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Deutsches Arzteblatt International Feb 2018Empty sella is the neuroradiological or pathological finding of an apparently empty sella turcica containing no pituitary tissue. The prevalence of primary empty sella,...
BACKGROUND
Empty sella is the neuroradiological or pathological finding of an apparently empty sella turcica containing no pituitary tissue. The prevalence of primary empty sella, i.e., empty sella without any discernible cause, is not precisely known; estimates range from 2% to 20%. Technical advances in neuroradiology have made empty sella an increasingly common incidental finding. It remains unclear whether, and to what extent, asymptomatic adult patients with an incidentally discovered empty sella should undergo diagnostic testing for hormonal disturbances.
METHODS
To answer this question, the authors carried out a systematic search in the PubMed and Web of Science databases for publications that appeared in the period 1995-2016 and that contained the search term "empty sella" (registration: PROSPERO 2015: CRD42015024550).
RESULTS
The search yielded 1282 hits. After the exclusion of duplicates, pediatric reports, case reports, and veterinary studies, 120 publications on primary empty sella syndrome (PES) were identified. 4 of these dealt with the prevalence of pituitary insufficiency in patients with PES as an incidental finding. Among patients with PES, the relative frequency of pituitary insufficiency in the pooled analysis was 52% (95% confidence interval [38; 65]).
CONCLUSION
The data on PES as an incidental finding are too sparse to enable any evidence-based recommendation on the potential indications for hormone testing or its nature and extent. We advise basic neuroendocrinological testing (fasting cortisol, free thyroxine [fT4], estradiol or testosterone, insulin-like growth factor 1 [IGF-1], and prolactin). There is an unexplained discrepancy between the reported high prevalence of pituitary insufficiency among persons with PES and its low prevalence in epidemiologic studies. We suspect that the former may be high because of selection bias in the publications that we reviewed, or else the latter may be erroneously low.
Topics: Empty Sella Syndrome; Endocrine System Diseases; Estradiol; Female; Humans; Hydrocortisone; Hypopituitarism; Incidental Findings; Insulin-Like Growth Factor I; Magnetic Resonance Imaging; Male; Neuroradiography; Pituitary Gland; Prevalence; Prolactin; Testosterone; Thyroxine
PubMed: 29510819
DOI: 10.3238/arztebl.2018.0099 -
Nutrients Apr 2017To investigate the association between serum concentration of insulin-like growth factor (IGF) and the risk of pancreatic cancer (PaC). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To investigate the association between serum concentration of insulin-like growth factor (IGF) and the risk of pancreatic cancer (PaC).
METHODS
We identified eligible studies in Medline and EMBASE databases (no reference trials from 2014 to 2016) in addition to the reference lists of original studies and review articles on this topic. A summary of relative risks with 95% confidence intervals (CI) was calculated using a random-effects model. The heterogeneity between studies was assessed using Cochran and ² statistics.
RESULTS
Ten studies (seven nested case-control studies and three retrospective case-control studies) were selected as they met our inclusion criteria in this meta-analysis. All these studies were published between 1997 and 2013. The current data suggested that serum concentrations of IGF-I, IGF-II and insulin-like growth factor binding protein-3 (IGFBP-3)in addition to the IGF-I/IGFBP-3 ratio were not associated with an increased risk of PaC (Summary relative risks (SRRs) = 0.92, 95% CI: 0.67-1.16 for IGF-I; SRRs = 0.84, 95% CI: 0.54-1.15 for IGF-II; SRRs = 0.93, 95% CI: 0.69-1.17 for IGFBP-3; SRRs = 0.97, 95% CI: 0.71-1.23 for IGF-I/IGFBP-3 ratio). There was no publication bias in the present meta-analysis.
CONCLUSION
Serum concentrations of IGF-I, IGF-II, IGFBP-1 and IGFBP-3 as well as the IGF-I/IGFBP-3 ratio were not associated with increased risk of PaC.
Topics: Humans; Insulin-Like Growth Factor Binding Protein 3; Insulin-Like Growth Factor I; Insulin-Like Growth Factor II; Pancreatic Neoplasms; Risk Factors
PubMed: 28420208
DOI: 10.3390/nu9040394 -
Cancer Causes & Control : CCC Jun 2017To establish whether the association between milk intake and prostate cancer operates via the insulin-like growth factor (IGF) pathway (including IGF-I, IGF-II, IGFBP-1,... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To establish whether the association between milk intake and prostate cancer operates via the insulin-like growth factor (IGF) pathway (including IGF-I, IGF-II, IGFBP-1, IGFBP-2, and IGFBP-3).
METHODS
Systematic review, collating data from all relevant studies examining associations of milk with IGF, and those examining associations of IGF with prostate cancer risk and progression. Data were extracted from experimental and observational studies conducted in either humans or animals, and analyzed using meta-analysis where possible, with summary data presented otherwise.
