Purpose: To investigate the carbohydrate metabolism in depend on acromegaly treatment.
Material and methods: 23 patients with newly diagnosed acromegaly (NA) were observed. Carbohydrate metabolism were investigated after somatostatine analogues treatment (SSA) (14 patients) or after surgery (TSA) (9 patients). Groups were comparable on age, BMI, acromegaly duration. Were researched HbA1c, fasting plasma glucose level (FPG), indexes of insulin resistance (the HOMA-IR, a Matsuda-index), areas under the curve of insulin within the first 30 minutes (AUCins30) and from 30 to 120 minute (AUC ins30-120) of the oral glucose tolerance test initially and after the treatment.
Results: At NA patients FPG, HbA1c authentically (P<0.05) worsened within 36 months of SSA treatment and considerably (P<0.08) improved after TSA. In 3 months of SSA therapy extent of depression of an AUCins30 considerably exceeded extent of depression of an AUCins30-120 (in 11 and 2.3 times respectively (P<0.05)). Whereas in 3 months after TSA extent of depression of an AUCins30 was comparable to extent of depression of an AUCins30-120 (2.4 times and 3.2 times respectively).
Conclusions: The decreasing of hepatic IR and peripheric insulin sensitivity in condition of higher level of insulin in compare with patients receiving SSA at most of these patients leads to normalization of carbohydrate metabolism. The greatest changes of parameters of carbohydrate metabolism (Matsuda-index augmentation, depression of the NOMA-IR index, insulin secretion depression) are noted in 3 months of SSA therapy, and further remain at the previous level or change slightly. It is recommended to carry out control of a condition of carbohydrate metabolism at patients with an acromegaly, first of all, in 3 months both after the carried-out surgical treatment, and after the beginning of SSA therapy.
Keywords: acromegaly; insulin resistance; secretion; insulin; somatostatine analogues; carbohydrate metabolism
20 - 23 May 2017
European Society of Endocrinology