Usefulness of insulin-like growth factor binding protein-3 levels to determine acromegaly activity and effectiveness of transsphenoidal pituitary surgery

Background. Several series reported in the literature concerning the result s of the treatment of acromegaly have been difficult to evaluate because th e indicators are inaccurate Methods. We investigated the usefulness of insulin-like growth factor bindi ng protein-3 (IGFBP) levels to determine disease activity after surgical tr eatment of acromegaly in 13 patients with confirmed somatotroph adenoma. Results. Before surgery, all 13 non-treated patients had elevated serum lev els of IGFBP-3 as well as total and free IGF-I. In addition, there was no o verlap with the normal controls (p <0.001). IGFBP-3 levels correlated signi ficantly (0.91, p <0.001) with GH suppressibility by glucose after surgery. Conclusions. These data confirm that IGFBP-3 is a better indicator of acrom egalic activity than either total or free IGF-I. There was a high correlati on with GH suppressibility by glucose after surgery; both free and total IG F-I could be considered sensitive markers only for diagnosis of active acro megaly but not for efficacy of surgery. (C) 1999 IMSS. Published by Elsevie r Science Inc.