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B Shahida Department of Clinical Sciences, Genomics, Diabetes and Endocrinology, Lund University, Malmö, Sweden
Department of Diabetes and Endocrinology, Skåne University Hospital, Malmö, Sweden

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P Sahlstrand Johnson Department of Oto-Rhino-Laryngology, Skåne University Hospital, Malmö, Sweden
Department of Clinical Sciences, Lund University, Malmö, Sweden

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R Jain Department of Clinical Sciences, Genomics, Diabetes and Endocrinology, Lund University, Malmö, Sweden

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H Brorson Department of Clinical Sciences, Lund University, Malmö, Sweden
Department of Plastic Surgery, Skåne University Hospital, Malmö, Sweden

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P Åsman Department of Clinical Sciences Malmö, Ophthalmology, Lund University, Malmö, Sweden
Department of Ophthalmology, Skåne University Hospital, Malmö, Sweden

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M Lantz Department of Clinical Sciences, Genomics, Diabetes and Endocrinology, Lund University, Malmö, Sweden
Department of Diabetes and Endocrinology, Skåne University Hospital, Malmö, Sweden

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T Planck Department of Clinical Sciences, Genomics, Diabetes and Endocrinology, Lund University, Malmö, Sweden
Department of Diabetes and Endocrinology, Skåne University Hospital, Malmö, Sweden

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as an autoantigen and is expressed by both preadipocytes and adipocytes in orbital tissue ( 1 , 2 ) as well as in the thyroid. Other autoantigens, such as the insulin-like growth factor 1 (IGF-1) receptor have been suggested to be involved in the

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Sheila Leone Department of Pharmacy, G. d’Annunzio University, Chieti, Italy

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Lucia Recinella Department of Pharmacy, G. d’Annunzio University, Chieti, Italy

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Annalisa Chiavaroli Department of Pharmacy, G. d’Annunzio University, Chieti, Italy

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Claudio Ferrante Department of Pharmacy, G. d’Annunzio University, Chieti, Italy

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Giustino Orlando Department of Pharmacy, G. d’Annunzio University, Chieti, Italy

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Michele Vacca Department of Pharmacy, G. d’Annunzio University, Chieti, Italy

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Roberto Salvatori Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

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Luigi Brunetti Department of Pharmacy, G. d’Annunzio University, Chieti, Italy

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Introduction Growth hormone (GH)-releasing hormone (GHRH), GH and insulin-like growth factor-1 (IGF-1), in addition to their recognised metabolic and endocrine effects, play a pivotal role in brain functions ( 1 , 2 ). Serum GH and IGF-1

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Jin Kyu Oh Department of Urology, College of Medicine, Gachon University, Incheon, Republic of Korea

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Young Jae Im Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea

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Kwanjin Park Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea

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Jae-Seung Paick Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea

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underlying molecular mechanisms have not been described, the GH–insulin-like growth factor 1 (IGF1) axis is a proactive mediator of the actions of testosterone and its potent derivative dihydrotestosterone. Accordingly, stimulation of IGF1 signalling

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Pinaki Dutta
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Bhuvanesh Mahendran Department of Endocrinology, Internal Medicine, Cardiology, Hematology, Histopathology, Gastroenterology, Neurosurgery, Pharmacology, Radiodiagnosis, 4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, India

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K Shrinivas Reddy Department of Endocrinology, Internal Medicine, Cardiology, Hematology, Histopathology, Gastroenterology, Neurosurgery, Pharmacology, Radiodiagnosis, 4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, India

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Jasmina Ahluwalia Department of Endocrinology, Internal Medicine, Cardiology, Hematology, Histopathology, Gastroenterology, Neurosurgery, Pharmacology, Radiodiagnosis, 4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, India

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Kim Vaiphei Department of Endocrinology, Internal Medicine, Cardiology, Hematology, Histopathology, Gastroenterology, Neurosurgery, Pharmacology, Radiodiagnosis, 4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, India

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Rakesh K Kochhar Department of Endocrinology, Internal Medicine, Cardiology, Hematology, Histopathology, Gastroenterology, Neurosurgery, Pharmacology, Radiodiagnosis, 4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, India

