The cumulative effect was investigated by Sherlock et al. [30] in a time-dependent approach and was found to be a better approach for the assessment of the prognostic outcomes as the authors reported that GH levels <1.0 μg/L were associated with a RR of 1.8 for mortality, while a GH levels <0.5 μg/L were associated with a lower RR of 1.5 among the investigated patients with acromegaly by using the time-dependent approach for assessment of GH levels. Here, GH1 is linked to acromegaly.