Effect of pituitary surgery in patients with acromegaly on adiponectin serum concentrations and alanine aminotransferase activity.
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.
Wiesli
Peter
P
Department of Internal Medicine, Division of Endocrinology and Diabetes, University Hospital of Zurich, CH-8091 Zurich, Switzerland. peter.wiesli@usz.ch
Bernays
René
R
Brändle
Michael
M
Zwimpfer
Cornelia
C
Seiler
Heidi
H
Zapf
Jürgen
J
A Spinas
Giatgen
G
Schmid
Christoph
C
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
D052242:Adiponectin; D036341:Intercellular Signaling Peptides and Proteins; D045162:Thiazolidinediones; D000410:Alanine Transaminase; D000077205:Pioglitazone