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Plasma Insulin-Like Growth Factor-I/Somatomedin-C in Acromegaly: Correlation With the Degree of Growth Hormone Hypersecretion^*

ARIEL L. BARKAN, INESE Z. BEITINS and ROBERT P. KELCH

Departments of Internal Medicine and Pediatrics, Veterans Administration and University Hospitals, University of Michigan Medical Center Ann Arbor, Michigan 48105

Address all correspondence and requests for reprints to: Ariel L. Barkan, M.D., Endocrine Section, Veterans Administration Medical Center, 2215 Fuller Road, Ann Arbor, Michigan 48105.

We measured plasma insulin-like growth factor I/somatomedin-C (IGF-I/SmC) concentrations and mean 24-h GH secretion serially before and during therapy with the longacting somatostatin analog SMS 201–995 in 21 patients with acromegaly. When mean plasma GH was elevated above 12.0 ± 0.6 (±SE) µg/L. plasma IGF-I/SmC concentrations were uniformly high, but a decline of mean plasma GH below this value was accompanied by a linear decrease in IGF-I/SmC concentrations (r = 0.89; P < 0.001). Even mildly abnormal mean GH concentrations (>4.6 but <10 µg/L) were accompanied by high plasma IGF-I/SmC values. The log dose-response interrelation between mean 24-h plasma GH and IGF-I/SmC concentrations was linear (r = 0.86; P < 0.001). We conclude that 1) an excellent log dose-response correlation between mean 24-h plasma GH and IGF-I/SmC concentrations is present in patients with acromegaly; 2) normalization of plasma IGF-I/SmC occurs only in patients with mean daily GH output within the normal range; and 3) determination of plasma IGF-I/SmC is an accurate indicator of normalcy of GH secretion and should be used in the diagnosis of active acromegaly as well as in monitoring the progress of therapy.

^* This work was supported by the V.A. Research Service and NIH Grants 1-R29-DK-38449-01 (to A.L.B.) and 5M01-RR-42 (to the Clinical Research Center).

Recipient of the Career Development Research Associate Award from the V.A.

Received December 8, 1987.

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