Disease activity and lifestyle influence comorbidities and cardiovascular events in patients with acromegaly

Sardella, Chiara; Cappellani, Daniele; Urbani, Claudio; Manetti, Luca; Marconcini, Giulia; Tomisti, Luca; Lupi, Isabella; Rossi, Giuseppe; Scattina, Ilaria; Lombardi, Martina; Bello, Vitantonio Di; Marcocci, Claudio; Martino, Enio; Bogazzi, Fausto

doi:10.1530/eje-16-0562

Cited by 28 publications

(21 citation statements)

References 33 publications

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“…During SSA therapy, an overall deterioration in the glycaemic profile was found in 44.4% of patients. This found percentage is in line with a study previously published by our group on a larger cohort of patients not affected by diabetes mellitus at diagnosis of acromegaly . Changes in the metabolic status occurred despite the biochemical control of acromegaly due to the SSA therapy.…”

Section: Discussionsupporting

confidence: 92%

“…As a consequence, in clinical terms, SSAs have different effects on glucose homeostasis. According to many studies, SSAs have a significant detrimental effect on glycaemic indexes both in acromegalic and nonacromegalic patients …”

Section: Discussionmentioning

confidence: 99%

“…Even though it is our practice to measure GH both for the diagnosis of acromegaly (both as random GH and during a oral glucose load) and during the follow‐up (as random GH measurement), for the purposes of this study, disease activity was assessed by serum IGF1 concentrations. To compare serum IGF1 concentrations over the study period, we adopted the IGF1‐index (the ratio between the IGF1 measured and the upper limit of the normal range for age), as previously reported . Remission or controlled disease was defined when the IGF1 index was ≤1.…”

Section: Methodsmentioning

confidence: 99%

“…To compare serum IGF1 concentrations over the study period, we adopted the IGF1index (the ratio between the IGF1 measured and the upper limit of the normal range for age), as previously reported. 3,16,17,20 Remission or controlled disease was defined when the IGF1 index was ≤1. On the other hand, uncontrolled disease was defined when the IGF1 index was >1.…”

Section: Assaysmentioning

confidence: 99%

“…acromegaly, diabetes mellitus, drug-induced diabetes mellitus, growth hormone-secreting pituitary adenoma, somatostatin analogues Acromegaly was diagnosed taking into account clinical and biochemical features. 3,16,17 The estimated duration of disease consisted in the length of time between the onset of symptoms suggestive of acromegaly and diagnosis. It is our practice to perform regular follow-up visits on a six monthly basis after acromegaly diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Diabetes mellitus induced by somatostatin analogue therapy is not permanent in acromegalic patients

Cappellani

Urbani

Sardella

et al. 2018

Endocrino Diabet & Metabol

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Summary Context Therapy with somatostatin analogues ( SSA s) may have deleterious effects on glucose metabolism in patients with acromegaly, often leading to the development of diabetes mellitus ( DM ). Aim The aim of the study was to evaluate whether DM , developed during therapy with SSA s, may revert after drug withdrawal and cure of acromegaly with pituitary adenomectomy. Design Retrospective cohort study, in a tertiary referral centre. Patients Eighteen acromegalic patients without DM at the diagnosis of acromegaly treated with SSA s as a primary therapy, and then cured by pituitary adenomectomy. Methods Endocrine status and glucose homeostasis were evaluated at diagnosis of acromegaly and at least every 6 months during SSA therapy. At each visit, patients were classified into one of the following classes: normal glucose tolerance, prediabetes, overt diabetes. Results Median follow‐up after starting SSA s therapy was 69 months ( IQR 54.75‐132.25). During SSA therapy, all patients had controlled acromegaly defined by normal serum IGF 1 concentrations for the age. Of the 13 euglycaemic patients at diagnosis, three developed prediabetes and three diabetes, whereas, of the five prediabetic patients at diagnosis, two worsened to overt diabetes and three remained in the prediabetic range ( P = 0.04). After curing acromegaly with pituitary adenomectomy and subsequent SSA withdrawal, prediabetes reverted in five of six patients, and diabetes in all five patients (three reverted to euglycaemia, while two reverted to prediabetes) ( P = 0.01). Conclusions In acromegalic patients with controlled disease, changes in glycaemic status induced by SSA s are not permanent.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%