ArticlePituitary2016
"Micromegaly": an update on the prevalence of acromegaly with apparently normal GH secretion in the modern era.
Article in Pituitary, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 46 citations in OpenAlex.
- Trial
- Changing understanding of acromegaly epidemiology and early mortality risk.The Journal of clinical endocrinology and metabolism · 2026Review
- Micromegaly: a distinct clinical entity? Insights from a monocentric cohort study.Frontiers in endocrinology · 2026Article
- Acromegaly: diagnostic challenges and individualized treatment.Expert review of endocrinology & metabolism · 2025Review
- Article
- Double pituitary neuroendocrine tumors in a patient with normal growth hormone level acromegaly: A case report and review of the literature.Surgical neurology international · 2023Article
- Factors associated with therapeutic response in acromegaly diagnosed in the elderly in Spain.Frontiers in endocrinology · 2022Article
- [Discordant parameters of insulin-like growth factor 1 and growth hormone in the diagnosis and monitoring of acromegaly].Problemy endokrinologii · 2021Review
- Soluble Alpha Klotho in Acromegaly: Comparison With Traditional Markers of Disease Activity.The Journal of clinical endocrinology and metabolism · 2021Article
- Clinical and hormonal findings in patients presenting with high IGF-1 and growth hormone suppression after oral glucose load: a retrospective cohort study.European journal of endocrinology · 2021Article
- The Biochemical Diagnosis of Acromegaly.Journal of clinical medicine · 2021Review
- Clinical presentation and management of acromegaly in elderly patients.Hormones (Athens, Greece) · 2021Article
- [Selective screening of patients with associated somatic diseases as a method of early detection of acromegaly].Problemy endokrinologii · 2021Article
- GPR64 promotes cAMP pathway in tumor aggressiveness in sparsely granulated growth hormone cell adenomas.Endocrine · 2020Article
- Acromegaly with congenital generalized lipodystrophy - two rare insulin resistance conditions in one patient: a case report.Journal of medical case reports · 2020Article
- Updates in Diagnosis and Treatment of Acromegaly.European endocrinology · 2018Review
- Silent somatotroph pituitary adenomas: an update.Pituitary · 2018Review
- Biochemical diagnosis of acromegaly without a typical clinical phenotype: what are the concerns?Archives of endocrinology and metabolism · 2017Article
- Acromegaly at diagnosis in 3173 patients from the Liège Acromegaly Survey (LAS) Database.Endocrine-related cancer · 2017Article
- Review
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeApproximately 25 % of cases of clinically active acromegaly cases treated in our academic center between 1996 and 2000, were diagnosed in patients who had elevated plasma IGF-1 levels, but apparently "normal" 24-h mean plasma GH levels. The current study served to update the data for patients with acromegaly referred to our facility, after increasing awareness of this "normal" GH subpopulation throughout the medical community.
methodsA retrospective chart review was conducted on 157 patients with acromegaly who underwent resection of a confirmed somatotroph pituitary adenoma at the University of Michigan Health System between the dates of 1 Jan 2001 to 23 Sept 2015.
resultsOverall prevalence of acromegalic patients with "normal" GH levels, defined as GH <4.7 ng/mL, was 31 %. Over time, the percentage of patients with "normal" GH at diagnosis did not decline: 26 % from 2001 to 2005, 19 % from 2006 to 2010, and 47 % from 2011 to 2015. Mean pituitary tumor size was 1.8 ± 0.1 cm for the group with elevated GH, and 1.2 ± 0.1 cm for the group with "normal" GH (p < 0.001). Percent microadenomas was higher in a group with "normal" GH as compared to those with elevated GH (48 vs. 12 %, p < 0.001), and tumors >2 cm in the maximal diameter were encountered more frequently in the group with elevated GH (43 vs. 14 %, p < 0.001).
conclusionsOur data show that a substantial percentage of patients with clinical acromegaly have "normal" GH, and therefore strengthens the growing body of evidence which supports the leading role of IGF-1 levels in diagnostic evaluation. At the present time, questions about the natural course of "micromegaly" and treatment benefits compared to the subpopulation with elevated GH levels remain unanswered, but research continues to build on our understanding of the heterogeneous population of individuals.
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