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Vila G, Jørgensen JOL, Luger A, et al. Insulin Resistance in Patients With Acromegaly. Front Endocrinol (Lausanne). 2019;10:509doi: 10.3389/fendo.2019.00509.
Vila, G., Jørgensen, J. O. L., Luger, A., & Stalla, G. K. (2019). Insulin Resistance in Patients With Acromegaly. Frontiers in endocrinology, 10509. https://doi.org/10.3389/fendo.2019.00509
Vila, Greisa, et al. "Insulin Resistance in Patients With Acromegaly." Frontiers in endocrinology vol. 10 (2019): 509. doi: https://doi.org/10.3389/fendo.2019.00509
Vila G, Jørgensen JOL, Luger A, Stalla GK. Insulin Resistance in Patients With Acromegaly. Front Endocrinol (Lausanne). 2019 Jul 30;10:509. doi: 10.3389/fendo.2019.00509. eCollection 2019. PMID: 31417493; PMCID: PMC6683662.
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Front Endocrinol (Lausanne). 2019 Jul 30;10:509. doi: 10.3389/fendo.2019.00509. eCollection 2019.

Insulin Resistance in Patients With Acromegaly.

Frontiers in endocrinology

Greisa Vila, Jens Otto L Jørgensen, Anton Luger, Günter K Stalla

Affiliations

  1. Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
  2. Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
  3. Max Planck Institute of Psychiatry, Munich, Germany.

PMID: 31417493 PMCID: PMC6683662 DOI: 10.3389/fendo.2019.00509

Abstract

Acromegaly is characterized by chronic overproduction of growth hormone (GH) that leads to insulin resistance, glucose intolerance and, ultimately, diabetes. The GH-induced sustained stimulation of lipolysis plays a major role not only in the development of insulin resistance and prediabetes/diabetes, but also in the reduction of lipid accumulation, making acromegaly a unique case of severe insulin resistance in the presence of reduced body fat. In the present review, we elucidate the effects of GH hypersecretion on metabolic organs, describing the pathophysiology of impaired glucose tolerance in acromegaly, as well as the impact of acromegaly-specific therapies on glucose metabolism. In addition, we highlight the role of insulin resistance in the development of acromegaly-associated complications such as hypertension, cardiac disease, sleep apnea, polycystic ovaries, bone disease, and cancer. Taken together, insulin resistance is an important metabolic hallmark of acromegaly, which is strongly related to disease activity, the development of comorbidities, and might even impact the response to drugs used in the treatment of acromegaly.

Keywords: IGF-I; acromegaly complications; comorbidities; diabetes; glucose; growth hormone; insulin; pathophysiology

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