Ertorer Melek Eda, Bakiner Okan, Anaforoglu Inan, Bozkirli Emre, Tutuncu Neslihan Bascil, Demirag Nilgun Guvener
Baskent University Faculty of Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
Neuro Endocrinol Lett. 2007 Dec;28(6):727-33.
To evaluate the short-term effects of Lanreotide Autogel on insulin sensitivity markers among acromegalic patients with pituitary tumors.
Prospective clinical trial with six months of follow-up.
A tertiary endocrinology clinic.
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.
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.
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.
评估兰瑞肽长效注射凝胶对垂体瘤所致肢端肥大症患者胰岛素敏感性标志物的短期影响。
为期6个月随访的前瞻性临床试验。
一家三级内分泌诊所。
纳入初治患者（患者1和患者3）以及曾接受过生长抑素类似物治疗的患者（患者2、患者4和患者5）。在接受兰瑞肽长效注射凝胶治疗6个月前后，采用胰岛素抵抗及β细胞功能稳态模型评估法测定每位受试者的胰岛素敏感性。还进行了正常血糖高胰岛素钳夹试验以评估整体胰岛素敏感性，并将其表示为“M”指数。
所有患者的HOMA-β均降低。我们注意到，患者1、2和3的HOMA-β大幅下降，同时M指数显著升高（分别为1.03对8.22、2.98对4.70以及5.09对13.09）。这些患者M指数的升高伴随着GH水平的显著下降（分别为34.20对15.30μg/l、4.25对0.74以及5.0对0.66 ng/mL）。患者4和患者5的HOMA-β略有下降，M指数恶化，GH水平几乎稳定。除患者3外，所有参与者的HOMA-IR均下降。
观察到短期使用兰瑞肽长效注射凝胶可改善GH水平显著降低的肢端肥大症患者的M指数。这种改善似乎与GH水平的降低有关，而非直接的药物作用。
