Changes in metabolic parameters and cardiovascular risk factors after therapeutic control of acromegaly vary with the treatment modality. Data from the Bicêtre cohort, and review of the literature

Briet, Claire; Ilie, Mirela Diana; Kuhn, Emmanuelle; Maione, Luigi; Brailly-Tabard, Sylvie; Salenave, Sylvie; Cariou, Bertrand; Chanson, Philippe

doi:10.1007/s12020-018-1797-8

Cited by 29 publications

(13 citation statements)

References 139 publications

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“…The relationship between parameters of glucose homeostasis and drugs used for treating acromegaly has been subject to extensive studies, as recently reviewed (130). A recent report compared the effect of the three main treatment modalities on glucose metabolism in patients with biochemically controlled acromegaly, finding out that plasma glucose decreases after successful surgery and after pegvisomant therapy, but increases in patients using first-generation somatostatin analogs (SSA) (131). First-generation somatostatin analogs (SSA) control GH secretion and IGF-I production, thereby lowering disease activity and improving insulin sensitivity in acromegaly.…”

Section: Insulin Resistance In Relationship To Disease Activity and Tmentioning

confidence: 99%

Insulin Resistance in Patients With Acromegaly

et al. 2019

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Acromegaly is characterized by chronic overproduction of growth hormone (GH) that leads to insulin resistance, glucose intolerance and, ultimately, diabetes. The GH-induced sustained stimulation of lipolysis plays a major role not only in the development of insulin resistance and prediabetes/diabetes, but also in the reduction of lipid accumulation, making acromegaly a unique case of severe insulin resistance in the presence of reduced body fat. In the present review, we elucidate the effects of GH hypersecretion on metabolic organs, describing the pathophysiology of impaired glucose tolerance in acromegaly, as well as the impact of acromegaly-specific therapies on glucose metabolism. In addition, we highlight the role of insulin resistance in the development of acromegaly-associated complications such as hypertension, cardiac disease, sleep apnea, polycystic ovaries, bone disease, and cancer. Taken together, insulin resistance is an important metabolic hallmark of acromegaly, which is strongly related to disease activity, the development of comorbidities, and might even impact the response to drugs used in the treatment of acromegaly.

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Section: Insulin Resistance In Relationship To Disease Activity and Tmentioning

confidence: 99%

Insulin Resistance in Patients With Acromegaly

et al. 2019

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“…Some insulin-related biomarkers such as HOMA-IR and HOMA-β assay are used to reveal the health of insulin generating cells and in sulin function in T2DM ( 25 ). In this study, the induction of diabetes elevated the level of HOMA-IR and HOMA-β in diabetic rats.…”

Section: Discussionmentioning

confidence: 99%

Hypoglycemic, hepatoprotective, and hypolipidemic effects of hydroalcoholic extract of Eryngium billardieri root on nicotinamide/streptozotocin-induced type II diabetic rats

Khani

Abdollahi

Asadi

et al. 2021

Research in Pharmaceutical Sciences

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Background and purpose: Erynginum billardieri has been used to control diabetes in traditional medicine. This research was performed to study the antidiabetic, hepatoprotective, and hypolipidemic effects of E. billardieri root extract (EBRE) on streptozotocin/nicotinamide-induced type 2 diabetic male rats. Experimental approach: Type two diabetic animals were treated by three different doses of EBRE (100, 200, and 400 mg/kg), orally administered for 4 weeks. Ultimately, after anesthesia, the glucose, insulin, lipid profiles, hepatic enzyme levels in the blood and liver, and pancreas tissues of the animals were analyzed. Findings/Results: Induction of diabetes caused a diminution in insulin level, high-density lipoprotein (HDL), and significantly enhanced the level of other lipid profiles, glucose, and liver enzymes ( P < 0.05). Administration of the EBRE to diabetic-male rats significantly reduced glucose level, lipid profiles, and liver enzymes, and increased the level of HDL to near normal. Conclusion and implications: The results of the present study showed that E. billardieri had a positive effect on diminishing the lipid profiles, liver enzymes, and controlling diabetes. The most effective dose was found to be 100 mg/kg.

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“…Similarly, beyond the treatment of classical risk factors, the effect of treatment aiming at normalizing IGF1 and GH levels is not known. Indeed, different therapeutic strategies have shown different outcomes on the reduction of cardiovascular and metabolic risk factors (35).…”

Section: Discussionmentioning

confidence: 99%

IGF-1 is an independent predictor of retinal arterioles remodeling in subjects with uncontrolled acromegaly

Chaigneau

Jublanc

Rosenbaum

et al. 2020

European Journal of Endocrinology

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Context Cardiovascular disease is one of the main causes of morbidity in active acromegaly due to the increased prevalence of risk factors and arterial consequences of increased growth hormone levels. No in vivo study has evaluated the consequences of acromegaly on the retinal microvasculature. Objective The aim of this study was to identify in vivo the presence of morphological alterations of retinal arterioles in subjects with acromegaly. Patients and methods Single-center retrospective study of a cohort of 60 subjects with acromegaly, matched to 60 controls, who were referred for adaptive optics camera (AOC) from September 2014 to December 2016. Of the subjects with acromegaly, 19 had an active disease (AD) and 41 a controlled disease (CD) based on the IGF1 ratio (IGF1r). Retinal arteriolar remodeling was previously assessed using adaptive optics camera (AOC) in order to measure wall-to-lumen ratio (WLR), wall thickness (WT), internal diameter (ID) and wall cross sectional area (WCSA). Results WLR was significantly higher in AD subjects compared to CD subjects and controls (AD: 0.311 ± 0.06, CD: 0.279 ± 0.04, controls: 0.281 ± 0.04, P = 0.031). A significant positive correlation was observed between WLR and IGF-1r (R2 = 0.215, P < 0.001), even after adjustment for gender, age, systolic blood pressure (SBP) and the presence of dopamine agonist treatment (R2 = 0.406, P < 0.001). Retinal arteriolar anatomical indices were comparable between CD and controls. Conclusion Active acromegaly is associated with the presence of small retinal arteriolar remodeling. These results provide new perspectives to better stratify cardiovascular risk and consequently optimize treatment in acromegaly.

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Changes in metabolic parameters and cardiovascular risk factors after therapeutic control of acromegaly vary with the treatment modality. Data from the Bicêtre cohort, and review of the literature

Cited by 29 publications

References 139 publications

Insulin Resistance in Patients With Acromegaly

Insulin Resistance in Patients With Acromegaly

Hypoglycemic, hepatoprotective, and hypolipidemic effects of hydroalcoholic extract of Eryngium billardieri root on nicotinamide/streptozotocin-induced type II diabetic rats

IGF-1 is an independent predictor of retinal arterioles remodeling in subjects with uncontrolled acromegaly

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