RESULTS
One hundred and seventy-two studies met the inclusion criteria: 31 examining the milk-IGF relationship; 132 examining the IGF-prostate cancer relationship in humans; and 10 animal studies examining the IGF-prostate cancer relationship. There was moderate evidence that circulating IGF-I and IGFBP-3 increase with milk (and dairy protein) intake (an estimated standardized effect size of 0.10 SD increase in IGF-I and 0.05 SD in IGFBP-3 per 1 SD increase in milk intake). There was moderate evidence that prostate cancer risk increased with IGF-I (Random effects meta-analysis OR per SD increase in IGF-I 1.09; 95% CI 1.03, 1.16; n = 51 studies) and decreased with IGFBP-3 (OR 0.90; 0.83, 0.98; n = 39 studies), but not with other growth factors. The IGFBP-3 -202A/C single nucleotide polymorphism was positively associated with prostate cancer (pooled OR for A/C vs. AA = 1.22; 95% CI 0.84, 1.79; OR for C/C vs. AA = 1.51; 1.03, 2.21, n = 8 studies). No strong associations were observed for IGF-II, IGFBP-1 or IGFBP-2 with either milk intake or prostate cancer risk. There was little consistency within the data extracted from the small number of animal studies. There was additional evidence to suggest that the suppression of IGF-II can reduce tumor size, and contradictory evidence with regards to the effect of IGFBP-3 suppression on tumor progression.
CONCLUSION
IGF-I is a potential mechanism underlying the observed associations between milk intake and prostate cancer risk.
Topics: Animals; Disease Progression; Humans; Insulin-Like Growth Factor Binding Protein 1; Insulin-Like Growth Factor Binding Protein 2; Insulin-Like Growth Factor Binding Protein 3; Insulin-Like Growth Factor I; Insulin-Like Growth Factor II; Male; Milk; Prostate; Prostatic Neoplasms; Risk
PubMed: 28361446
DOI: 10.1007/s10552-017-0883-1 -
BMC Cancer Aug 2016Insulin-like growth factors (IGF´s) play a crucial role in controlling cancer cell proliferation, differentiation and apoptosis. Exercise has been postulated as an... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Insulin-like growth factors (IGF´s) play a crucial role in controlling cancer cell proliferation, differentiation and apoptosis. Exercise has been postulated as an effective intervention in improving cancer-related outcomes and survival, although its effects on IGF´s are not well understood. This meta-analysis aimed to determine the effects of exercise in modulating IGF´s system in breast cancer survivors.
METHODS
Databases of PuMed, EMBASE, Cochrane Central Register of Controlled Trials, EMBASE, ClinicalTrials.gov, SPORTDiscus, LILACS and Scopus were systematically searched up to November 2014. Effect estimates were calculated through a random-effects model of meta-analysis according to the DerSimonian and Laird method. Heterogeneity was evaluated with the I (2) test. Risk of bias and methodological quality were evaluated using the PEDro score.
RESULTS
Five randomized controlled trials (n = 235) were included. Most women were post-menopausal. High-quality and low risk of bias were found (mean PEDro score = 6.2 ± 1). Exercise resulted in significant improvements on IGF-I, IGF-II, IGFBP-I, IGFBP-3, Insulin and Insulin resistance (P < 0.05). Non-significant differences were found for Glucose. Aerobic exercise improved IGF-I, IGFBP-3 and Insulin. No evidence of publication bias was detected by Egger´s test (p = 0.12).
CONCLUSIONS
Exercise improved IGF´s in breast cancer survivors. These findings provide novel insight regarding the molecular effects of exercise on tumoral microenvironment, apoptosis and survival in breast cancer survivors.
Topics: Biomarkers; Breast Neoplasms; Combined Modality Therapy; Exercise; Female; Humans; Insulin-Like Growth Factor Binding Protein 3; Insulin-Like Growth Factor I; Insulin-Like Growth Factor II; Neoplasm Staging; Publication Bias; Somatomedins; Survivors
PubMed: 27562357
DOI: 10.1186/s12885-016-2733-z -
Acta Obstetricia Et Gynecologica... Sep 2013Insulin-like growth factors (IGFs) and their binding proteins (IGFBPs) are key regulators of fetal growth. However, the literature is inconsistent. Our objective was to... (Meta-Analysis)
Meta-Analysis Review
Insulin-like growth factors (IGFs) and their binding proteins (IGFBPs) are key regulators of fetal growth. However, the literature is inconsistent. Our objective was to systematically and objectively evaluate the available literature and to develop a balanced opinion on the relation between maternal and fetal IGF-axes and birthweight. A systematic review and a meta-analysis were conducted according to the published Moose (Meta-analysis of Observational Studies in Epidemiology) guidelines. A robust recognized systematic methodology was used in the literature search and analysis to avoid bias. Weighted mean difference and 95% confidence intervals of cord/maternal IGFs and IGFBP-1 and -3 were calculated. Eleven observational studies were included. Cord IGF-I (p < 0.0001) and IGFBP-3 (p = 0.003) were significantly higher in large-for-gestational age (LGA) than appropriate-for-gestational age (AGA) babies. Cord IGFBP-1 was significantly higher in small-for-gestational age (SGA) than AGA babies (p < 0.0001). LGA and AGA babies had similar IGF-II levels, whereas SGA and AGA babies had comparable IGF-I levels. IGF-I was significantly higher in mothers of AGA than SGA babies (p < 0.0001). The assay methods and background population marginally affect the overall homogeneity and the direction of the primary analysis. Fetal IGFs and their binding proteins play different roles in fetal growth at either end of the growth spectrum. Fetal IGF-I and IGFBP-3 may be influential in LGA. However, fetal IGFBP-1 has a more prominent role in SGA.
