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IGF-I levels reflect hypopituitarism severity in adults with pituitary dysfunction

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Abstract

Purpose

To evaluate the utility of Insulin-like growth factor I (IGF-I) standard deviation score (SDS) as a surrogate marker of severity of hypopituitarism in adults with pituitary pathology.

Methods

We performed a retrospective data analysis, including 269 consecutive patients with pituitary disease attending a tertiary endocrine clinic in 1990–2015. The medical files were reviewed for the complete pituitary hormone profile, including IGF-I, and clinical data. Age-adjusted assay reference ranges of IGF-I were used to calculate IGF-I SDS for each patient. The main outcome measures were positive and negative predictive values of low and high IGF-I SDS, respectively, for the various pituitary hormone deficiencies.

Results

IGF-I SDS correlated negatively with the number of altered pituitary axes (p < 0.001). Gonadotropin was affected in 76.6 % of cases, followed by thyrotropin (58.4 %), corticotropin (49.1 %), and prolactin (22.7 %). Positive and negative predictive values yielded a clear trend for the probability of low/high IGF-I SDS for all affected pituitary axes. Rates of diabetes insipidus correlated with IGF-I SDS values both for the full study population, and specifically for patients with non-functioning pituitary adenomas.

Conclusions

IGF-I SDS can be used to evaluate the somatotroph function, as a valid substitute to absolute IGF-I levels. Moreover, IGF-I SDS predicted the extent of hypopituitarism in adults with pituitary disease, and thus can serve as a marker of hypopituitarism severity.

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Authors contributions

Amit Tirosh, Data gathering and analysis and manuscript writing; Yoel Toledano, Data gathering and manuscript review; Hiba Masri-Iraqi, Data gathering; Yoav Eizenberg, Assistance in data gathering and manuscript review; Gloria Tzvetov, Assistance in data gathering and manuscript review; Dania Hirsch, Assistance in data gathering; Carlos Benbassat, Assistance in data gathering and manuscript review; Eyal Robenshtok, Data gathering and manuscript review; Ilan Shimon, Primary investigator, study initiator, manuscript review.

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Authors and Affiliations

  1. Endocrine Institute, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel

    Amit Tirosh, Hiba Masri-Iraqi, Gloria Tzvetov, Dania Hirsch, Carlos Benbassat, Eyal Robenshtok & Ilan Shimon

  2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Amit Tirosh, Yoel Toledano, Hiba Masri-Iraqi, Yoav Eizenberg, Gloria Tzvetov, Dania Hirsch, Carlos Benbassat, Eyal Robenshtok & Ilan Shimon

  3. Endocrinology Clinic, Division of Maternal Fetal Medicine, Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel

    Yoel Toledano

  4. Tel Aviv-Jaffa District Clalit Health Services, Tel Aviv, Israel

    Yoav Eizenberg

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  1. Amit Tirosh
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  2. Yoel Toledano
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  3. Hiba Masri-Iraqi
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  4. Yoav Eizenberg
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  5. Gloria Tzvetov
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  6. Dania Hirsch
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  7. Carlos Benbassat
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  8. Eyal Robenshtok
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  9. Ilan Shimon
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Corresponding author

Correspondence to Ilan Shimon.

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The authors declare that they have no conflict of interest.

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Tirosh, A., Toledano, Y., Masri-Iraqi, H. et al. IGF-I levels reflect hypopituitarism severity in adults with pituitary dysfunction. Pituitary 19, 399–406 (2016). https://doi.org/10.1007/s11102-016-0718-1

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  • DOI: https://doi.org/10.1007/s11102-016-0718-1

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