Soluble alpha-klotho as an adjunct biomarker of disease activity in acromegaly: Added value beyond GH and IGF-1.

IF 3.8 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Pituitary Pub Date : 2026-08-20 DOI:10.1007/s11102-026-01748-9

Vivek Jha, Sanja Medenica, Naresh Sachdeva, Vaishali Kaur, Pinaki Dutta

{"title":"Soluble alpha-klotho as an adjunct biomarker of disease activity in acromegaly: Added value beyond GH and IGF-1.","authors":"Vivek Jha, Sanja Medenica, Naresh Sachdeva, Vaishali Kaur, Pinaki Dutta","doi":"10.1007/s11102-026-01748-9","DOIUrl":null,"url":null,"abstract":"Purpose: Assessment of disease activity in acromegaly is mainly based on growth hormone and insulin-like growth factor 1. However, discordance between these markers is common and may make follow-up difficult. This study evaluated soluble alpha-Klotho as an adjunct biomarker of biochemical disease activity in acromegaly.Methods: This case-control study included 80 patients with acromegaly and 80 controls. Patients were categorized as controlled, discordant, uncontrolled, or active disease. Serum soluble alpha-Klotho was measured by sandwich enzyme-linked immunosorbent assay and analyzed across groups, disease-status categories, and clinical-biochemical variables. Receiver operating characteristic analysis and nested models assessed its diagnostic and incremental value.Results: Alpha-Klotho concentrations were higher in acromegaly than controls [1551.9 (835.0-3158.3) vs. 759.7 (625.0-898.5) pg/mL; P < 0.001] and increased across disease-status categories: controlled treated acromegaly [722.0 (668.4-837.8)], discordant treated acromegaly [1426.9 (1119.0-1499.9)], uncontrolled treated acromegaly [2980.0 (2585.0-3650.0)], and newly diagnosed active acromegaly [3820.0 (2460.0-4620.0) pg/mL; overall P < 0.001]. Alpha-Klotho correlated with growth hormone and insulin-like growth factor 1 and identified active/uncontrolled disease with an area under the curve of 0.983. Its addition to growth hormone, insulin-like growth factor 1, age, sex, and body mass index improved discrimination from 0.947 to 0.986. Alpha-Klotho ≥ 1579.8 pg/mL was independently associated with active/uncontrolled disease.Conclusion: Soluble alpha-Klotho may serve as an adjunct marker of current biochemical activity in acromegaly, particularly for identifying uncontrolled treated or newly diagnosed active disease. It may aid selected cases with difficult biochemical interpretation, but should be used alongside GH, IGF-1, clinical assessment, and pituitary imaging, not as a replacement test.","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 5","pages":""},"PeriodicalIF":3.8000,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pituitary","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11102-026-01748-9","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: Assessment of disease activity in acromegaly is mainly based on growth hormone and insulin-like growth factor 1. However, discordance between these markers is common and may make follow-up difficult. This study evaluated soluble alpha-Klotho as an adjunct biomarker of biochemical disease activity in acromegaly.

Methods: This case-control study included 80 patients with acromegaly and 80 controls. Patients were categorized as controlled, discordant, uncontrolled, or active disease. Serum soluble alpha-Klotho was measured by sandwich enzyme-linked immunosorbent assay and analyzed across groups, disease-status categories, and clinical-biochemical variables. Receiver operating characteristic analysis and nested models assessed its diagnostic and incremental value.

Results: Alpha-Klotho concentrations were higher in acromegaly than controls [1551.9 (835.0-3158.3) vs. 759.7 (625.0-898.5) pg/mL; P < 0.001] and increased across disease-status categories: controlled treated acromegaly [722.0 (668.4-837.8)], discordant treated acromegaly [1426.9 (1119.0-1499.9)], uncontrolled treated acromegaly [2980.0 (2585.0-3650.0)], and newly diagnosed active acromegaly [3820.0 (2460.0-4620.0) pg/mL; overall P < 0.001]. Alpha-Klotho correlated with growth hormone and insulin-like growth factor 1 and identified active/uncontrolled disease with an area under the curve of 0.983. Its addition to growth hormone, insulin-like growth factor 1, age, sex, and body mass index improved discrimination from 0.947 to 0.986. Alpha-Klotho ≥ 1579.8 pg/mL was independently associated with active/uncontrolled disease.