Topics: Female; Fetal Development; Humans; Insulin-Like Growth Factor Binding Proteins; Pregnancy; Somatomedins
PubMed: 23745729
DOI: 10.1111/aogs.12192 -
Hormone Research in Paediatrics 2013Growth hormone (GH) therapy is used to treat a variety of growth disorders in childhood/adolescence. Its efficacy is thought to be dependent on patients' adherence to... (Review)
Review
INTRODUCTION
Growth hormone (GH) therapy is used to treat a variety of growth disorders in childhood/adolescence. Its efficacy is thought to be dependent on patients' adherence to their treatment regimen.
METHODS
PubMed was searched using the keywords 'growth hormone', 'child'[Mesh], 'adolescent'[Mesh], and 'patient compliance'[Mesh].
RESULTS
Most studies of adherence to paediatric GH therapy have used either issued/encashed GH prescriptions or questionnaires. Estimates of prevalence of non-adherence vary from 5-82%, depending on the methods and definitions used. Different studies have variously demonstrated an association (or lack thereof) between adherence and age, socioeconomic status, treatment duration, injection device used and injection-giver. A number of interventions have been proposed to improve adherence, including offering a choice of injection device, but none are supported by trials. Poor adherence is associated with reduced height velocity and likely increased economic costs; evidence for other effects is circumstantial.
CONCLUSION
Adherence to paediatric GH therapy is suboptimal, which may partially explain why the mean final height attained is below that of the general population. Analysis of the causes of non-adherence is complicated by conflicting evidence from different studies. Multifactorial interventions are most likely to be successful in improving adherence. We make recommendations for further research.
Topics: Body Height; Choice Behavior; Growth Disorders; Human Growth Hormone; Humans; Injections, Subcutaneous; Insulin-Like Growth Factor I; Patient Compliance; Recombinant Proteins
PubMed: 23635797
DOI: 10.1159/000350251 -
Osteoarthritis and Cartilage Feb 2012To evaluate the association between radiographic osteoarthritis (OA) and either serum insulin-like growth factor-1 (IGF-1) levels or IGF-1 gene polymorphisms in patients... (Review)
Review
OBJECTIVE
To evaluate the association between radiographic osteoarthritis (OA) and either serum insulin-like growth factor-1 (IGF-1) levels or IGF-1 gene polymorphisms in patients with primary OA.
METHODS
We conducted a systematic review of reported associations between circulating IGF-1 and/or IGF-1 gene polymorphisms and radiographic OA. Studies were eligible when: (1) investigating serum IGF-1 and/or IGF-1 gene polymorphisms in relation to prevalent or incident radiographic OA; (2) written in English; (3) full-text article or abstract; (4) patients had primary OA in knee, hip, hand or spine; (5) longitudinal, case-control or cross-sectional design. Quality assessment was done using a standardized criteria set. Best-evidence synthesis was performed based on guidelines on systematic review from the Cochrane Collaboration Back Review Group, using five evidence levels: strong, moderate, limited, conflicting and no evidence.
RESULTS
We included 11 studies with more than 3000 primary OA cases. Data on the relationship between serum IGF-1 and radiographic OA were inconsistent. Adjustment for body mass index (BMI) was often omitted. Of four high-quality studies, three studies reported no association, one study found significantly higher IGF-1 levels in OA patients compared to controls. Patients with IGF-1 gene promoter polymorphisms and a genetic variation at the IGF-1R locus had an increased OA prevalence compared to controls.
CONCLUSIONS
Observational data showed no association between serum IGF-1 and occurrence of radiographic OA (moderate level of evidence), and a positive relationship between IGF-1 gene polymorphisms and radiographic OA (moderate level of evidence); however the confounding effect of BMI was insufficiently addressed. Future well-designed prospective studies should further elaborate the role of the complex GH/IGF-1 system in primary OA.
