Impact of long-acting somatostatin analogues on glycolipid metabolism in postoperative patients with acromegaly / 中国医师进修杂志

ABSTRACT

Objective:To analyze the effect of long-acting somatostatin treatment on blood glucose, blood lipid, insulin resistance and islet function in patients with acromegaly after surgical treatment.Methods:Self-control study before and after treatment was used. A total of 30 subjects who were diagnosed as acromegalyand received surgical treatment in Beijing Tiantan Hospital from January 2016 to January 2018 were enrolled in this study. Because patients′ growth hormone (GH) level was notc ompletely controlled after surgery, all the patients were treated with long-acting octreotide for more than 1 year. Before and 1 year after treatment, oral glucose tolerance testing (OGTT) was performed at pretreatment and 1 year after initiation of treatment with long-acting octreotide. Homeostatic model assessment (HOMA) was used to estimate insulin resistance (HOMA-IR) and β-cell function (HOMA-β). The HOMA-IR and HOMA-β were detected by 75 g glucose, insulin, C peptide release test and growth hormone suppression test to evaluate the therapy effects on insulin resistance and islet function.Results:The levels of GH, insulin-like growth factor 1(IGF-1), HOMA-IR, HOMA-β, and triacylglycerol(TG) were all decreased after 1 year of octreotide treatment compared with that before treatment (2.8 ± 2.5) μg/L vs. (12.1 ± 10.5) μg/L, (356.8 ± 209.2) μg/L vs. (698.1 ± 207.3) μg/L, 1.56 ± 1.08 vs. 2.71 ± 1.52, 1.01 ± 0.97 vs. 4.87 ± 3.57, (1.12 ± 0.49) mmol/L vs. (1.76 ± 0.92) mmol/L, and the differences were statistically significant ( P<0.05). After treatment, the level of fasting blood glucose was increased compared with that before treatment (5.83 ± 1.19) mmol/L vs.(5.11 ± 1.73) mmol/L, and the difference was statistically significant ( P<0.05). While there were no significant changes in postprandial 2 h blood glucose and glycosylated hemoglobin (GHb), total cholesterol (TC), low-density lipoprotein cholesterol(LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels before and after treatment ( P>0.05). Conclusions:Long-acting somatostatin therapy can effectively improve the insulin sensitivity of acromegaly patients, reduce β cell function, and slightly increase fasting blood glucose. It has no adverse effect on GHb, and can reduce the level of TG of the patients.