URINARY GROWTH-HORMONE EXCRETION IN ACROMEGALY - DIAGNOSTIC-VALUE IN MILD DISEASE-ACTIVITY

The biochemical assessment of disease activity in acromegaly still pre sents a problem, especially in treated patients with mild clinical sym ptoms. We therefore examined the diagnostic value of the measurement o f urinary growth hormone (GH) excretion in seventy unselected patients with acromegaly of different activity by comparing it to serum GH, se rum insulin-like growth factor I (IGF-I) and clinical activity. There were highly significant. positive correlations between urinary GH and serum GH, serum IGF-I as well as clinical activity score (p < 0.00005) , although some overlap between the groups was observed. In seven pati ents with low serum GH values (< 2.0 mug/l) discordant results were fo und. Two of the seven patients were clinically mildly active, but only IGF-I was either elevated or within the upper normal range: in three other patients who appeared clinically cured either IGF-I (N = 1) or u rinary GH (n = 2) alone were increased. In the remaining two patients elevated serum IGF-I and urinary GH as well as activity score suggeste d disease activity. Thus, in the majority of cases. urinary GH was sig nificantly correlated to the other three parameters. but added little information to that obtained by serum IGF-I. In conclusion, urinary GH measurements in difficult cases may provide a more direct information on the GH status than IGF-I.