JCEM:肢端肥大患者生长抑素类似物对糖代谢有何影响?

2018-03-27 MedSci MedSci原创

众所周知生长抑素类似物(SSAs)在肢端肥大症的一线和二线治疗中能有效控制生长激素分泌,但是其对葡萄糖代谢的影响仍然存在争议。

众所周知生长抑素类似物(SSAs)在肢端肥大症的一线和二线治疗中能有效控制生长激素分泌,但是其对葡萄糖代谢的影响仍然存在争议。

近日在JCEM上发表的一篇文章则进行了一项前瞻性干预研究的Meta分析,试图回答一下问题: 1)SSAs是否影响空腹血糖(FPG),空腹血浆胰岛素(FPI),糖化血红蛋白(HbA1c),葡萄糖负荷(2h-OGTT),HOMA-I,HOMA-β,甘油三酯(TGD ),体重(W)或体重指数(BMI)? 2)兰瑞肽(LAN)和奥曲肽LAR(OCT)对代谢有不同影响吗? 3)他们的效果是否取决于疾病控制?研究人员对前瞻性介入治疗肢端肥大症的SSAs进行了荟萃分析。纳入标准:所有研究报告SSAs之前和之后的糖代谢结果,最少6个月随访。

47项研究纳入了1297名受试者(631 F)满足纳入标准。 SSA治疗有效地降低FPI(效应大小[ES] -6.67mU / L,95%CI:-8.38至-4.95mU / L; p <0.001)、HOMA-1(ES -1.57,CI:-2.42至-0.72)、HOMA-β(ES-47.45,CI:-73.15至-21.76; p <0.001)和TGD(ES-0.37mmol / L,CI:-0.47至-0.27mmol / L; p <0.001)。 SSAs恶化2h-OGTT(ES 0.59 mmol / L,CI:0.05至1.13 mmol / L; p = 0.032),但对FPG无效。在OCT治疗的受试者中发现轻微但显着的HbA1c增加(ES 0.12%,CI:0.00至0.25%; p = 0.044)。

上述研究表明SSA治疗肢端肥大症患者,在改善病情的同时,也会降低胰岛素水平,增加糖载量最终导致HbA1c水平增加却不影响EPG,提示临床医生在用SSA治疗肢端肥大患者的时候应该考虑针对餐后血糖。

原始出处:

Alessia Cozzolino.et al. Somatostatin Analogs and Glucose Metabolism in Acromegaly: A Meta-analysis of Prospective Interventional Studies. J Clin Endocrinol Metab. 2018.

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    2018-12-09 achengzhao
  5. [GetPortalCommentsPageByObjectIdResponse(id=1664764, encodeId=e2461664e6450, content=<a href='/topic/show?id=65b5818609b' target=_blank style='color:#2F92EE;'>#肢端肥大#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81860, encryptionId=65b5818609b, topicName=肢端肥大)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1cad25837873, createdName=654699882_84926994, createdTime=Sat May 19 23:30:00 CST 2018, time=2018-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1970228, encodeId=557119e0228d7, content=<a href='/topic/show?id=b69b69624fe' target=_blank style='color:#2F92EE;'>#生长抑素类似物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69624, encryptionId=b69b69624fe, topicName=生长抑素类似物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f612331, createdName=gds2009, createdTime=Fri Dec 21 19:30:00 CST 2018, time=2018-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2019182, encodeId=a33520191821e, content=<a href='/topic/show?id=35516962114' target=_blank style='color:#2F92EE;'>#生长抑素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69621, encryptionId=35516962114, topicName=生长抑素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Thu Sep 06 07:30:00 CST 2018, time=2018-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2063182, encodeId=0f21206318296, content=<a href='/topic/show?id=14fb10264d7' target=_blank style='color:#2F92EE;'>#JCE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10264, encryptionId=14fb10264d7, topicName=JCE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e656479, createdName=achengzhao, createdTime=Sun Dec 09 06:30:00 CST 2018, time=2018-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1777800, encodeId=b4a41e7780072, content=<a href='/topic/show?id=eb9610265ed' target=_blank style='color:#2F92EE;'>#JCEM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10265, encryptionId=eb9610265ed, topicName=JCEM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2a4439169927, createdName=smallant2015, createdTime=Tue Feb 12 17:30:00 CST 2019, time=2019-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1360604, encodeId=879f13606043f, content=<a href='/topic/show?id=16a6e66155b' target=_blank style='color:#2F92EE;'>#糖代谢#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76615, encryptionId=16a6e66155b, topicName=糖代谢)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30f5146, createdName=zz70, createdTime=Thu Mar 29 10:30:00 CST 2018, time=2018-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=300256, encodeId=fc4330025666, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Tue Mar 27 20:10:43 CST 2018, time=2018-03-27, status=1, ipAttribution=)]
    2019-02-12 smallant2015
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    2018-03-29 zz70
  7. [GetPortalCommentsPageByObjectIdResponse(id=1664764, encodeId=e2461664e6450, content=<a href='/topic/show?id=65b5818609b' target=_blank style='color:#2F92EE;'>#肢端肥大#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81860, encryptionId=65b5818609b, topicName=肢端肥大)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1cad25837873, createdName=654699882_84926994, createdTime=Sat May 19 23:30:00 CST 2018, time=2018-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1970228, encodeId=557119e0228d7, content=<a href='/topic/show?id=b69b69624fe' target=_blank style='color:#2F92EE;'>#生长抑素类似物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69624, encryptionId=b69b69624fe, topicName=生长抑素类似物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f612331, createdName=gds2009, createdTime=Fri Dec 21 19:30:00 CST 2018, time=2018-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2019182, encodeId=a33520191821e, content=<a href='/topic/show?id=35516962114' target=_blank style='color:#2F92EE;'>#生长抑素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69621, encryptionId=35516962114, topicName=生长抑素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Thu Sep 06 07:30:00 CST 2018, time=2018-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2063182, encodeId=0f21206318296, content=<a href='/topic/show?id=14fb10264d7' target=_blank style='color:#2F92EE;'>#JCE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10264, encryptionId=14fb10264d7, topicName=JCE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e656479, createdName=achengzhao, createdTime=Sun Dec 09 06:30:00 CST 2018, time=2018-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1777800, encodeId=b4a41e7780072, content=<a href='/topic/show?id=eb9610265ed' target=_blank style='color:#2F92EE;'>#JCEM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10265, encryptionId=eb9610265ed, topicName=JCEM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2a4439169927, createdName=smallant2015, createdTime=Tue Feb 12 17:30:00 CST 2019, time=2019-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1360604, encodeId=879f13606043f, content=<a href='/topic/show?id=16a6e66155b' target=_blank style='color:#2F92EE;'>#糖代谢#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76615, encryptionId=16a6e66155b, topicName=糖代谢)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30f5146, createdName=zz70, createdTime=Thu Mar 29 10:30:00 CST 2018, time=2018-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=300256, encodeId=fc4330025666, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Tue Mar 27 20:10:43 CST 2018, time=2018-03-27, status=1, ipAttribution=)]
    2018-03-27 1e0f8808m18(暂无匿称)

    学习了.谢谢分享.

    0

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