Parameters identified in multivariate analysis:
(1) serum growth hormone concentration
(2) serum IGF-I (insulin growth factor I) concentration (as SD score, or number of standard deviations from the mean for age and gender)
(3) age
(4) duration of symptoms before treatment (timeliness of diagnosis)
(5) blood pressure
|
Parameter
|
Finding
|
Points
|
|
serum GH or IGF-I
|
GH < 2 µg/L and IGF-I < 2 SD score
|
0
|
|
|
GH >= 2 µg/L
|
1
|
|
|
IGF >= 2 SD score
|
1
|
|
age
|
< 55 years of age
|
0
|
|
|
>= 55 years of age
|
1
|
|
duration of symptoms (timeliness of treatment)
|
short (prompt)
|
0
|
|
|
long (delayed)
|
1
|
|
blood pressure
|
normal or low
|
0
|
|
|
hypertensive
|
1
|
where:
• The use of age is a little confusing. In the abstract it refers to the age at diagnosis.
• Variation between laboratories in the measurement of growth hormone would affect the cutoff value.
number of risk factors for increased mortality =
= SUM(points for the risk factors present)
Additional risk factors not confirmed by the multivariate model as independent:
(1) hypopituitarism
(2) diabetes
A patient with acromegaly can often have a mortality rate similar to the general population if the growth hormone concentration can be kept < 1 µg/L and the IGF-I low (SD score <= 0).
