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International Journal of Endocrinology
Volume 2018, Article ID 3015854, 10 pages
https://doi.org/10.1155/2018/3015854
Clinical Study

Impact of Long-Acting Somatostatin Analogues on Glucose Metabolism in Acromegaly: A Hospital-Based Study

1Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
2Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai 200040, China
3Department of Endocrinology and Metabolism, The Second People’s Hospital of Kashi, Xinjiang Uygur Autonomous Region 844000, China
4Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China

Correspondence should be addressed to Xiaoyun Cao; moc.361@4952nuyoaixoac and Zhaoyun Zhang; nc.ude.naduf@gnahznuyoahz

Received 13 July 2017; Accepted 13 December 2017; Published 26 April 2018

Academic Editor: Mario Maggi

Copyright © 2018 Ming Shen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. To evaluate the change in glucose tolerance in treatment-naïve patients with acromegaly after administration of SSA and to identify predictive factors of glucose impairment during SSA therapy. Methods. Oral glucose tolerance testing (OGTT) was performed on 64 newly diagnosed and treatment-naïve patients with acromegaly both at pretreatment and 3 months after initiation of treatment with long-acting SSA. Insulin resistance (IR) was assessed by homeostatic model assessment- (HOMA-) IR and ISOGTT. Insulin secretion was assessed by HOMA-β, INS0/BG0, IGI (insulinogenic index), IGI/IR, ISSI2, and AUCINS/AUCBG. Receiver-operating characteristic (ROC) curves were generated to determine the optimal cutoffs to predict the impact of SSA on glucose metabolism. Results. Pretreatment, 19, 24, and 21 patients were categorized as having normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and diabetes mellitus (DM), respectively. Posttreatment, IR, represented by ISOGTT, was significantly improved in all 3 groups. Insulin secretion, represented by HOMA-β, declined in the NGT and IGT groups, but was unaltered in the DM group. The glucose tolerance status deteriorated in 18 (28.1%) patients, including 13 patients in the NGT group and 5 patients in the IGT group. Deterioration was associated with lower baseline BG120 (plasma glucose 120 min post-OGTT), less reduction of growth hormone (GH), and greater reduction of insulin secretion after SSA therapy. BG120 greater than 8.1 mmol/l provided the greatest sensitivity and specificity in predicting the stabilization and/or improvement of glucose tolerance status after SSA treatment (PPV 90.7%, NPV 66.7%, ). Conclusions. The deterioration of glucose metabolism induced by SSA treatment is caused by the less reduction of GH and the more inhibition of insulin secretion, which can be predicted by the baseline BG120 during OGTT.