Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2007) 13 P207

SFEBES2007 Poster Presentations AMEND Young Investigator's Award (21 abstracts)

The effect of lanreotide autogel on insulin resistance, β-cell function and related metabolic variables in acromegaly

Bernd Franke 1 , Gina Twine 2 , Daniel Flanagan 2 & Terry Wilkin 3


1Rotherham General Hospital, Rotherham, United Kingdom; 2Derriford Hospital, Plymouth, United Kingdom; 3Peninsula Medical School, Plymouth, United Kingdom.


Background: Growth hormone (GH) excess is associated with increased insulin resistance (IR). Lanreotide autogel (Autogel) reduces GH-levels effectively in patients with active acromegaly. However, the effect of somatatostatin analogues on IR and (-cell function (HOMA %B) is complex and unpredictable. Our study prospectively monitored IR and related metabolic parameters in acromegalics treated with Autogel.

Methods: Nine patients (P) with active acromegaly, who were switched to Autogel from a different analogue after a wash-out period of four months (4 P) or who were commenced on Autogel (5 P) after failed surgery. Measurements: fasting levels of glucose (FPG), insulin, IGF-1, IGFBP-3, IGFBP-1, lipids HbA1c and GH day curve at the start of treatment (visit (V0) and six months (V6) on treatment with Autogel).

Results: Compared to V0, the following measurements were significantly reduced at V6: mean GH (5.3 mU/L vs 2.0 mU/L P=0.01); IGF-1 (38.7 nmol vs 20.1 nmol/l, P=0.008); IGFBP3 (3.27 mg/L vs. 2.62 mg/L, P=0.007); insulin (15 mU/L vs. 9.1 mU/L, P=0.04). GH <5 mU/L was achieved in 7/9 P. HOMA-IR was reduced by 39% after treatment with Autogel (P=0.047), but at the same time HOMA %B showed a reduction from a mean 95% to a mean 59% (P=0.045). FPG did not change significantly, but HbA1c deteriorated (5.8% vs 6.2%, P<0.0001,). HDL-C increased by 15% (P=0.012). HOMA-IR correlated with mean log GH (r=0.47, P=0.012), IGF-1 (r=0.68, P<0.001), IGFBP3 (r=0.69, P<0.001), negatively with log IGFBP1 (r=−0.56 P=0.002) and HDL-C, (r=−0.41, P=0.034).

Conclusion: 78% of patients achieved ‘safe’ GH levels during the study. Treatment with Autogel resulted in a significant reduction of IR which was accompanied by a 15% increase in HDL. However, HOMA %B decreased also significantly with no change in FPG, but an increase in HbA1c, suggesting post-prandrial disturbances in glucose homeostasis in patients on Autogel.

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