IGF1 and pituitary gland adenoma: It has recently been reported that older patients present with lower basal IGF-1 levels as well as smaller pituitary adenomas[26, 27]; nevertheless, in our cohort, all patients presented invariably with increased basal GH, thus excluding the novel entity called micromegaly.[26] Regarding IGF-1 levels, the absolute values of IGF-I were lower in group 3; however, it must be noted that GH secretion decreases with age in both normal and acromegalic individuals.[28] Therefore, ULN of IGF-1 levels did not differ between the groups when the levels were adequately adjusted for gender and age.