Association of pre- and postoperative αKlotho levels with long-term remission after pituitary surgery for acromegaly
Abstract Soluble αKlotho (sKl) is a disease-specific biomarker that is elevated in patients with acromegaly and declines after surgery for pituitary adenoma. Approximately 25% of patients do not achieve remission after surgery, therefore a risk stratification for patients early in the course of thei...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2022-08-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-19078-8 |
| _version_ | 1817994063903719424 |
|---|---|
| author | Marian Christoph Neidert Anna Maria Zeitlberger Henning Leske Oliver Tschopp Lisa Sze Cornelia Zwimpfer Peter Wiesli David Bellut René-Ludwig Bernays Elisabeth Jane Rushing Christoph Schmid |
| author_facet | Marian Christoph Neidert Anna Maria Zeitlberger Henning Leske Oliver Tschopp Lisa Sze Cornelia Zwimpfer Peter Wiesli David Bellut René-Ludwig Bernays Elisabeth Jane Rushing Christoph Schmid |
| author_sort | Marian Christoph Neidert |
| collection | DOAJ |
| description | Abstract Soluble αKlotho (sKl) is a disease-specific biomarker that is elevated in patients with acromegaly and declines after surgery for pituitary adenoma. Approximately 25% of patients do not achieve remission after surgery, therefore a risk stratification for patients early in the course of their disease may allow for the identification of patients requiring adjuvant treatment. Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) have been assessed as biomarker for disease activity, however the value of sKl as a predictive biomarker of surgical success has not been evaluated yet. In this study, we measured serum biomarkers before and after transsphenoidal pituitary surgery in 55 treatment-naïve patients. Based on biochemical findings at follow-up (7–16 years), we divided patients into three groups: (A) long-term cure (defined by normal IGF-1 and random low GH (< 1 μg/l) or a suppressed GH nadir (< 0.4/μg/l) on oral glucose testing); (B) initial remission with later disease activity; (C) persistent clinical and/or biochemical disease activity. sKl levels positively related to GH, IGF-1 levels and tumor volume. Interestingly, there was a statistically significant difference in pre- and postoperative levels of sKl between the long-term cure group and the group with persistent disease activity. This study provides first evidence that sKl may serve as an additional marker for surgical success, decreasing substantially in all patients with initial clinical remission while remaining high after surgery in patients with persistent disease activity. |
| first_indexed | 2024-04-14T01:47:09Z |
| format | Article |
| id | doaj.art-a22f441b41a74a26a3d30ab8de9eead1 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-14T01:47:09Z |
| publishDate | 2022-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-a22f441b41a74a26a3d30ab8de9eead12022-12-22T02:19:29ZengNature PortfolioScientific Reports2045-23222022-08-011211910.1038/s41598-022-19078-8Association of pre- and postoperative αKlotho levels with long-term remission after pituitary surgery for acromegalyMarian Christoph Neidert0Anna Maria Zeitlberger1Henning Leske2Oliver Tschopp3Lisa Sze4Cornelia Zwimpfer5Peter Wiesli6David Bellut7René-Ludwig Bernays8Elisabeth Jane Rushing9Christoph Schmid10Department of Neurosurgery, University Hospital ZurichDepartment of Neurosurgery, Kantonsspital St.GallenDepartment of Neuropathology, University Hospital ZurichDivision of Endocrinology and Diabetes, University Hospital ZurichDivision of Endocrinology and Diabetes, Kantonsspital WinterthurDivision of Endocrinology and Diabetes, University Hospital ZurichDepartment of Internal Medicine, Kantonsspital FrauenfeldDepartment of Neurosurgery, University Hospital ZurichDepartment of Neurosurgery, Clinic HirslandenDepartment of Neuropathology, University Hospital ZurichDivision of Endocrinology and Diabetes, University Hospital ZurichAbstract Soluble αKlotho (sKl) is a disease-specific biomarker that is elevated in patients with acromegaly and declines after surgery for pituitary adenoma. Approximately 25% of patients do not achieve remission after surgery, therefore a risk stratification for patients early in the course of their disease may allow for the identification of patients requiring adjuvant treatment. Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) have been assessed as biomarker for disease activity, however the value of sKl as a predictive biomarker of surgical success has not been evaluated yet. In this study, we measured serum biomarkers before and after transsphenoidal pituitary surgery in 55 treatment-naïve patients. Based on biochemical findings at follow-up (7–16 years), we divided patients into three groups: (A) long-term cure (defined by normal IGF-1 and random low GH (< 1 μg/l) or a suppressed GH nadir (< 0.4/μg/l) on oral glucose testing); (B) initial remission with later disease activity; (C) persistent clinical and/or biochemical disease activity. sKl levels positively related to GH, IGF-1 levels and tumor volume. Interestingly, there was a statistically significant difference in pre- and postoperative levels of sKl between the long-term cure group and the group with persistent disease activity. This study provides first evidence that sKl may serve as an additional marker for surgical success, decreasing substantially in all patients with initial clinical remission while remaining high after surgery in patients with persistent disease activity.https://doi.org/10.1038/s41598-022-19078-8 |
| spellingShingle | Marian Christoph Neidert Anna Maria Zeitlberger Henning Leske Oliver Tschopp Lisa Sze Cornelia Zwimpfer Peter Wiesli David Bellut René-Ludwig Bernays Elisabeth Jane Rushing Christoph Schmid Association of pre- and postoperative αKlotho levels with long-term remission after pituitary surgery for acromegaly Scientific Reports |
| title | Association of pre- and postoperative αKlotho levels with long-term remission after pituitary surgery for acromegaly |
| title_full | Association of pre- and postoperative αKlotho levels with long-term remission after pituitary surgery for acromegaly |
| title_fullStr | Association of pre- and postoperative αKlotho levels with long-term remission after pituitary surgery for acromegaly |
| title_full_unstemmed | Association of pre- and postoperative αKlotho levels with long-term remission after pituitary surgery for acromegaly |
| title_short | Association of pre- and postoperative αKlotho levels with long-term remission after pituitary surgery for acromegaly |
| title_sort | association of pre and postoperative αklotho levels with long term remission after pituitary surgery for acromegaly |
| url | https://doi.org/10.1038/s41598-022-19078-8 |
| work_keys_str_mv | AT marianchristophneidert associationofpreandpostoperativeaklotholevelswithlongtermremissionafterpituitarysurgeryforacromegaly AT annamariazeitlberger associationofpreandpostoperativeaklotholevelswithlongtermremissionafterpituitarysurgeryforacromegaly AT henningleske associationofpreandpostoperativeaklotholevelswithlongtermremissionafterpituitarysurgeryforacromegaly AT olivertschopp associationofpreandpostoperativeaklotholevelswithlongtermremissionafterpituitarysurgeryforacromegaly AT lisasze associationofpreandpostoperativeaklotholevelswithlongtermremissionafterpituitarysurgeryforacromegaly AT corneliazwimpfer associationofpreandpostoperativeaklotholevelswithlongtermremissionafterpituitarysurgeryforacromegaly AT peterwiesli associationofpreandpostoperativeaklotholevelswithlongtermremissionafterpituitarysurgeryforacromegaly AT davidbellut associationofpreandpostoperativeaklotholevelswithlongtermremissionafterpituitarysurgeryforacromegaly AT reneludwigbernays associationofpreandpostoperativeaklotholevelswithlongtermremissionafterpituitarysurgeryforacromegaly AT elisabethjanerushing associationofpreandpostoperativeaklotholevelswithlongtermremissionafterpituitarysurgeryforacromegaly AT christophschmid associationofpreandpostoperativeaklotholevelswithlongtermremissionafterpituitarysurgeryforacromegaly |