Acromegaly is a characteristic clinical syndrome caused in most cases by a GH-producing pituitary macroadenoma. Tumoral GH hypersecretion results in skeletal changes, metabolic abnormalities, multi-systemic complications and a significant increase in the overall mortality. The diagnosis is suspected on clinical grounds, and it is normally confirmed by biochemical and radiological examinations. From the biochemical standpoint, the diagnostic approach for demonstration of GH excess involves either basal hormone measurements, mainly GH and insulin-like growth factor-1 (IGF-1), and endocrine tests, such as the oral glucose load. Transphenoidal adenomectomy remains the primary therapy of choice for most patients but, unfortunately, post-surgical remission is observed in less than half of the patients with macroadenomas. Consequently, hormone measurements have an important role in the follow-up of acromegalic patients, not only to define criteria for remission ("cure"), both also to evaluate the outcome of other therapeutic approaches such as radiotherapy and medical treatment. In this article, the most common biochemical measurements used in the management of acromegaly and some novel experimental assays are reviewed. In addition, a summary of a recently published consensus statement with guidelines for the diagnosis and therapeutic approach of acromegaly is presented.
Growth hormone; Acromegaly; IGF-1
