| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on July 29, 2005
Accepted on October 20, 2005
Institute of Endocrine Sciences (C.L.R., V.V., P.B.P., E.O., F.D., C.G., E.F., A.L., A.S., M.A.) and EPOCA Epidemiology Research Center (A.B.), Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena and Department of Endocrinology, Ospedale S. Giuseppe-Fatebenefratelli, AfaR (M.A.), University of Milan, Milan, Italy
* To whom correspondence should be addressed. E-mail: cristina.ronchi{at}unimi.it.
Context: The effects of chronic therapy with long acting somatostatin analogs (SSTa) on metabolic and cardiovascular parameters have been partially elucidated in acromegalic patients.
Objective: To compare long term effects of SSTa treatment and successful surgery on GH/IGF-I secretion and cardiovascular risk parameters in acromegaly.
Design, patients and intervention: Retrospective study of 36 acromegalic patients treated with SSTa and evaluated after a median of 66 months, and 33 sex, age and BMI-matched cured patients evaluated after a similar period from remission, all from the Institute of Endocrine Sciences, Milan.
Main outcome measures: Fasting and after oral load glucose homeostasis, HbA1c, insulin sensitivity and secretion by several indexes, lipid profile and blood pressure.
Results: Fasting and AUCGLUC glucose rose in patients resulted controlled (SSTa-C, n = 29) and not controlled (SSTa-NC, n = 7) by SSTa, becoming higher than in cured. A 1% HbA1c increase was observed in all non diabetic SSTa patients, but not in cured. Basal insulin secretion and resistance, evaluated by HOMA-B% and -S%, decreased in all SSTa patients while OGTT-derived insulin secretion and resistance, evaluated by IGI and OGTTISI, improved only in SSTa-C. Triglycerides did not change during SSTa, while HDL-cholesterol increased in SSTa-C. At last visit the contemporary presence of at least 3 cardiovascular risk factors was more frequent in SSTa than in cured subjects.
Conclusions: SSTa therapy induces long lasting disease control and improvement of insulin sensitivity and HDLc levels in responsive patients. The progressive glucose homeostasis alterations, observed independently from the degree of cure, suggests the need for glucose homeostasis and peripheral vascular complications monitoring during chronic SSTa treatment.
This article has been cited by other articles:
 |
|
 |
|
  A. Colao, R. Pivonello, M. Galderisi, P. Cappabianca, R. S. Auriemma, M. Galdiero, L. M. Cavallo, F. Esposito, and G. Lombardi Impact of Treating Acromegaly First with Surgery or Somatostatin Analogs on Cardiomyopathy J. Clin. Endocrinol. Metab., July 1, 2008; 93(7): 2639 - 2646. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Sze, C. Schmid, K. E Bloch, R. Bernays, and M. Brandle Effect of transsphenoidal surgery on sleep apnoea in acromegaly Eur. J. Endocrinol., March 1, 2007; 156(3): 321 - 329. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Melmed Acromegaly N. Engl. J. Med., December 14, 2006; 355(24): 2558 - 2573. [Full Text] [PDF]
|
|
|
|
|
|
A. Colao, R. Pivonello, R. S Auriemma, M. C. De Martino, M. Bidlingmaier, F. Briganti, F. Tortora, P. Burman, I. A Kourides, C. J Strasburger, et al. Efficacy of 12-month treatment with the GH receptor antagonist pegvisomant in patients with acromegaly resistant to long-term, high-dose somatostatin analog treatment: effect on IGF-I levels, tumor mass, hypertension and glucose tolerance. Eur. J. Endocrinol., March 1, 2006; 154(3): 467 - 477. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
| Endocrinology | Endocrine Reviews | J. Clin. End. & Metab. |
| Molecular Endocrinology | Recent Prog. Horm. Res. | All Endocrine Journals |
