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Serum phosphate: Does it more closely reflect the true state of acromegaly?

血清磷酸盐: 它是否更密切地反映了肢端肥大症的真实状态?

  • 影响因子:1.63
  • DOI:10.1016/j.jocn.2019.11.012
  • 作者列表:"Xie T","Tian P","Wu S","Zhang X","Liu T","Gu Y","Sun C","Hu F
  • 发表时间:2020-01-01
Abstract

:An increased serum phosphate (P) level is common in acromegaly patients, however, the relationships among P, growth hormone (GH), insulin-like growth factor 1 (IGF-1) and disease status remain unknown. To reveal these relationships, we examined the association of P with comprehensive clinical data. We measured the serum P, calcium, GH, oral glucose tolerance test-GH (OGTT-GH), IGF-1, and insulin-like growth factor binding protein-3 (IGBP-3) levels in 103 acromegaly patients. SAGIT® was used to assess the disease status comprehensively. Spearman's rank correlation coefficient was obtained to evaluate the associations among the above parameters. Stepwise multiple linear regression analysis was performed to investigate factors independently associated factors with the SAGIT scores. The area under the receiver operating characteristic curve (AUCROC) was used to evaluate the efficacy of the percentage change in the serum phosphate level in predicting remission in patients with postoperatively discordant GH and IGF-1 levels. Hyperphosphatemia was found in 68.9% of patients at baseline. The serum P level was higher in the non-remission group, but no correlation was found between hyperphosphatemia and remission. We revealed a significant correlation between the P level and SAGIT® score in patients both preoperatively (r = 0.659, p = 0.000) and 1-year postoperatively without remission patients (r = 0.534, p = 0.027). All biochemical levels decreased significantly postoperatively, and the GH and OGTT-GH levels achieved early stability (1 month); however, the P, IGF-1 and IGBP-3 levels showed a gradual decline. A percentage change in P of -8.12% is recommended as a cut-off value for predicting remission in patients with postoperatively discordant GH and IGF-1 levels. As a metabolic product which affected by the GH/IGF-1 axis, serum P appears to more closely reflect the comprehensive disease status in acromegaly. When the GH and IGF-1 levels are discordant during follow-up, perioperative change in the P level may be a potential predictor of remission.

摘要

: 肢端肥大症患者血清磷酸盐 (P) 水平升高是常见的,然而,P、生长激素 (GH) 、胰岛素样生长因子1 (IGF-1) 和疾病状态之间的关系仍然未知。为了揭示这些关系,我们检查了P与综合临床数据的相关性。我们测量了103例肢端肥大症患者的血清P、钙、GH、口服葡萄糖耐量试验-GH (OGTT-GH) 、IGF-1和胰岛素样生长因子结合蛋白-3 (IGBP-3) 水平。SAGIT®用于综合评估疾病状态。获得Spearman等级相关系数以评估上述参数之间的关联。进行逐步多元线性回归分析以研究与SAGIT评分相关的独立因素。受试者工作特征曲线下面积 (AUCROC) 用于评估血清磷酸盐水平的百分比变化在预测术后GH和IGF-1水平不一致的患者的缓解中的功效。在基线时,在68.9% 的患者中发现高磷酸盐血症。非缓解组血清P水平较高,但高磷血症与缓解无相关性。我们揭示了P水平和SAGIT之间的显著相关性。®术前 (r = 0.659,p = 0.000) 和术后1年无缓解患者 (r = 0.534,p = 0.027) 的评分。术后所有生化水平显著下降,GH和OGTT-GH水平达到早期稳定 (1个月); 然而,P、IGF-1和IGBP-3水平呈逐渐下降。建议将P的百分比变化-8.12% 作为预测术后GH和IGF-1水平不一致的患者缓解的临界值。作为受GH/IGF-1轴影响的代谢产物,血清P似乎更密切地反映了肢端肥大症的综合疾病状态。当随访期间GH和IGF-1水平不一致时,围手术期P水平的变化可能是缓解的潜在预测因子。

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影响因子:0.85
发表时间:2020-01-02
来源期刊:Laboratory medicine
DOI:10.1093/labmed/lmz025
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