Acromegaly Clinical Trial
Official title:
Inter-Assay Growth Hormone and IGF-I Variability
The purpose of this study is to demonstrate the degree of variability in commercially available assays for Growth Hormone measurement in the context of clinical decision making for Growth Hormone (GH) deficiency and Acromegaly and to determine variability among IGF-I inter-assay samples obtained at the time of Growth-Hormone Releasing Hormone Arginine Testing and Oral Glucose Tolerance Testing.
This research will explore the variability of GH and IGF-1 measurements by commercially
available tests. The hypothesis is that the variability in GH and IGF-1 measurement will be
sizable enough that different conclusions would be drawn in patient case decision making in
the diagnosis and management of GH deficiency and acromegaly.
In order to correctly diagnose disorders of growth hormone secretion, either deficiency or
excess, it is necessary to have the accurate measurement of GH (growth hormone) serum and
Insulin-like growth factor (IGF-1).
For this study, subjects will be asked to give the Investigators additional blood during
either an OGTT (a test for acromegaly) or a growth hormone stimulation test (GHRH-arginine
stimulation). Ordinarily, blood would be measured at the beginning and end of the OGTT, and
for the GHRH-arginine it would be measured one half hour before the test and then every half
hour for 2 hours.
For this study, subjects will provide us with additional blood at the times when blood is
drawn for the clinically-indicated tests. No additional needle sticks will be necessary and
taking the additional blood will not interfere with the clinical test.
The test we will be doing with the additional blood will be identical to the tests we
ordinarily do, but will be done by a different lab. We are testing to see if these results
would be the same as our usual lab.
The study population will include 1) subjects with pituitary disease undergoing testing for
GH deficiency (GHRH arginine stimulation test), 2) subjects with suspicion of acromegaly
undergoing the oral glucose tolerance test (oGTT), and 3) normal controls undergoing both
the GHRH Arginine test and the oGTT. Patients from all groups will have their blood drawn
for the measurement of IGF-1. The serum from each test will be aliquoted and sent to the
designated labs.
For subject groups 1 and 2, this study poses no more than minimal risk, as it involves
procedures that do not go beyond clinical care. For healthy controls, we know that
participants will be asked to undergo testing that would not normally be required, and
therefore feel that the study poses more than minimal risk.
For the primary endpoint research samples will be compared to samples sent to the usual
clinical lab, and diagnoses made based on research samples will be compared to clinical
samples.
For secondary endpoints, each result from a commercially available assay will be correlated
to another corresponding method of analysis of the same hormone from the same time point by
using the Bland-Altman analysis wherein the difference between two methods is compared to
the mean of the two methods. Each sample will be compared to the sample used for clinical
evaluation.
Information from the medical records will be obtained and correlated with the lab test
results.
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Observational Model: Cohort, Time Perspective: Prospective
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