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Petersenn S, Althoff R, Unger N, Jäger A, Strasburger CJ, Bidlingmaier M, Saller B, Mann K. GH peak levels during GHRH-Arginine testing depend on BMI, sex and age – establishment of normative data. Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-972218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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77
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Kreutzer J, Bidlingmaier M, Olk A, Hennig F, Buchfelder M. A prospective longitudinal study on pituitary function after TBI and SAH – preliminary data from the acute phase in 71 patients. Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-972490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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78
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Roemmler J, Steffin B, Bidlingmaier M, Schopohl J. Case report: Estradiol lowers IGF-I in a 46 year old acromegalic female treated with pegvisomant. Exp Clin Endocrinol Diabetes 2006. [DOI: 10.1055/s-2006-954702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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79
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Muessig K, Gallwitz B, Honegger J, Strasburger CJ, Bidlingmaier M, Machicao F, Bornemann A, Ranke MB, Haering HU, Petersenn S. Pegvisomant treatment in gigantism caused by a growth hormone-secreting giant pituitary adenoma. Exp Clin Endocrinol Diabetes 2006. [DOI: 10.1055/s-2006-954701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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80
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Hübener C, Bidlingmaier M, Hasbargen U. Nachweis des Humanen Plazentaren Wachstumshormons (hGH-V) im maternalen Serum bei Extrauteringravidität. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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81
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Steffin B, Gutt B, Bidlingmaier M, Dieterle C, Oltmann F, Schopohl J. Effects of the long-acting somatostatin analogue Lanreotide Autogel on glucose tolerance and insulin resistance in acromegaly. Eur J Endocrinol 2006; 155:73-8. [PMID: 16793952 DOI: 10.1530/eje.1.02185] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECT Treatment with somatostatin analogues (SA) not only inhibits GH secretion but may also impair insulin secretion. In order to evaluate the influence of SA on glucose metabolism, we investigated insulin resistance (IR) and beta-cell function, using the recommended combination of homeostatic model assessment of IR (HOMA-IR) and beta-cell function (HOMA-beta). DESIGN AND METHODS This is a prospective, cross-sectional study. We measured fasting insulin, blood glucose and IGF-I. Insulin and blood glucose measurements were taken 120 min after an oral glucose tolerance test with 75 g glucose. We studied 51 patients (27 female/24 male, age 54 years (20-75)). Eighteen patients were on Lanreotide Autogel (LA) treatment, 33 had no medical treatment. GH-levels of more than 2.5 ng/ml was reached by 59% of the patients, 74.5% had normal IGF-I levels. RESULTS We found no significant influence of disease activity on HOMA-IR and HOMA-beta. In the 33 of 51 subjects without any drug treatment, median HOMA-beta was 170.4% (36.0-624.0%). In contrast, in the 18 patients on LA treatment, median HOMA-beta was found to be significantly lower (84.2% (36.5-346.2%); P = 0.001). Despite this, there was no difference in HOMA-IR in both groups (2.4 (0.7-8.4) vs 2.3 (0.7-6.1); P < 0.001) despite similar insulin values. CONCLUSION In conclusion, we found that LA decreases beta-cell function significantly without affecting IR. Therefore, we think that insulin secretagogues are probably more effective in the treatment of diabetes mellitus in acromegalic patients on LA therapy than insulin sensitizers.