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Prakamya Gupta Department of Endocrinology, Internal Medicine, Cardiology, Hematology, Histopathology, Gastroenterology, Neurosurgery, Pharmacology, Radiodiagnosis, 4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, India

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Anand Srinivasan Department of Endocrinology, Internal Medicine, Cardiology, Hematology, Histopathology, Gastroenterology, Neurosurgery, Pharmacology, Radiodiagnosis, 4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, India

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Mahesh Prakash Department of Endocrinology, Internal Medicine, Cardiology, Hematology, Histopathology, Gastroenterology, Neurosurgery, Pharmacology, Radiodiagnosis, 4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, India

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Kanchan Kumar Mukherjee Department of Endocrinology, Internal Medicine, Cardiology, Hematology, Histopathology, Gastroenterology, Neurosurgery, Pharmacology, Radiodiagnosis, 4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, India

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Viral N Shah
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Girish Parthan
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Anil Bhansali
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and or radiotherapy at our institution. After treatment, patients who had suppressible GH OGTT (<1 ng/ml) were subjected to insulin-induced hypoglycemia (IIH). GHD was defined as peak GH level ≤3 ng/ml during IIH and insulin-like growth factor 1 (IGF1

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Guillem Cuatrecasas Endocrinology Department, Hospital Quiron-Teknon, CPEN S.L., Barcelona, Spain
Universitat Oberta Catalunya (UOC), Barcelona, Spain

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Hatice Kumru Institut Guttmann, Institut Universitari de Neurorehabilitació Adscrit a la UAB, Barcelona, Spain
Univ Autònoma de Barcelona, Cerdanyola del Vallès, Spain
Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain

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M Josep Coves Endocrinology Department, Hospital Quiron-Teknon, CPEN S.L., Barcelona, Spain

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Joan Vidal Institut Guttmann, Institut Universitari de Neurorehabilitació Adscrit a la UAB, Barcelona, Spain
Univ Autònoma de Barcelona, Cerdanyola del Vallès, Spain
Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain

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cause (43.7%). Male/female ratio stands at 3.9/1, tetraplegia (cervical lesions) accounts for 38.5% of the cases and complete injuries affect 56.7% of the patients ( 6 ). As known, GH mediates its action mainly on the liver acting through IGF1

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Dan Liang Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

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Han Chen Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

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Li-Yong Zhong Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

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/mL). Impairment to growth hormone–insulin-like growth factor-1 (GH/IGF1): children with growth retardation or adults with obvious hypometabolic syndrome had IGF1 levels below 2 s.d. than their peers and had additional pituitary hormone deficiencies. Impairment

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Patrizia Bruzzi Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena & Reggio Emilia, Paediatric Unit, Modena, Italy

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Silvia Vannelli Pediatric Endocrinologic Unit, Regina Margherita Children’s Hospital, Turin, Italy

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Emanuela Scarano Unit of Pediatrics, Department of Medical and Surgical Sciences, Policlinico St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

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Natascia Di Iorgi Department of Pediatrics, IRCCS Istituto Giannina Gaslini, University of Genova, Genova, Italy

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Maria Parpagnoli Anna Meyer Children's University Hospital, Florence, Italy

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MariaCarolina Salerno Department of Translational Medicine, University Federico II, Naples, Italy

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Marco Pitea Pediatric Unit, Ospedale San Raffaele, Milano, Italy

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Maria Elisabeth Street Division of Paediatric Endocrinology and Diabetology, Paediatrics, Department of Mother and Child-AUSL of Reggio Emilia-IRCCS, Reggio Emilia, Italy

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Andrea Secco Pediatric Unit, Azienda ospedaliero Nazionale SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy

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Adolfo Andrea Trettene Pediatric Unit, ASST Sette Laghi, Varese, Italy

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Malgorzata Wasniewska Department of Human Pathology in Adulthood and Childhood, University of Messina, Messina, Italy

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Nicola Corciulo Pediatric Unit, P.O. Gallipoli, ASL Lecce, Italy

