title: Effect of pituitary surgery in patients with acromegaly on adiponectin serum concentrations and alanine aminotransferase activity.
abstract: BACKGROUND
  Thiazolidinediones increase adiponectin concentrations, improve insulin sensitivity and fatty liver disease (reflected by decreased alanine aminotransferase [ALT] activity) in type 2 diabetes. This study was performed to test the effect of neurosurgery in acromegaly (sharing at baseline insulin resistance but not increased visceral fat with type 2 diabetes) on insulin sensitivity, adiponectin concentrations and ALT activity.
  
  
  METHODS
  Sixteen patients with acromegaly undergoing pituitary surgery (and 16 patients with type 2 diabetes treated with pioglitazone) were included. Insulin sensitivity, adiponectin concentrations and ALT activity were determined at baseline and after 4 months.
  
  
  RESULTS
  Pituitary surgery in acromegalic patients increased adiponectin concentrations from mean (+/-S.D.) 9.3+/-3.8 to 10.2+/-4.4 mg/L (p<0.05). HOMA scores fell from 6.8+/-4 at baseline to 3.5+/-0.9 following neurosurgery (p<0.005) and ALT activity decreased from median (range) 21 (13-30) to 13 (10-42) U/L (p<0.05). In type 2 diabetics, pioglitazone treatment increased adiponectin concentrations; HOMA scores and ALT activity fell significantly.
  
  
  CONCLUSIONS
  Pituitary surgery in patients with acromegaly led to a marked increase in insulin sensitivity and a slight increase in adiponectin serum concentrations, whereas ALT activity significantly decreased.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Diabetes, University Hospital of Zurich, CH-8091 Zurich, Switzerland. peter.wiesli@usz.ch
authors.forename: Peter
authors.initials: P
authors.lastname: Wiesli
authors.forename: René
authors.initials: R
authors.lastname: Bernays
authors.forename: Michael
authors.initials: M
authors.lastname: Brändle
authors.forename: Cornelia
authors.initials: C
authors.lastname: Zwimpfer
authors.forename: Heidi
authors.initials: H
authors.lastname: Seiler
authors.forename: Jürgen
authors.initials: J
authors.lastname: Zapf
authors.forename: Giatgen
authors.initials: G
authors.lastname: A Spinas
authors.forename: Christoph
authors.initials: C
authors.lastname: Schmid
mesh_terms: D000172:Acromegaly / Q000097:blood* / Q000188:drug therapy / Q000601:surgery*; D052242:Adiponectin; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D000077205:Pioglitazone; D010902:Pituitary Gland / Q000378:metabolism / Q000601:surgery*; D018709:Statistics, Nonparametric; D045162:Thiazolidinediones / Q000627:therapeutic use
chemical_list: D052242:Adiponectin; D036341:Intercellular Signaling Peptides and Proteins; D045162:Thiazolidinediones; D000410:Alanine Transaminase; D000077205:Pioglitazone