Prevalence of diabetes mellitus in patients with acromegaly.

Early carbohydrate metabolism disorders (ECMDs) and diabetes mellitus (DM) are frequently associated with acromegaly. We aimed to assess the prevalence of ECMDs in patients with acromegaly and to compare the results with those in adults without acromegaly using two population-based epidemiologic surveys. We evaluated 97 patients with acromegaly in several phases of their disease (mean age, 56 years and estimated duration of acromegaly, 12.5 years). An oral glucose tolerance test was done in those not yet diagnosed with DM to reveal asymptomatic DM or ECMDs (impaired glucose tolerance+impaired fasting glucose). Comparisons were made between patients with acromegaly and participants from the general adult population (n=435) and an adult population with multiple type 2 diabetes risk factors (n=314), matched for gender, age and BMI. DM was diagnosed in 51 patients with acromegaly (52.5%) and 14.3% of the general population (P<0.001). The prevalence of ECMDs was also higher in patients with acromegaly than in the general population and in the high-risk group; only 22% of patients with acromegaly were normoglycaemic. The prevalence of newly diagnosed ECMDs or DM was 1.3-1.5 times higher in patients with acromegaly compared with the high-risk group. Patients with acromegaly having ECMDs or DM were older, more obese and had longer disease duration and higher IGF1 levels (Z-score). Logistic regression showed that the severity of glucose derangement was predicted by age, BMI and IGF1 levels. In patients with acromegaly, the prevalence of DM and ECMDs considerably exceeds that of the general population and of a high-risk group, and development of DM depends on age, BMI and IGF1 levels.

[Role of somatotropic hormone in the dystrophic syndrome of patients with chronic circulatory failure]. / Znachenie somatotropnogo gormona pri distroficheskom sindrome u bol'nykh s khronicheskoi nedostatochnost'iu krovoobrashcheniia.

Concentrations of somatotropic hormone (STH) in the blood were determined in 71 patients with varying degrees of chronic circulatory insufficiency and the dystrophic syndrome and in 12 healthy individuals. The degree of dystrophic changes in the body was evaluated by figures of the dry body weight. In 36 patients with severe circulatory insufficiency albumin metabolism was also studied. The results showed that the basal level of STH of the blood rises when chronic circulatory insufficiency supervenes and develops. No relationship between the degree of STH rise in the blood and dystrophic changes in body was found. A reverse correlation between the STH content in the blood and the size of the dry body weight in patients with enhanced breakdown of albumen suggests that in cardiac insufficiency STH plays a role in the adaptation of metabolism to the dystrophic process in the body, perhaps by stimulating the metabolism of fats.