Conclusion: Soluble alpha-Klotho may serve as an adjunct marker of current biochemical activity in acromegaly, particularly for identifying uncontrolled treated or newly diagnosed active disease. It may aid selected cases with difficult biochemical interpretation, but should be used alongside GH, IGF-1, clinical assessment, and pituitary imaging, not as a replacement test.

查看原文本刊更多论文

可溶性α -klotho作为肢端肥大症疾病活动性的辅助生物标志物：超越生长激素和IGF-1的附加价值。

目的：肢端肥大症的疾病活动性评价主要基于生长激素和胰岛素样生长因子1。然而，这些指标之间的不一致是常见的，可能会使随访困难。本研究评估了可溶性α - klotho作为肢端肥大症生化疾病活性的辅助生物标志物。方法：本研究纳入80例肢端肥大症患者和80例对照组。患者被分为控制型、不协调型、不控制型和活动性疾病。采用夹心酶联免疫吸附法测定血清可溶性α - klotho，并对各组、疾病状态类别和临床生化变量进行分析。接受者工作特征分析和嵌套模型评估其诊断和增值价值。结果：肢端肥大症患者α - klotho浓度高于对照组[1551.9（835.0-3158.3）比759.7 (625.0-898.5)pg/mL；P < 0.001]，并在不同疾病状态类别中升高：控制治疗的肢端肥大症[722.0(668.4-837.8)]、不一致治疗的肢端肥大症[1426.9(1119.0-1499.9)]、未控制治疗的肢端肥大症[2980.0(2585.0-3650.0)]和新诊断的活动性肢端肥大症[3820.0 (2460.0-4620.0)pg/mL；总P < 0.001]。α - klotho与生长激素和胰岛素样生长因子1相关，识别活动性/非控制性疾病的曲线下面积为0.983。除了生长激素、胰岛素样生长因子1、年龄、性别和体重指数外，它还将歧视从0.947提高到0.986。α - klotho≥1579.8 pg/mL与活动性/未控制的疾病独立相关。结论：可溶性α - klotho可作为肢端肥大症患者当前生化活性的辅助标志物，特别是用于识别未控制治疗或新诊断的活动性疾病。它可以帮助某些生化解释困难的病例，但应与生长激素、IGF-1、临床评估和垂体成像一起使用，而不是作为替代测试。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Pituitary 医学-内分泌学与代谢

CiteScore

7.10

自引率

7.90%

发文量

审稿时长

6 months

期刊介绍： Pituitary is an international publication devoted to basic and clinical aspects of the pituitary gland. It is designed to publish original, high quality research in both basic and pituitary function as well as clinical pituitary disease. The journal considers: Biology of Pituitary Tumors Mechanisms of Pituitary Hormone Secretion Regulation of Pituitary Function Prospective Clinical Studies of Pituitary Disease Critical Basic and Clinical Reviews Pituitary is directed at basic investigators, physiologists, clinical adult and pediatric endocrinologists, neurosurgeons and reproductive endocrinologists interested in the broad field of the pituitary and its disorders. The Editorial Board has been drawn from international experts in basic and clinical endocrinology. The journal offers a rapid turnaround time for review of manuscripts, and the high standard of the journal is maintained by a selective peer-review process which aims to publish only the highest quality manuscripts. Pituitary will foster the publication of creative scholarship as it pertains to the pituitary and will provide a forum for basic scientists and clinicians to publish their high quality pituitary-related work.