[Evaluation of glucose metabolism in acromegalic patients before and after treatment with octreotide LAR].
OBJECTIVE
To evaluate the glucose metabolism in acromegalic patients before and after treatment with octreotide LAR.


METHODS
This was a prospective and longitudinal study involving 30 patients from the acromegaly research outpatient clinic of the Endocrinology unit of the HUCFF/UFRJ. They underwent clinical and laboratorial evaluations, with measurements of growth hormone (GH), insulin-like growth factor type I (IGF-I), insulin, proinsulin, C peptide, glycosylated hemoglobin (HbA1c), IGF binding protein type 1 (IGFBP-1) and glucose, during oral glucose tolerance test (OGTT), before and after six months of treatment with octreotide LAR. The Wilcoxon signed-rank test was used and values of 5% were considered statistically significant.


RESULTS
We found 16 (54%) patients with normal glucose tolerance, 7 (23%) with impaired glucose tolerance and 7 (23%) diabetics. Twelve patients completed the six-month treatment, out of which three showed worsening of glucose tolerance and two (diabetics) had worse blood glucose control. Whereas there was an increase in waist circumference (p=0.03), there was a decrease in GH (p=0.04), with %IGF-I above the upper limit of reference values (% ULRV) [p=0.001], insulin (p=0.019), C peptide levels (p=0.002) and homeostatic model assessment (HOMA-IR) [p=0.039].


CONCLUSIONS
In this series, treatment with octreotide LAR led to a worsening of glucose tolerance in three non-diabetic patients and worsened glycemic control in two diabetics, in spite of reducing insulin resistance.
Correa
Lívia L
LL
Serviço de Endocrinologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, RJ, Brazil.
Taboada
Giselle F
GF
Van Haute
Flávia R
FR
Casini
Alessandra F
AF
Balarini
Giovanna A
GA
Vieira Neto
Leonardo
L
Machado
Evelyn de O
Ede O
Fontes
Rosita
R
Andrade
Cláudia C de
CC
Schrank
Yolanda
Y
Gadelha
Mônica R
MR
D000172:Acromegaly / Q000188:drug therapy / Q000378:metabolism*; D000293:Adolescent; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D005260:Female; D005947:Glucose / Q000378:metabolism*; D018149:Glucose Intolerance / Q000139:chemically induced / Q000175:diagnosis*; D005951:Glucose Tolerance Test; D019382:Human Growth Hormone / Q000097:blood* / Q000378:metabolism; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D015282:Octreotide / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D018931:Antineoplastic Agents, Hormonal; D015415:Biomarkers; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D005947:Glucose; D015282:Octreotide