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82
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Reisch N, Mauracher B, Bidlingmaier M, Reincke M. ACTH stability depends on different preanalytical procedures. Exp Clin Endocrinol Diabetes 2006. [DOI: 10.1055/s-2006-933089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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83
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Bidlingmaier M, Petru R, Schoechlin C, Pedrosa Gil F, Angerer P. Working conditions and salivary cortisol in young hospital physicians. Exp Clin Endocrinol Diabetes 2006. [DOI: 10.1055/s-2006-933087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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84
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Steffin B, Gutt B, Roemmler J, Bidlingmaier M, Schopohl J, Neuroendokrinologie AG. Evaluation of glucose-suppressed GH and IGF-I levels in patients with active and inactive acromegaly. Exp Clin Endocrinol Diabetes 2006. [DOI: 10.1055/s-2006-932932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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85
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Berg C, Pokrajac A, Bidlingmaier M, Strasburger C, Mann K, Shalet SM, Trainer PJ. The influence of a GH receptor antagonist (GHRA) on the relationship between GH and IGF-I in Adults with Growth Hormone Deficiency (AGHD). Exp Clin Endocrinol Diabetes 2006. [DOI: 10.1055/s-2006-932874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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86
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Pokrajac A, Berg C, Paisley A, Bidlingmaier M, Strasburger C, Shalet S, Trainer P. Can Adults with severe Growth Hormone Deficiency (AsGHD) and a low IGF-I be distinguished from those with a normal IGF-I? Exp Clin Endocrinol Diabetes 2006. [DOI: 10.1055/s-2006-932937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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87
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Zwermann O, Vakrilova Y, Mauracher B, Bidlingmaier M, Reincke M. Aberrant receptor expression in primary aldosteronism. Exp Clin Endocrinol Diabetes 2006. [DOI: 10.1055/s-2006-933065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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88
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Feelders RA, Bidlingmaier M, Strasburger CJ, Janssen JAMJL, Uitterlinden P, Hofland LJ, Lamberts SWJ, van der Lely AJ, de Herder WW. Postoperative evaluation of patients with acromegaly: clinical significance and timing of oral glucose tolerance testing and measurement of (free) insulin-like growth factor I, acid-labile subunit, and growth hormone-binding protein levels. J Clin Endocrinol Metab 2005; 90:6480-9. [PMID: 16159936 DOI: 10.1210/jc.2005-0901] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
CONTEXT It is not exactly known when patients with acromegaly should be evaluated for cure after transsphenoidal adenomectomy (TA). OBJECTIVE The objective of this study was to define the optimal time point of postoperative evaluation by serial measurements of glucose-suppressed GH levels [oral glucose tolerance test (OGTT)] and the GH-dependent parameters IGF-I, free IGF-I, acid labile subunit (ALS), and GH-binding protein (GHBP). DESIGN We describe a prospective study with 1-yr follow-up. SETTING The study was conducted at a university hospital. PATIENTS Seventeen patients with acromegaly were included in the study. MAIN OUTCOME MEASURES The main outcome measures were OGTT results at 1, 2, 3, 8, and 12 wk after TA; weekly measured GH, (free) IGF-I, ALS, and GHBP levels up to 12 wk; and total IGF-I levels measured at 52 wk. RESULTS Postoperatively, nine patients were in remission with an OGTT GH nadir of less than 0.5 microg/liter and normalized IGF-I levels, whereas eight patients had persistent acromegaly. In both cured and noncured patients, OGTT results at 1 wk after TA were highly reproducible over time. In contrast, early postoperative IGF-I levels fluctuated and only stabilized at 12 wk. In all cured patients, free IGF-I levels rapidly normalized within 2 wk after TA (specificity, 100%). Preoperative ALS levels were elevated in all patients and normalized only in the cured patients after TA (specificity, 89%). Preoperative GHBP levels were low and increased from 2 wk after surgery. CONCLUSIONS We show that in the postoperative evaluation of patients with acromegaly, already 1 wk after surgery, an OGTT using 0.5 microg as the GH nadir cutoff value has a high predictive value for cure, whereas early IGF-I levels show varying patterns toward stabilization. Therefore, IGF-I should be measured as a predictive parameter not within 3 months after surgery. Free IGF-I and ALS levels may have an additional value in the postoperative assessment of disease activity.
