Preoperative octreotide therapy and surgery in acromegaly: associations between glucose homeostasis and treatment respon
- PDF / 487,073 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 93 Downloads / 148 Views
ORIGINAL ARTICLE
Preoperative octreotide therapy and surgery in acromegaly: associations between glucose homeostasis and treatment response R. Helseth1 • S. M. Carlsen2,3 • J. Bollerslev4,5 • J. Svartberg6,7 • M. Øksnes8 S. Skeie9 • S. L. Fougner2
•
Received: 19 February 2015 / Accepted: 29 June 2015 Ó Springer Science+Business Media New York 2015
Abstract In acromegaly, high GH/IGF-1 levels associate with abnormal glucose metabolism. Somatostatin analogs (SSAs) reduce GH and IGF-1 but inhibit insulin secretion. We studied glucose homeostasis in de novo patients with acromegaly and changes in glucose metabolism after treatment with SSA and surgery. In this post hoc analysis from a randomized controlled trial, 55 de novo patients with acromegaly, not using antidiabetic medication, were included. Before surgery, 26 patients received SSAs for
Electronic supplementary material The online version of this article (doi:10.1007/s12020-015-0679-6) contains supplementary material, which is available to authorized users. & S. L. Fougner [email protected] 1
Department of Internal Medicine, Drammen Hospital, Vestre Viken, Drammen, Norway
2
Department of Endocrinology, Medical Clinic, St. Olavs University Hospital, 7006 Trondheim, Norway
3
Unit for Applied Clinical Research, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
4
Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
5
Faculty of Medicine, University of Oslo, Oslo, Norway
6
Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
7
Tromsø Endocrine Research Group, Institute of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
8
Department of Medicine and Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
9
Division of Medicine, Stavanger University Hospital, Stavanger, Norway
6 months. HbA1c, fasting glucose, and oral glucose tolerance test were performed at baseline, after SSA pretreatment and at 3 months postoperative. Area under curve of glucose (AUC-G) was calculated. Glucose homeostasis was compared to baseline levels of GH and IGF-1, change after SSA pretreatment, and remission both after SSA pretreatment and 3 months postoperative. In de novo patients, IGF-1/GH levels did not associate with baseline glucose parameters. After SSA pretreatment, changes in GH/IGF-1 correlated positively to change in HbA1c levels (both p \ 0.03). HbA1c, fasting glucose, and AUC-G increased significantly during SSA pretreatment in patients not achieving hormonal control (all p \ 0.05) but did not change significantly in patients with normalized hormone levels. At 3 months postoperative, HbA1c, fasting glucose, and AUC-G were significantly reduced in both cured and not cured patients (all p \ 0.05). To conclude, in de novo patients with acromegaly, disease activity did not correlate with glucose homeostasis. Surgical treatment of acromegaly improved glucose metabolism in both cured and not cured
Data Loading...
