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新诊断肢端肥大症患者中长效生长抑素类似物对脂代谢的影响:120 例回顾性研究。

Effects of Long-Acting Somatostatin Analogues on Lipid Metabolism in Patients with Newly Diagnosed Acromegaly: A Retrospective Study of 120 Cases.

机构信息

Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China.

Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China.

出版信息

Horm Metab Res. 2022 Jan;54(1):25-32. doi: 10.1055/a-1717-9332. Epub 2022 Jan 5.

DOI:10.1055/a-1717-9332
PMID:34986497
Abstract

The short-term effects of long-acting somatostatin analogues (SSAs) on lipid profiles in patients with acromegaly are not well studied. We retrospectively analyzed the effects of SSAs on lipid profiles and associated cardiovascular risk factors in a cohort of 120 newly diagnosed acromegaly patients. In this study, 69 females and 51 males were included. These patients were treated with either octreotide LAR (OCT) or lanreotide SR (LAN) for 3 months. After SSAs treatment, both GH and IGF-1 significantly decreased (p<0.001). Triglyceride (TG), total to high-density lipoprotein cholesterol (HDL-C) ratio, and lipoprotein (a) [Lp(a)] levels were significantly decreased, while HDL-C levels were increased (p<0.05). The reduction of mean serum GH (GH) was positively associated with the decrease of TG (r=0.305, p=0.001) and Lp(a) (r=0.257, p=0.005), as well as the increase of HDL-C (r=-0.355, p<0.001). The changes of lipid profiles were observed only in OCT group, but not in LAN group. In addition, systolic blood pressure (SBP) had significantly declined after SSAs treatment, with an average reduction of 4.4 mmHg (126.7±1.28 vs. 122.3±1.44 mmHg, p=0.003), while no change was observed regarding diastolic blood pressure (DBP) (p>0.05). Fasting insulin, fasting C-peptide, and HOMA-IR were significantly decreased after SSAs treatment. In conclusion, our current study revealed that short-term SSAs treatment improves lipid profiles and other cardiovascular risk factors in patients with acromegaly.

摘要

长效生长抑素类似物 (SSAs) 对肢端肥大症患者血脂谱的短期影响尚未得到充分研究。我们回顾性分析了 120 例新诊断肢端肥大症患者接受 SSAs 治疗后对血脂谱和相关心血管危险因素的影响。本研究共纳入 69 例女性和 51 例男性患者,分别接受奥曲肽 LAR(OCT)或兰瑞肽 SR(LAN)治疗 3 个月。SSAs 治疗后,GH 和 IGF-1 均显著降低(p<0.001)。甘油三酯(TG)、总胆固醇与高密度脂蛋白胆固醇(HDL-C)比值和脂蛋白(a)[Lp(a)]水平显著降低,而 HDL-C 水平升高(p<0.05)。血清 GH(GH)的平均下降与 TG(r=0.305,p=0.001)和 Lp(a)(r=0.257,p=0.005)的降低以及 HDL-C(r=-0.355,p<0.001)的升高呈正相关。仅在 OCT 组观察到血脂谱的变化,而在 LAN 组未观察到。此外,SSAs 治疗后收缩压(SBP)显著下降,平均降低 4.4mmHg(126.7±1.28 与 122.3±1.44mmHg,p=0.003),而舒张压(DBP)无变化(p>0.05)。SSAs 治疗后空腹胰岛素、空腹 C 肽和 HOMA-IR 均显著降低。综上所述,本研究表明短期 SSAs 治疗可改善肢端肥大症患者的血脂谱和其他心血管危险因素。

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