Effects of somatostatin receptor ligands on bone metabolism in acromegaly
10.3760/cma.j.cn311282-20220504-00280
- VernacularTitle:生长抑素受体配体对肢端肥大症患者骨代谢的影响
- Author:
Fei SUN
1
;
Yifei YU
;
Meng WANG
;
Lijie XIE
;
Xinmei HUANG
;
Quanya SUN
;
Min HE
;
Yongfei WANG
;
Yao ZHAO
;
Hongying YE
;
Yiming LI
;
Zhaoyu ZHANG
Author Information
1. 复旦大学附属华山医院内分泌科，上海 200040
- Keywords:
Acromegaly;
Somatostatin receptor ligand;
Acromegaly bone disease;
Bone metabolism;
Oteoporosis
- From:
Chinese Journal of Endocrinology and Metabolism
2022;38(6):517-521
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of somatostatin receptor ligands (SRLs) on bone metabolism in patients with acromegaly.Methods:Retrospective analysis of clinical data of acromegaly patients( n=100) received surgery or SRLs alone for 3 months. The changes of growth hormone (GH), insulin-like growth factor-1 (IGF-1), osteocalcin (OC), N-mid fragment of osteocalcin (N-MID), amino-terminal peptide of type I procollagen (P1NP) and C-terminal peptide degradation product of type I collagen(CTX) were compared before and after treatment. Patients were divided into drug treatment group and surgical group according to treatment methods. According to the decline of GH after medication, patients in the drug treatment group were further divided into drug sensitive group and drug insensitive group. Results:The average dynamic GH and IGF-1 indexes in the drug treatment group were significantly decreased after treatment compared with before treatment (both P<0.05), and CTX was also significantly decreased after treatment [1.25 (0.67, 1.40) ng/mL vs 1.34 (0.57, 1.68) ng/mL, P<0.05]. The mean dynamic GH, IGF-1 index, OC, N-MID, P1NP, and CTX in surgical group were significantly decreased after treatment compared with before treatment (all P<0.01). In the surgical group, there was a positive correlation between GH difference (ΔGH) and N-mid difference (ΔN-MID; r=0.454, P=0.026), and there was a positive correlation between IGF-1 index difference (ΔIGF-1 index) and CTX difference (ΔCTX; r=0.339, P=0.036). After treatment, the mean dynamic GH, IGF-1 index, CTX, P1NP, and N-MID in drug treatment group were significantly higher than those in surgical group (all P<0.001). CTX and N-MID decreased significantly after treatment in drug sensitive group compared with drug insensitive group (35.3% vs 7.2%, P<0.001; 24.1% vs 11.8%, P<0.05), and ΔGH was positively correlated with ΔCTX ( r=0.328, P=0.004). Conclusion:SRLs treatment can reduce bone formation marker N-MID and bone resorption marker CTX, improving the high turnover state of bone metabolism in patients with acromegaly, which may attribute to the reduction of GH and IGF-1 levels.