Topics: Biomarkers; Evidence-Based Medicine; Genetic Predisposition to Disease; Humans; Insulin-Like Growth Factor I; Osteoarthritis; Polymorphism, Genetic; Radiography
PubMed: 22178467
DOI: 10.1016/j.joca.2011.11.012 -
IGF-I and IGFBP-3 and the risk of lung cancer: a meta-analysis based on nested case-control studies.Journal of Experimental & Clinical... Jun 2009Lung cancer is the leading cause of death from cancer worldwide. Conventional studies mainly think that insulin-like growth factor-I (IGF-I) and IGF-binding protein-3... (Comparative Study)
Comparative Study Meta-Analysis
BACKGROUND
Lung cancer is the leading cause of death from cancer worldwide. Conventional studies mainly think that insulin-like growth factor-I (IGF-I) and IGF-binding protein-3 (IGFBP-3) may promote and inhibit tumor growth, respectively. However, there are many different results about their function in some recent epidemiological studies. To evaluate the relationship between circulating serum levels of IGF-I, IGFBP-3 and lung cancer, a systematic review and meta-analysis of the published data was performed.
METHODS
Literatures searched on PubMed and Embase databases were enrolled in the Meta-analysis. The Meta-analysis of all eligible studies was applied with Stata 10.0 software, and the pooled odds ratio(OR) and weighted mean difference (WMD) value were obtained. The Q test, Egger's test and Begg's funnel plot were used to evaluate the heterogeneity and publication bias between the studies.
RESULTS
There are no statistically significant heterogeneity and publication bias between the studies. For IGF- I, the pooled OR and WMD were 0.87(95%CI: 0.60 approximately 1.13,) and -3.04(95%CI: -7.10 approximately 1.02, P = 0.14), respectively. For IGFBP-3, the pooled OR and WMD were 0.68(95%CI: 0.48 approximately 0.88,) and -112.28(95%CI: -165.88 approximately -58.68, P < 0.0001), respectively.
CONCLUSION
The association between circulating IGF- I levels and the risk of lung cancer were not statistically significant; IGFBP-3, acts as a tumor suppressor and has a inverse correlation with the risk of lung cancer.
Topics: Case-Control Studies; Humans; Insulin-Like Growth Factor Binding Protein 3; Insulin-Like Growth Factor I; Lung Neoplasms; Risk Factors
PubMed: 19549343
DOI: 10.1186/1756-9966-28-89 -
International Journal of Cancer May 2009Insulin-like growth factors (IGF-I, IGF-II) and their binding proteins (IGFBP-1-6) play a key role in cell proliferation, differentiation and apoptosis, suggesting... (Meta-Analysis)
Meta-Analysis Review
Insulin-like growth factors (IGF-I, IGF-II) and their binding proteins (IGFBP-1-6) play a key role in cell proliferation, differentiation and apoptosis, suggesting possible involvement in carcinogenesis. Several epidemiological studies show associations of IGFs with prostate cancer. We searched the published literature for all studies relating levels of IGFs or IGFBPs with prostate cancer. We performed random effects meta-analysis to calculate summary odds ratios. The number of studies (prostate cancer cases) included in each meta-analysis were 42 (7,481) IGF-I; 10 (923) IGF-II; 3 (485) IGFBP-1; 5 (577) IGFBP-2; 29 (6,541) IGFBP-3 and 11 (3,545) IGF-1:IGFBP-3 ratio. The pooled odds ratios (95% confidence intervals) per standard deviation increase in peptide were: IGF-I, OR = 1.21 (1.07, 1.36); IGF-II, OR = 1.17 (0.93, 1.47); IGFBP-1, OR = 1.21 (0.62, 2.33); IGFBP-2, OR = 1.18 (0.90, 1.54); IGFBP-3, OR = 0.88 (0.79, 0.98); IGFI:IGFBP-3 ratio, OR = 1.10 (0.97, 1.24). For all exposures, there was substantial heterogeneity (all I(2) > 75%), partly explained by study design: the magnitude of associations was smaller in prospective vs. retrospective studies, and for IGFBP-3, the inverse association with prostate cancer risk was seen in retrospective but not prospective studies. There was weak evidence that associations of IGF-I and IGFBP-3 with prostate cancer were stronger for advanced disease. Our meta-analysis confirms that raised circulating lGF-I is positively associated with prostate cancer risk. Associations between IGFBP-3 and prostate cancer were inconsistent, and there was little evidence for a role of IGF-II, IGFBP-1 or IGFBP-2 in prostate cancer risk.
Topics: Humans; Insulin-Like Growth Factor Binding Proteins; Male; Peptides; Prostatic Neoplasms; Risk Factors; Somatomedins
PubMed: 19142965
DOI: 10.1002/ijc.24202