GLUCOSE AND LIPID METABOLIC DISORDERS AS COMPLICATIONS OF ACROMEGALY AND THEIR REVERSIBILITY AFTER TRANSSPHENOIDAL SURGERY

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 88-129-Acromegaly & Prolactinoma
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-114
Izumi Fukuda*1, Naomi Hizuka2, Toko Muraoka3 and Atsuhiro Ichihara3
1Tokyo Women's Medical University, Tokyo, Japan, 2Tokyo Women's Medical Univ, 3Tokyo Women's Medical University, Tokyo, Japan
Background:  Acromegaly is associated with various metabolic complications due to long-standing excess of growth hormone (GH) and IGF-I.  Some biological effects of GH are mediated through IGF-I, whereas metabolic effects of GH and IGF-I are not always similar.

Objective:  In this study, we analyzed glucose and lipid metabolic disorders in patients with acromegaly and their reversibility after transsphenoidal surgery (TSS).

Patients and Methods:  74 patients with acromegaly (M/F 27/47, 21-72 yr.) were studied.  After treatment of acromegaly, serum GH and IGF-I levels decreased in all patients, and 57 patients achieved post-surgical remission (nadir GH levels <1ng/ml during OGTT).  Pre- and post-surgical status of glucose tolerance and incidence of dyslipidemia were studied and relationships between these metabolic abnormalities and serum GH, IGF-I levels, HOMA-R and BMI were analyzed.

Results:  Before TSS, 24 (32%), 31 (42%) and 19 (26%) patients had DM, IGT and NGT, respectively.  Patients with DM had higher mean GH levels compared with patients with IGT or NGT (29.7, 9.1, 10.7 ng/ml, P<0.05), but there were no significant differences in IGF-I levels (648, 619, 732 ng/ml) nor patient’s BMI.  Hypertriglyceridemia (high-TG), high-LDL and low-HDL were observed in 10 (14%), 11 (15%) and 19 (26%) patients.  Patients with high-TG had significantly higher HOMA-R and BMI and patients with low-HDL levels had significantly higher HOMA-R, BMI and IGF-I levels.  There was no relationship between dyslipidemia and mean serum GH levels.  After TSS, glucose metabolism improved in 8 patients with DM and 19 patients with IGT, including 5 patients who did not meet the remission criteria.  As a result, the incidence of DM, IGT and NGT became 18 (24%), 17 (23%) and 39 (53%), respectively.  One year after TSS, median TG significantly decreased from 101 to 83 mg/dl (P<0.05) and median HDL increased from 56 to 60 mg/dl (P<0.05), although median LDL did not change (110 vs 107 mg/dl).

Conclusion:  Excess of GH might directly involve in abnormal glucose metabolism.  Median TG, LDL and HDL levels of the patients remained within the reference values, although total number of 28 patients had dyslipidemia.  Preferable changes in glucose and lipid metabolism were observed in patients with acromegaly, even when complete biochemical cure was not achieved after TSS.

Nothing to Disclose: IF, NH, TM, AI

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