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Endocrine Abstracts (2019) 63 P1095 | DOI: 10.1530/endoabs.63.P1095

ECE2019 Poster Presentations Pituitary and Neuroendocrinology 3 (73 abstracts)

Poor response to pre-surgical treatment with Somatostatin Receptor Ligands is associated with diabetes in patients with acromegaly

Francesco Tecilazich 1 , Stefano Frara 1 , Marco Losa 2 , Anna Maria Formenti 3 , Eugenia Resmini 4 , Mauro Doga 1 , Pietro Mortini 2 & Andrea Giustina 1


1Endocrinology & Metabolism, IRCCS San Raffaele, Milan, Italy; 2Neurosurgery, IRCCS San Raffaele, Milan, Italy; 3IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; 4Endocrinology/Medicine Departments, Hospital Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona, Barcellona, Spain.


Purpose: To evaluate whether the degree of response to surgical pre-treatment with somatostatin receptor ligands (SRL) predicts alterations in blood glucose levels.

Patients and methods: We retrospectively studied 181 patients attending the Unit of Neurosurgery of our Hospital prior to transsphenoidal surgery. All patients had a diagnosis of acromegaly (nadir GH during OGTT >0.4 ng/ml; and IGF-I above age-standardized UNL); diagnosis of diabetes (DM) and impaired fasting glucose (IFG) was performed on fasting blood glucose (FBG) according to the American Diabetes Association guidelines; all parameters of the pituitary axes were determined. The response to SRL treatment was determined as percent change of GH levels. Data are presented as mean±s.d.; Continuous data normally distributed were analyzed using a two-tailed Student’s t test to compare two groups, and one-way ANOVA to compare several groups, followed by the Bonferroni post-hoc procedure for pairwise comparison of groups after the null hypothesis was rejected (P<0.05); categorical data were analyzed by chi-squared test.

Results: 97 (54%) patients with acromegaly underwent pre-surgical treatment with SRL; we found no difference in age (53±11 vs 51±12 years; P=NS) and sex (M/F: 51/46 vs 43/41; P=NS) between SRL treated and non-treated patients. We found no difference in FBG between SRL treated vs non-treated patients. In contrast, we found increased proportions of IFG and DM patients in SRL treated when compared to non-treated patients (euglycemic: 45%, IFG: 42%, DM: 13% vs euglycemic: 70%, IFG: 22%, DM: 8%, respectively; P=0.006). In addition, SRL treatment increased the odds ratio of IFG and DM (OR 4.7; 95%CI 2.1-10.3). When considering the degree of response to SRL pre-surgical treatment, we found that poor responders displayed at the time of surgery glycemias diagnostic of DM; whereas, good responders displayed glycemias in the range of IFG (percent change in GH levels 50±35% vs 79±22%, respectively; P<0.05).

Conclusions: Our findings show that the proportion of patients with acromegaly undergoing surgery with glycemic levels diagnostic of DM, is modest. Interestingly, pre-treatment with SRL represents an independent risk factor for high glucose levels. Moreover, among patients on SRL pre-treatment, the ones that respond poorly are the ones that at the time of surgery display glycemias diagnostic of DM. Our findings suggest that SRL pre-treatment may predispose to worsened glucose metabolism but selectively affecting those patients in whom biochemical control is not reached.

Volume 63

21st European Congress of Endocrinology

Lyon, France
18 May 2019 - 21 May 2019

European Society of Endocrinology 

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