Glucose intolerance in acromegaly is driven by low insulin secretion; results from an intravenous glucose tolerance test
Authors' conclusion
We demonstrated that low insulin secretion is the main driver behind glucose intolerance in acromegaly. Compared to NGT and IGT controls with obesity, patients with NGT or IGT acromegaly had higher Si. Together, these findings suggest that impaired insulin secretion might be a specific mechanism for glucose intolerance in acromegaly.
Study context
- Population
- Patients with active acromegaly without medical treatment for acromegaly or diabetes, and controls25 patients · 23 controls
- Participants
- 13 / 6 / 6 / 8 / 8 / 7
- Comparison
- Active acromegaly vs controls
- Acromegaly NGTn = 13reference
- Acromegaly IGTn = 6
- Acromegaly DMn = 6
- Lean NGT controlsn = 8
- Obese NGT controlsn = 8
- Obese IGT controlsn = 7
- Outcome
- Stimulated insulin secretion (acute insulin response, AIRg) on IVGTT
Methodological detailsIntravenous glucose tolerance test (IVGTT), case-control, Serum glucose and insulin measured at 20 time points; no medical treatment for acromegaly or diabetes allowed
- IVGTT
- Case-control
- Serum glucose and insulin measured at 20 time points; no medical treatment for acromegaly or diabetes allowed
Main finding
As reported in the abstract
AIRg
Acromegaly NGT: P for trend < 0.001 · Obese NGT controls vs Acromegaly NGT: P = 0.01 · Obese IGT controls vs Acromegaly IGT: P = 0.17
Further findings
| Outcome | Values | P value |
|---|---|---|
| Insulin sensitivity (Si)Obese NGT controls vs Acromegaly NGT · lower Si in obese NGT controls | Acromegaly IGT 0.68 (range in brackets 0.37–0.88) 106*L/pmol*min · Acromegaly DM 0.60 (range in brackets 0.42–0.84) 106*L/pmol*min · Acromegaly NGT 0.81 (range in brackets 0.58–1.55) 106*L/pmol*min · Obese NGT controls 0.33 (range in brackets 0.30–0.47) 106*L/pmol*min · Obese IGT controls 0.37 (range in brackets 0.21–0.66) 106*L/pmol*min | P = 0.001 |
| Insulin sensitivity (Si)Obese IGT controls vs Acromegaly IGT · lower Si in obese IGT controls | P = 0.43 |
Insulin sensitivity (Si)
- Si not significantly lower in IGT and DM than NGT acromegaly
Original publication
Glucose intolerance in acromegaly is driven by low insulin secretion; results from an intravenous glucose tolerance test. Pituitary. Published 21 February 2024. doi:10.
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