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Utility of baseline serum phosphorus levels for predicting remission in acromegaly patients

Journal of Endocrinological Investigation volume 40, pages 867–874 (2017)Cite this article

Abstract

Purpose

High GH and IGF I levels increase tubular phosphate reabsorption in patients with acromegaly. We aimed to investigate the utility of serum phosphorus levels as an indicator for predicting chance of remission in acromegaly patients.

Design

Fifty-one patients (n: 51; F: 24, M: 27) with diagnosis of acromegaly were included in the study. Plasma IGF-1, Phosphorus (P) and nadir GH levels on oral glucose tolerance test (OGTT) at the time of diagnosis were analysed retrospectively. Patients were classified into two groups according to their plasma P levels; P ≤ 4.5 mg/dl (Group-1, n: 23, 45.1%), P > 4.5 mg/dl (Group-2, n: 28, 54.9%). Two groups were compared according to remission status; remission (n: 27) and non-remission (n: 24). Remission was defined with absence of clinical symptoms, normal plasma IGF-1 (adjusted for age and gender) and GH levels (<1 mcg/dl) at least 3 months after initial treatment.

Results

Serum P levels decreased significantly after treatment in both groups (p < 0.001). There was a significant correlation between baseline phosphorus levels and remission rates, nadir GH in OGTT, pituitary adenoma size and Ki-67 scores (p = 0.001, r: −0.51; p = 0.01, r: 0.44; p = 0.001, r: 0.52; p = 0.02, r: 0.71, respectively). Mean baseline P levels were significantly higher in patients with non-remission (4.8 vs 4.2, P < 0.001). Logistic regression analysis did not reveal an independent effect on remission with any of these risk factors.

Conclusion

High serum P levels may be an indicator for a low likelihood of onset of remission in acromegaly patients. Further studies with wider spectrum are needed to make specific suggestions.

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Acknowledgements

The authors are grateful to Professor Nese Colak Ozbey from Istanbul University, Istanbul Medical Faculty, Department of Internal Medicine, Division of Endocrinology and Metabolism Disorders for review of this article.

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  1. Division of Endocrinology and Metabolism Disorders, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Capa, 34090, Istanbul, Turkey

    G. Y. Yalin, S. Tanrikulu, N. Gul, A. K. Uzum, F. Aral & R. Tanakol

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  1. G. Y. Yalin
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  2. S. Tanrikulu
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  3. N. Gul
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  4. A. K. Uzum
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  5. F. Aral
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  6. R. Tanakol
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Correspondence to G. Y. Yalin.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Ethics Committee of Istanbul University Istanbul Medical Faculty, and all procedures were performed in accordance with the Declaration of Helsinki.

Informed consent

Informed consent was obtained from all individuals included in the study.

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Yalin, G.Y., Tanrikulu, S., Gul, N. et al. Utility of baseline serum phosphorus levels for predicting remission in acromegaly patients. J Endocrinol Invest 40, 867–874 (2017). https://doi.org/10.1007/s40618-017-0657-3

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  • DOI: https://doi.org/10.1007/s40618-017-0657-3

Keywords

  • Acromegaly
  • Phosphorus
  • IGF-1
  • Remission