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89
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Weiss S, Zimmermann G, Baumgart R, Kasten P, Bidlingmaier M, Henle P. Systemic regulation of angiogenesis and matrix degradation in bone regeneration--distraction osteogenesis compared to rigid fracture healing. Bone 2005; 37:781-90. [PMID: 16202678 DOI: 10.1016/j.bone.2005.06.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2005] [Revised: 06/28/2005] [Accepted: 06/30/2005] [Indexed: 10/25/2022]
Abstract
Aim of this study was the investigation of systemic biochemical regulation mechanisms of bone regeneration by angiogenic and matrix-degrading enzymes during distraction osteogenesis compared to rigid osteotomy bone healing. Serum samples of 10 otherwise healthy patients with callus distraction for lower limb-lengthening and 10 osteotomy patients undergoing elective axis correction have been collected prospectively in a standardized time schedule before and up to 6 months after the procedure. At the end of the individual investigation period, concentrations of metalloproteinases (MMP-9, -13), tissue inhibitors of metalloproteinases (TIMP-1, TIMP-2) and the angiogenic factors angiogenin and VEGF have been detected by use of commercially available enzyme immunoassays. Results have been compared to our preliminary study on proMMP-1-3. In distraction osteogenesis, significantly elevated serum concentrations compared to baseline could be detected postoperatively for proMMP-1, MMP-9, TIMP-1, angiogenin and VEGF but not for proMMP-2, proMMP-3 or TIMP-2. In patients with rigid osteotomy healing, MMP-9, TIMP-1, TIMP-2, angiogenin and VEGF were significantly increased respectively. Comparison of both patient collectives revealed significantly higher increases of serum proMMP-1, VEGF and TIMP-1 in distraction patients during the lengthening period and significantly higher serum concentrations of TIMP-2 in late fracture healing period in osteotomy patients. Serum levels of MMP-13 were below the lowest standards, and therefore quantitative analysis was not possible. Bone regeneration in distraction osteogenesis and rigid osteotomy healing is accompanied by systemic increase of matrix-degrading and angiogenic factors in a certain time course and quantity. This might reflect biochemical regulation of local bone healing in the circulation. ProMMP-1, VEGF and TIMP-1 seem to be key regulatory factors during distraction osteogenesis.
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90
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Gutt B, Bidlingmaier M, Kretschmar K, Dieterle C, Steffin B, Schopohl J. Four-year follow-up of acromegalic patients treated with the new long-acting formulation of Lanreotide (Lanreotide Autogel). Exp Clin Endocrinol Diabetes 2005; 113:139-44. [PMID: 15789272 DOI: 10.1055/s-2005-837520] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Lanreotide Autogel (Ipsen) is a long-acting somatostatin analogue (SA) in a new galenic formulation suitable for subcutaneous (s.c.) injection. In our department, 11 patients with therapy-resistant acromegaly were treated with Lanreotide Autogel for 48 months. 10/11 patients had previously undergone transsphenoidal surgery. For a median duration of 1.4 years prior to Lanreotide Autogel, the patients received Lanreotide PR 30 mg every 7, 10, or 14 days. 60, 90, or 120 mg of Lanreotide Autogel was administered by deep s.c. injection every 28 days, with the higher dosage being given to those with the previously shortest injection interval under Lanreotide PR. Dose was adjusted on the basis of Growth Hormone (GH) level after 4, 8, and 12 months with a minimum dose of 60 mg and a maximum dose of 120 mg. The efficacy of Lanreotide Autogel treatment was evaluated by measuring GH concentrations (4 hour profiles) and IGF-I levels. Before switching to Lanreotide Autogel, the multiple of the upper limit of normal (xULN) of IGF-I levels was 1.2 (median) and the median GH level was 1.3 microg/l. 3 out of 11 patients had an IGF-I within the age- and sex-adjusted normal range. After 48 months of treatment with Lanreotide Autogel, six patients had an IGF-I within the normal range. Median GH levels were at 1.3 microg/l and xULN of IGF-I was at 1.0 compared to Lanreotide PR 30 mg treatment (p < 0.001). At the end of the study, 8 patients received 120 mg Lanreotide Autogel, 2 patients 90 mg and 1 patient 60 mg, respectively. There was slight but significant deterioration of glucose metabolism with an increase of HbA1c. In conclusion, the new galenic formulation of Lanreotide improves not only the control of biochemical markers of acromegaly compared to the conventional PR formulation, but is also easier to administer given its deep s.c. method of administration. Glucose metabolism has to be followed carefully in patients on high-dose Lanreotide Autogel.
