Long-term depot specific changes in adipose tissue after treatment of acromegaly.

Abstract

CONTEXT:

Patients with active acromegaly present a decreased adipose tissue (AT) mass, and short-term studies show that treatment leads to AT depot-specific gain. However, it remains unclear if the increase is persistent in the long-term perspective and/or is sex-dependent.

DESIGN:

To characterize the depot-specific changes of AT after treatment of acromegaly and identify contributing factors.

METHODS:

Adipose tissue, including visceral (VAT), subcutaneous (SAT), and total (TAT), and android to gynoid ratio (A/G ratio) were measured by dual energy X-ray absorptiometry at diagnosis (n = 62), and after treatment at short-term (median (IQR) 1.9 (1.5-2.3)) and long-term 5.5 (3.9-9.5) years, and correlated to clinical and biochemical measurements. Growth hormone (GH), insulin-like growth factor 1 (IGF-1), glucose and HbA1c levels, gonadal status, and the presence of diabetes mellitus were recorded. Remission status was assessed at the long-term visit (IGF-1/ULN ≤ 1.3). Differences in the temporal course of AT from baseline to short- and long-term follow-up according to sex, diabetes, gonadal, and remission status were evaluated by mixed model analysis, adjusted for age.

RESULTS:

Despite a stable body mass index, VAT and A/G ratio increased at both time points, whereas SAT mainly increased at short-term, plateauing afterwards (P < .05 for all). Visceral adipose tissue and A/G ratio were higher in men (P = .035 and P < .001), and the A/G ratio increased more than in women (P = .003). Glucose and HbA1c decreased short-term (P < .05) and remained stable at long-term. The increase in AT depots correlated with the decrease of disease activity at long-term. Remission status had no effect on changes in AT mass during follow-up.

CONCLUSION:

Treatment of acromegaly leads to an increase in AT mass in a depot- and sex-specific manner both at short-term and long-term follow-up. Glucose metabolism improves rapidly after disease control and persists.

• Authors: Camilla M Falch, Kristin Godang, Tove Lekva, Thor Ueland, Ansgar Heck, Jens Bollerslev, Nicoleta C Olarescu
• Journal: European journal of endocrinology (Eur J Endocrinol) Vol. 190 Issue 3 Pg. K37-K42 (Mar 02 2024) ISSN: 1479-683X [Electronic] England
• PMID: 38401530 (Publication Type: Journal Article)
• Copyright: © The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Endocrinology.

Chemical References

• Insulin-Like Growth Factor I
• Glycated Hemoglobin
• Glucose

Topics

• Male
• Humans
• Female
• Acromegaly (drug therapy)
• Insulin-Like Growth Factor I (metabolism)
• Glycated Hemoglobin
• Adipose Tissue (metabolism)
• Glucose (metabolism)