Document Detail


Glucose tolerance and somatostatin analog treatment in acromegaly: a 12-month study.
MedLine Citation:
PMID:  19491229     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of the study was to investigate the impact of first-line somatostatin analogs (SSAs) on glucose tolerance (GT) in acromegaly. DESIGN: The design was open and prospective. PATIENTS: One hundred twelve patients [63 with normal GT (56.2%), 24 with impaired GT (21.4%), and 25 with diabetes (22.3%)] were treated with depot SSAs for 12 months: 54 patients (48.2%) achieved mean fasting GH levels less than 2.5 microg/liter in presence of normal IGF-I levels (controlled) during SSA. PRIMARY OUTCOME MEASURES: Fasting glucose and glycosylated hemoglobin levels were measured. RESULTS: At study end, 57 patients had normal GT (50.1% vs. baseline; P = 0.55), 30 had impaired fasting glucose or impaired GT (26.8%, P =0.43) and 25 had diabetes (22.3%; P = 1.0). Twenty-eight patients (25.0%), modified their GT [11 improved (9.8%), 17 worsened (15.2%)]: 90% of the patients with GT improvement achieved control of acromegaly and 89% of those having GT worsening did not (P < 0.0001). The major predictors of GT changing were disease control (t = -4.99; P < 0.0001), baseline GT (t = -2.84; P = 0.0054), and GH levels (t = 2.70; P = 0.008). Fasting glucose levels were predicted by patients' age (t = 2.74; P = 0.0071) and IGF-I levels (t = 2.14; P = 0.035). Glycosylated hemoglobin levels were predicted by disease duration (t = 3.53; P = 0.0006), GH levels (t = 2.70; P = 0.0071), and IGF-I levels (t = 2.11; P = 0.037). CONCLUSIONS: This study showed a similar prevalence of deterioration and improvement of GT 12 months after first-line SSA treatment. Uncontrolled acromegaly during SSA treatment and abnormal GT at baseline were associated with GT worsening.
Authors:
Annamaria Colao; Renata S Auriemma; Silvia Savastano; Mariano Galdiero; Ludovica F S Grasso; Gaetano Lombardi; Rosario Pivonello
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Publication Detail:
Type:  Journal Article     Date:  2009-06-02
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  94     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-08-06     Completed Date:  2009-08-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2907-14     Citation Subset:  AIM; IM    
Affiliation:
Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, via S. Pansini 5, Naples, Italy. colao@unina.it
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00615004
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MeSH Terms
Descriptor/Qualifier:
Acromegaly / drug therapy*,  metabolism
Adult
Aged
Blood Glucose / analysis
Body Mass Index
Diabetes Mellitus / drug therapy
Female
Glucose Tolerance Test*
Hemoglobin A, Glycosylated / analysis
Humans
Male
Middle Aged
Prospective Studies
Somatostatin / analogs & derivatives*,  therapeutic use
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 0/hemoglobin A1c protein, human; 51110-01-1/Somatostatin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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