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91
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Steffin B, Gutt B, Bidlingmaier M, Dieterle C, Oltmann F, Schopohl J. Effects of long acting somatostatin analogues on glucose tolerance and insulin resistance in acromegaly. Exp Clin Endocrinol Diabetes 2005. [DOI: 10.1055/s-2005-862953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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92
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Gutt B, Steffin B, Bidlingmaier M, Goodwin L, Schopohl J. Endogenous GH levels after growth hormone receptor antagonist treatment with and without additional Octreotide. Exp Clin Endocrinol Diabetes 2005. [DOI: 10.1055/s-2005-863012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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93
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Otto B, Rochlitz H, Möhlig M, Burget L, Kampe J, Pfluger P, Castenada T, Krishna R, Bodani U, Mehta K, Cuntz U, Tschöp M, Bidlingmaier M, Pfeiffer A, Spranger J. Circulating Concentrations of Human Peptide YY: Influence of Acute and Chronic Energy Balance Changes. Exp Clin Endocrinol Diabetes 2005. [DOI: 10.1055/s-2005-862856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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94
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Bidlingmaier M, Wu Z, Strasburger CJ. True total growth hormone (hGH) measurement: Elimination of hGH binding protein (hGHBP) interference by a hGH receptor blocking monoclonal antibody. Exp Clin Endocrinol Diabetes 2005. [DOI: 10.1055/s-2005-862937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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95
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Burget L, Castaeda T, Strasburger CJ, Tschöp M, Bidlingmaier M. Brain specific growth hormone receptor blockade modulates feeding in rats. Exp Clin Endocrinol Diabetes 2005. [DOI: 10.1055/s-2005-862862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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96
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Gutt B, Steffin B, Bidlingmaier M, Kretschmar K, Dieterle C, Schopohl J. Four year results of Lanreotide Autogel treatment in acromegalic patients. Exp Clin Endocrinol Diabetes 2004. [DOI: 10.1055/s-2004-832883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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97
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Linnemann K, Bidlingmaier M, May K, Siebert N, Fusch C. Freisetzung des plazentaren Wachstumshormons (hGH-V) im dualen in vitro Plazentaperfusionsmodell. Z Geburtshilfe Neonatol 2004. [DOI: 10.1055/s-2004-829335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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98
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Schiessl B, Strasburger CJ, Bidlingmaier M, Friess S, Kirk S, Kainer F. Spielt plazentares Wachstumshormon eine Rolle in der NO-vermittelten Gefäßrelaxation? Z Geburtshilfe Neonatol 2004. [DOI: 10.1055/s-2003-818321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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99
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Schiessl B, Strasburger CJ, Bidlingmaier M, Ugele B, Kainer F. NO-Produktion und maternaler arterieller Gefäßwiderstand bei unauffälligen Schwangerschaften und Präeklampsie. Z Geburtshilfe Neonatol 2004. [DOI: 10.1055/s-2003-818113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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100
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Milward A, Metherell L, Maamra M, Barahona MJ, Wilkinson IR, Camacho-Hübner C, Savage MO, Bidlingmaier M, Bidlingmaier CM, Clark AJL, Ross RJM, Webb SM. Growth hormone (GH) insensitivity syndrome due to a GH receptor truncated after Box1, resulting in isolated failure of STAT 5 signal transduction. J Clin Endocrinol Metab 2004; 89:1259-66. [PMID: 15001620 DOI: 10.1210/jc.2003-031418] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Congenital GH insensitivity syndrome (GHIS) is usually the result of a mutation in the extracellular domain of the GH receptor (GHR). We report one of only a small number of mutations so far identified within the intracellular domain of the GHR. The probands are a 53-yr-old woman, height 114 cm (SD score, -8.7), peak GH 45 microg/liter during hypoglycemia, IGF-I 8.0 microg/liter [normal range (N) N 54-389], IGF binding protein-3 16 nmol/liter (N 61-254), GHBP 6.8% (N > 10); and her 57-yr-old brother, height 140 cm (SD score, -6), IGF-I 38.8 micro g/liter (N 54-290), IGF binding protein-3 30 nmol/liter (N 61-196). Both patients were homozygous for a 22-bp deletion in the DNA encoding the cytoplasmic domain of the GHR, resulting in a frameshift and premature stop codon. The resultant GHR is truncated at amino acid 449 (GHR1-449) after Box1, the Janus kinase 2 binding domain of the receptor. Functional studies in HEK293 and Chinese hamster ovary cells show GHR1-449 to have a cellular distribution similar to that of the wild-type GHR, judged by binding of iodinated GH, FACS analysis, and immunocytochemistry. Western blot analysis showed GH-induced phosphorylation of Janus kinase 2, signal transducer and activator of transcription (Stat)3, and Erk2 for both GHR1-449 and wild-type GHR. However, no Stat5 activity was detected in cells expressing GHR1-449, consistent with the fact that GHR1-449 contains no Stat5 binding site. In conclusion, we report two adult siblings with GHIS due to a mutation in the intracellular domain of GHR resulting in a selective loss of Stat5 signaling. Results are consistent with the hypothesis that the loss of signaling through the Stat5 pathway results in GHIS.
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