IGF1 and hypopituitarism: The definition included baseline IGF-1 1.3-fold greater than the ULN and twofold less than the ULN, one sign or symptom of acromegaly (headache, sweating, joint symptoms, swelling), up to two associated comorbidities of acromegaly (diabetes, hypertension, sleep apnea, heart disease, hypopituitarism), and a pituitary adenoma on imaging [1].