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Effects of somatostatin analogs on glucose homeostasis: a metaanalysis of acromegaly studies

Gherardo Mazziotti1, Irene Floriani, Stefania Bonadonna

  • 1Department of Medical and Surgical Sciences, University of Brescia, 25125 Brescia, Italy.

The Journal of Clinical Endocrinology and Metabolism
|February 12, 2009
PubMed
Abstract

Insights

Somatostatin analogs (SSA) significantly decreased fasting insulin but did not alter fasting glucose or HbA1c in acromegaly patients. While glucose levels during oral glucose tolerance tests changed, the overall clinical impact on glucose homeostasis is minor.

Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Pharmacology

Background:

  • Somatostatin analogs (SSA) are used in acromegaly treatment.
  • Potential effects of SSA on glucose metabolism require further clinical clarification due to limitations in existing trial data.

Purpose of the Study:

  • To conduct a meta-analysis of acromegaly studies to evaluate the clinical impact of SSA on glucose metabolism.
  • To analyze changes in fasting plasma glucose, fasting plasma insulin, hemoglobin A1c, and oral glucose tolerance test results.

Main Methods:

  • A systematic meta-analysis was performed on 31 eligible studies.
  • Inclusion criteria included a minimum SSA treatment duration of 3 weeks and availability of pre- and post-treatment biochemical outcome data.
  • Studies excluded patients selected based on SSA responsiveness.

Main Results:

  • SSA treatment led to a statistically significant decrease in fasting plasma insulin (effect size -0.45, P < 0.001).
  • No significant changes were observed in fasting plasma glucose (P = 0.52) or hemoglobin A1c (P = 0.09).
  • A significant increase in serum glucose during oral glucose tolerance tests was noted (effect size +0.31, P < 0.001), though with considerable heterogeneity among studies.

Conclusions:

  • The meta-analysis indicates that SSA treatment induces statistically significant changes in specific glucose metabolism markers in acromegaly.
  • Despite these changes, particularly in fasting insulin and during glucose tolerance tests, the overall clinical relevance for glucose homeostasis in acromegaly appears to be minor.

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