CLINICAL STUDY Remission criteria for the follow-up of patients with acromegaly

Objective: The aim was to evaluate the validity of current remission criteria in acromegaly, a random GH level of,2.5mg/l, a glucose-suppressed GH level of,1mg/l and a normal IGF-I level. Design: In forty-one patients treated for acromegaly (23 males and 18 females, 20–69 years) and 94 healthy subjects (50 males and 44 females, 20–78 years), basal GH and IGF-I levels and nadir GH levels after 75 g oral glucose were evaluated in decade blocks; these were assayed by sensitive immu-noradiometric assays. Results: Basal GH levels varied widely from 0.022 to 10.4 in healthy subjects and were.2.5mg/l in 19%. The mean post-glucose GH nadir was 0.067^0.009mg/l (range 0.003–0.4mg/l) and the upper limit of the GH nadir was 0.26mg/l (means þ 2 S.D.) in healthy subjects. Thirty-five patients with acromegaly had high-for-age IGF-I levels in relation to our healthy subjects. In this group, 15 (42.9%) patients had basal GH levels of,2.5mg/l, 14 (40%) patients had nadir GH levels of,1mg/l, and three (8.6%) patients had GH suppression to,0.26mg/l which was defined as normal GH suppression in our healthy subjects. Only six patients with acromegaly had normal-for-age IGF-I levels and all of these patients had basal GH levels of,2.5mg/l and all but one had nadir GH levels of,0.26mg/l