{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:50:03Z","timestamp":1790470203570,"version":"4.1.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","issue":"6","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:p>To gain more insight on the pathogenesis of somatotroph pituitary adenomas, recent studies have focused on a subgroup of patients with acromegaly displaying a paradoxical growth hormone (GH) response during oral glucose tolerance test (OGTT). The paradoxical rise of GH after oral glucose intake occurs in about one-third of acromegaly patients and has been pathogenetically linked, by analogy to glucose-dependent insulinotropic polypeptide (GIP)-dependent Cushing's syndrome, to the ectopic expression of GIP receptor (GIPR) in somatotroph adenoma cells. GIPR-expressing adenomas are negative for activating <jats:italic>GNAS<\/jats:italic> gene mutations and display distinct cytogenetic and DNA methylation profiles, highlighting their unique molecular pathogenesis. Acromegaly patients with a paradoxical GH response pattern seem to display higher insulin-like growth factor-1 (IGF-1) concentrations and harbour smaller adenomas that are more often of the densely granulated phenotype. They seem also to show a better response to somatostatin receptor ligands. In addition, persistent paradoxical GH response after surgery may be a biological marker of the residual disease postoperatively. Targeted therapy to antagonize GIP receptor on GIPR-expressing somatotroph adenomas could be a new treatment approach for acromegaly patients with a paradoxical pattern of GH response to OGTT.<\/jats:p>","DOI":"10.1530\/eje-20-1448","type":"journal-article","created":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T17:09:16Z","timestamp":1617901756000},"page":"R261-R268","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-7","source":"Crossref","is-referenced-by-count":23,"title":["MANAGEMENT OF ENDOCRINE DISEASE: Etiology and outcome of acromegaly in patients with a paradoxical GH response to glucose"],"prefix":"10.1093","volume":"184","author":[{"given":"Mirella","family":"Hage","sequence":"first","affiliation":[{"name":"1Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital Ambroise Par\u00e9, Service d\u2019Endocrinologie Diab\u00e9tologie et Nutrition, F- 92100 Boulogne Billancourt, Paris, France"},{"name":"2Universit\u00e9 Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital Bic\u00eatre, Service d\u2019Endocrinologie et des Maladies de la Reproduction, Centre de R\u00e9f\u00e9rence des Maladies Rares de l\u2019Hypophyse, Le Kremlin-Bic\u00eatre, \u00cele-de-France, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e9ment","family":"Janot","sequence":"additional","affiliation":[{"name":"2Universit\u00e9 Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital Bic\u00eatre, Service d\u2019Endocrinologie et des Maladies de la Reproduction, Centre de R\u00e9f\u00e9rence des Maladies Rares de l\u2019Hypophyse, Le Kremlin-Bic\u00eatre, \u00cele-de-France, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie","family":"Salenave","sequence":"additional","affiliation":[{"name":"2Universit\u00e9 Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital Bic\u00eatre, Service d\u2019Endocrinologie et des Maladies de la Reproduction, Centre de R\u00e9f\u00e9rence des Maladies Rares de l\u2019Hypophyse, Le Kremlin-Bic\u00eatre, \u00cele-de-France, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Chanson","sequence":"additional","affiliation":[{"name":"2Universit\u00e9 Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital Bic\u00eatre, Service d\u2019Endocrinologie et des Maladies de la Reproduction, Centre de R\u00e9f\u00e9rence des Maladies Rares de l\u2019Hypophyse, Le Kremlin-Bic\u00eatre, \u00cele-de-France, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kamenick\u00fd","sequence":"additional","affiliation":[{"name":"2Universit\u00e9 Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital Bic\u00eatre, Service d\u2019Endocrinologie et des Maladies de la Reproduction, Centre de R\u00e9f\u00e9rence des Maladies Rares de l\u2019Hypophyse, Le Kremlin-Bic\u00eatre, \u00cele-de-France, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","container-title":["European Journal of Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/eje.bioscientifica.com\/view\/journals\/eje\/184\/6\/EJE-20-1448.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/eje.bioscientifica.com\/downloadpdf\/journals\/eje\/184\/6\/EJE-20-1448.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T16:16:10Z","timestamp":1676391370000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejendo\/article\/184\/6\/R261\/6653987"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,1]]},"references-count":0,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.1530\/eje-20-1448","relation":{},"ISSN":["0804-4643","1479-683X"],"issn-type":[{"value":"0804-4643","type":"print"},{"value":"1479-683X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,1]]}}}