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肢端肥大症中糖尿病的现状和新进展。

Current and Emerging Aspects of Diabetes Mellitus in Acromegaly.

机构信息

Endocrinology and Metabolic Diseases Unit, Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy.

Endocrine Unit, ASST Carlo Poma, 46100 Mantova, Italy.

出版信息

Trends Endocrinol Metab. 2016 Jul;27(7):470-483. doi: 10.1016/j.tem.2016.04.014. Epub 2016 May 24.

Abstract

Diabetes mellitus is a frequent complication of acromegaly, a disease characterized by chronic hypersecretion of growth hormone (GH) by a pituitary adenoma. Diabetes occurs commonly but not only as a consequence of an insulin-resistant state induced by GH excess. The development of diabetes in patients with acromegaly is clinically relevant, since such a complication is thought to increase the already elevated cardiovascular morbidity and mortality risk of the disease. Emerging data suggest that a specific cardiomyopathy can be identified in acromegaly patients with diabetes. Moreover, the presence of diabetes may also influence therapeutic decision making in acromegaly, since traditional and newly developed drugs used in this clinical setting may impact glucose metabolism regardless of control of GH hypersecretion.

摘要

糖尿病是肢端肥大症的常见并发症,肢端肥大症是一种由垂体腺瘤引起的生长激素(GH)慢性过度分泌的疾病。糖尿病很常见,但不仅是由于 GH 过多引起的胰岛素抵抗状态所致。肢端肥大症患者发生糖尿病具有临床意义,因为这种并发症被认为会增加该疾病已经升高的心血管发病率和死亡率风险。新出现的数据表明,在患有糖尿病的肢端肥大症患者中可以识别出一种特定的心肌病。此外,糖尿病的存在也可能影响肢端肥大症的治疗决策,因为在这种临床环境中使用的传统和新开发的药物可能会影响葡萄糖代谢,而不管 GH 过度分泌的控制情况如何。

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