Lanreotide autogel and insulin sensitivity markers: report of 5 acromegalic patients and literature review.
OBJECTIVE
To evaluate the short-term effects of Lanreotide Autogel on insulin sensitivity markers among acromegalic patients with pituitary tumors.


METHODS
Prospective clinical trial with six months of follow-up.


METHODS
A tertiary endocrinology clinic.


METHODS
Naïve patients (patient No. 1 and patient No. 3) and patients who experienced prior somatostatin analogue treatment (patient No. 2, patient No. 4, and patient No. 5) were included. Before and after 6 months of Lanreotide Autogel therapy, insulin sensitivity in each subject was determined using homeostasis model assessment of insulin resistance and beta-cell function formula. Euglycemic hyperinsulinemic clamp test was also performed to evaluate whole insulin sensitivity and was indicated as an 'M' index.


RESULTS
All patients experienced reduction in their HOMA-beta. We noted major HOMA-beta decreases accompanied by pronounced increases in M indices for patients Nos. 1, 2 and 3 (1.03 vs. 8.22, 2.98 vs. 4.70, and 5.09 vs. 13.09, respectively). The increases in M indices of these patients were with marked decreases in GH levels (34.20 vs. 15.30 microg/l, 4.25 vs. 0.74 and 5.0 vs. 0.66 ng/mL, respectively). Minor decline in HOMA-beta and worsened M index and almost stable GH were observed in patients Nos. 4 and 5. Except for patient No. 3, all participants showed declining HOMA-IR.


CONCLUSIONS
Short-term Lanreotide Autogel treatment has been observed to improve M indices of acromegalic patients whose GH levels exhibited marked reduction. This amelioration seemed to be related to decreases in GH levels rather than to a direct drug effect.
Baskent University Faculty of Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey. e_ertorer@yahoo.com
Melek Eda
ME
Ertorer
Okan
O
Bakiner
Inan
I
Anaforoglu
Emre
E
Bozkirli
Neslihan Bascil
NB
Tutuncu
Nilgun Guvener
NG
Demirag
D000172:Acromegaly / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001786:Blood Glucose / Q000378:metabolism; D003692:Delayed-Action Preparations; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006706:Homeostasis / Q000187:drug effects; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D050417:Insulin-Secreting Cells / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000008:administration & dosage / Q000627:therapeutic use*; D010911:Pituitary Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D011446:Prospective Studies; D013004:Somatostatin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000970:Antineoplastic Agents; D001786:Blood Glucose; D003692:Delayed-Action Preparations; D007328:Insulin; D010456:Peptides, Cyclic; C060347:lanreotide; D019382:Human Growth Hormone; D013004:Somatostatin; D007334:Insulin-Like Growth Factor I