Clinical features: Some researchers have suggested that acromegaly patients exhibiting a paradoxical GH response pattern appear to have higher concentrations of IGF-1 and tend to have smaller adenomas compared to acromegaly patients without paradoxical GH response [46], but others do not sustain these data, affirming that gender distribution and basal tumor diameter were similar in both groups [119]. This evidence concerns the gene GH1 and acromegaly.