Prevalence of diabetes mellitus in patients with acromegaly

Abstract

Early carbohydrate metabolism disorders (ECMDs) and diabetes mellitus (DM) are frequently associated with acromegaly. We aimed to assess the prevalence of ECMDs in patients with acromegaly and to compare the results with those in adults without acromegaly using two population-based epidemiologic surveys. We evaluated 97 patients with acromegaly in several phases of their disease (mean age, 56 years and estimated duration of acromegaly, 12.5 years). An oral glucose tolerance test was done in those not yet diagnosed with DM to reveal asymptomatic DM or ECMDs (impaired glucose tolerance+impaired fasting glucose). Comparisons were made between patients with acromegaly and participants from the general adult population (n=435) and an adult population with multiple type 2 diabetes risk factors (n=314), matched for gender, age and BMI. DM was diagnosed in 51 patients with acromegaly (52.5%) and 14.3% of the general population (P<0.001). The prevalence of ECMDs was also higher in patients with acromegaly than in the general population and in the high-risk group; only 22% of patients with acromegaly were normoglycaemic. The prevalence of newly diagnosed ECMDs or DM was 1.3–1.5 times higher in patients with acromegaly compared with the high-risk group. Patients with acromegaly having ECMDs or DM were older, more obese and had longer disease duration and higher IGF1 levels (Z-score). Logistic regression showed that the severity of glucose derangement was predicted by age, BMI and IGF1 levels. In patients with acromegaly, the prevalence of DM and ECMDs considerably exceeds that of the general population and of a high-risk group, and development of DM depends on age, BMI and IGF1 levels.

60 YEARS OF NEUROENDOCRINOLOGY: Acromegaly

“…DM prevalence has been variably reported (reflecting the series heterogeneity with respect to ethnicity, disease status, age, etc. ), but the highest prevalence rates were 40-52% (Biering et al 2000, Dreval et al 2014; similarly, IGT can be found in up to 28-46% of cases (Biering et al 2000, Kasayama et al 2000.…”

Wpływ cukrzycy na przeżycie pacjentów z akromegalią

“…The disease activity of GH-producing tumours in patients with acromegaly has been suggested to be associated with visceral adiposity index and insulin sensitivity [18,19]; however, IGF-I correlates more closely than GH with insulin resistance and glucose intolerance [20,21]. Previous studies show that 16% to 52.5% of patients with acromegaly are diagnosed with DM [16,22], with the incidence of DM varying depending on the prospective or retrospective nature of the study, different geographic area, nutritional habits, age, body mass index, and referral pattern [16]. Most studies have shown that among those with GH-producing tumours, survival rates of DM patients are lower than those of non-DM patients.…”

“…Our results show that the DM group is older, but there were no gender differences. Data from an Italian group show that active acromegaly in women is strongly associated with higher visceral adiposity dysfunction, insulin resistance, and DM [22]. That elevated GH, IGF-1, and insulin levels in acromegaly are potentially involved in tumour promotion and progression has been a concern for several decades [9,23].…”

Mechanisms of development of carbohydrate metabolism disturbances in acromegalic patients depending on treatment

“…[2,[4][5][6] и специфические для акромегалии (длительность и *e-mail: trigolosova_ira@mail.ru © Коллектив авторов, 2015 активность заболевания, проводимое лечение и т.п.) [2,7,8]. Основной метод лечения акромегалии -хирургический, который, по данным современных исследований [9,10], является не только наиболее эффективным, но и оказывает положительное влия-ние на состояние углеводного обмена.…”

“…Можно выделить два класса факторов риска развития СД при акромега-лии: общепопуляционные (возраст, женский пол, наличие артериальной гипертензии, отягощенный анамнез по СД 2-го типа (СД2) и др.) [2,[4][5][6] и специфические для акромегалии (длительность и *e-mail: trigolosova_ira@mail.ru © Коллектив авторов, 2015 активность заболевания, проводимое лечение и т.п.) [2,7,8].…”