstrates that a paradoxical GH response to OGTT in the preoperative setting predicts a lower risk of disease recurrence after initial surgical cure. The pattern of GH responsiveness to OGTT is, therefore, useful to predict the long-term outcome of patients with acromegaly.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgae410","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T15:51:15Z","timestamp":1718380275000},"page":"1404-1409","source":"Crossref","is-referenced-by-count":5,"title":["The Preoperative Paradoxical GH Response to Oral Glucose Load Predicts a Low Risk of Recurrence in Acromegaly"],"prefix":"10.1210","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7810-8247","authenticated-orcid":false,"given":"Marco","family":"Losa","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, IRCCS San Raffaele Scientific Institute, Vita-Salute University , 20132 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Garbin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, IRCCS San Raffaele Scientific Institute, Vita-Salute University , 20132 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Calcagnile","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, IRCCS San Raffaele Scientific Institute, Vita-Salute University , 20132 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Voltan","sequence":"additional","affiliation":[{"name":"Department of Medicine DIMED, University of Padua , 35128 Padua ,","place":["Italy"]},{"name":"Endocrine Unit, University-Hospital of Padua , 35128 Padua ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Ceccato","sequence":"additional","affiliation":[{"name":"Department of Medicine DIMED, University of Padua , 35128 Padua ,","place":["Italy"]},{"name":"Endocrine Unit, University-Hospital of Padua , 35128 Padua 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