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Gianluca Tornese Institute for maternal and child health IRCCS Burlo Garofalo, Trieste, Italy

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Maria Felicia Faienza DAI Scienze Chirurgiche e Pediatriche, Ospedale Pediatrico Giovanni XXIII, Bari, Italy

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Maurizio Delvecchio U.O. Malattie Metaboliche e Genetiche e Diabetologia, Ospedale Pediatrico Giovanni XXIII, Bari, Italy

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Simona Filomena Madeo Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena & Reggio Emilia, Paediatric Unit, Modena, Italy

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Lorenzo Iughetti Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena & Reggio Emilia, Paediatric Unit, Modena, Italy

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verified and collected at each study time. All patients were submitted to rhGH treatment according to the Italian Agency for Drugs guidelines ( 25 ). Biochemical analysis Fasting glucose, insulin and insulin-like growth factor 1 (IGF1) values were

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Imane Benabbad Endocrinology and Diabetes Unit, Eli Lilly, Neuilly-sur-Seine, France

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Myriam Rosilio Endocrinology and Diabetes Unit, Eli Lilly, Neuilly-sur-Seine, France

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Maité Tauber Department Endocrine, Bone Diseases, Genetics, Obesity, and Gynecology Unit, Children’s Hospital, University Hospital, Toulouse, France

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Emmanuel Paris BioClinica, Lyon, France

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Anne Paulsen Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Robert-Debré, Department of Pediatric Endocrinology and Diabetology, and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Paris, France

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Lovisa Berggren Eli Lilly and Company, Bad Homburg, Germany

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Hiren Patel Eli Lilly and Company, Indianapolis, Indiana, USA

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Jean-Claude Carel Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Robert-Debré, Department of Pediatric Endocrinology and Diabetology, and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Paris, France
Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Robert-Debré, Department of Pediatric Endocrinology and Diabetology, and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Paris, France

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the Phoenix Study Group
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( 17 ) and confirmed by a centralised bone age reading. Patients were excluded if they had GH deficiency (defined as peak GH ≤20 IU/L in each of two stimulation tests), had insulin-like growth factor (IGF)-I SDS >3, were born small for gestational age

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Mônica R Gadelha Endocrine Unit, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

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Feng Gu Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Beijing, China

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Marcello D Bronstein Neuroendocrine Unit, Division of Endocrinology and Metabolism, University of São Paulo Medical School, São Paulo, Brazil

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Thierry C Brue Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale, Marseille Medical Genetics, and Assistance Publique Hôpitaux de Marseille, Department of Endocrinology, Hôpital de la Conception, Centre de Référence des Maladies Rares de l’Hypophyse, Marseille, France

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Maria Fleseriu Northwest Pituitary Center, Oregon Health & Science University, Portland, Oregon, USA

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Ilan Shimon Institute of Endocrinology and Metabolism, Rabin Medical Center, and Sackler School of Medicine, Tel-Aviv University, Petah-Tiqva, Israel

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Aart J van der Lely Erasmus University Medical Center, Rotterdam, The Netherlands

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Shoba Ravichandran Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA

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Albert Kandra Recordati AG, Basel, Switzerland

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Alberto M Pedroncelli Recordati AG, Basel, Switzerland

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Annamaria A L Colao Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy

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Introduction Acromegaly is a chronic endocrine disorder typically caused by a benign tumor of the pituitary gland ( 1 ), which hypersecretes growth hormone (GH) with subsequent secretion of insulin-like growth factor I (IGF-I). Long

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Yuanyuan Li Department of Endocrinology, Inner Mongolia People’s Hospital, Hohhot, Inner Mongolia, China

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Dongmei Li Department of Endocrinology, Inner Mongolia People’s Hospital, Hohhot, Inner Mongolia, China

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Xingbo Cheng Department of Endocrinology, The First Affiliated Hospital of Soochow University, Suzhou, China

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metabolism through insulin signalling-related pathways. hPL can stimulate insulin-like growth factor (IGF), insulin, adrenocortical hormone and pulmonary surfactant (PS) and enhance the acquisition of glucose and amino acid in the foetus to facilitate its

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