Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street No: 53, Fatih, 34098, Istanbul, Turkey.
Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Pituitary. 2021 Apr;24(2):184-191. doi: 10.1007/s11102-020-01095-3. Epub 2020 Oct 19.
To evaluate the effects of somatostatin analogs and disease activity status on the upper gastrointestinal system in patients with acromegaly.
One hundred eighty-one patients with acromegaly were retrospectively assessed. The demographic, biochemical, pathologic, and radiologic data of the patients were evaluated. The upper gastrointestinal endoscopies and endoscopic biopsies were investigated. We divided patients into four groups according to the use of somatostatin analogs, and into two groups according to disease activity. We compared the data of patients between groups A, B, C, and D, and controlled/uncontrolled groups separately.
Before and in the peri-endoscopic period, 67 and 27 patients were being treated with octreotide long-acting release (LAR) (group A) and lanreotide autogel (group B), respectively. Twenty-one patients used somatostatin analogs, but they were stopped for various reasons before upper gastrointestinal endoscopy (group C), and 66 patients did not use a somatostatin analog (group D). In the peri-endoscopic period, 103 (60%) patients were responsive to medical and/or surgical treatment and 67 (40%) patients were non-responsive. The rate of gastritis was higher in group A than in groups B and D. The incidence of duodenitis and gastric ulcer was much higher in group D. The rate of gastritis was higher in the controlled group compared to the uncontrolled group.
The study showed that octreotide LAR treatment could be a risk factor in addition to known factors for the development of gastritis in patients with acromegaly.
评估生长抑素类似物和疾病活动状态对肢端肥大症患者上消化道系统的影响。
回顾性评估了 181 例肢端肥大症患者。评估了患者的人口统计学、生化、病理和影像学数据。研究了上消化道内镜检查和内镜活检。根据生长抑素类似物的使用情况，我们将患者分为 4 组，并根据疾病活动情况分为两组。我们分别比较了组 A、B、C 和 D 以及控制/未控制组患者之间的数据。
在进行内镜检查之前和内镜检查期间，67 例患者使用奥曲肽长效释放剂（LAR）（组 A），27 例患者使用兰瑞肽微球（组 B）。21 例患者使用了生长抑素类似物，但由于各种原因在进行上消化道内镜检查之前停止使用（组 C），66 例患者未使用生长抑素类似物（组 D）。在内镜检查期间，103 例（60%）患者对药物和/或手术治疗有反应，67 例（40%）患者无反应。组 A 的胃炎发生率高于组 B 和组 D。组 D 的十二指肠炎和胃溃疡发生率明显更高。与未控制组相比，控制组的胃炎发生率更高。
本研究表明，奥曲肽 LAR 治疗可能是除已知因素外，肢端肥大症患者发生胃炎的另一个危险因素。
