HOMA-IR in acromegaly: a systematic review and meta-analysis
Por:
Biagetti, B, Aulinas, A, Casteras, A, Perez-Hoyos, S, Simo, R
Publicada:
1 abr 2021
Ahead of Print:
1 oct 2020
Resumen:
Purpose This review is aimed at examining whether the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) is higher in Caucasian, adult, treatment-naive patients with acromegaly (ACRO) than in the reference population independently of diabetes presence and to evaluate the impact of treatment [surgery and somatostatin analogues (SSAs)] on its assessment. Methods We systematically reviewed in PubMed and Web of Science from July 1985 to December 2019, registered with the code number CRD42020148737. The inclusion criteria comprised studies conducted in Caucasian adult treatment-naive patients with active ACRO in whom HOMA-IR or basal insulin and glucose were reported. Three reviewers screened eligible publications, extracted the outcomes, and assessed the risk of biases. Results Of 118 originally selected studies, 15 met the inclusion criteria. HOMA-IR was higher in ACRO than the reference population, with mean difference and (95% confidence intervals) of 2.04 (0.65-3.44), even in ACRO patients without diabetes, 1.89 (1.06-2.73). HOMA-IR significantly decreased after treatment with either surgery or SSAs - 2.53 (- 3.24- - 1.81) and - 2.30 (- 3.05- - 1.56); respectively. However, the reduction of HOMA-IR due to SSAs did not improve basal glucose. Conclusion HOMA-IR in treatment-naive ACRO patients is higher than in the reference population, even in patients without diabetes. This finding, confirms that insulin resistance is an early event in ACRO. Our results also suggest that HOMA-IR is not an adequate tool for assessing insulin resistance in those patients treated with SSAs.
Filiaciones:
Biagetti, B:
Univ Autonoma Barcelona, Diabet & Metab Res Unit, Vall DHebron Res Inst, Barcelona, Spain
Univ Autonoma Barcelona, CIBERDEM ISCIII, Barcelona, Spain
Aulinas, A:
Hosp La Santa Creu & St Pau, Dept Endocrinol & Nutr, Barcelona, Spain
St Pau Biomed Res Inst IIB St Pau, Dept Endocrinol & Nutr, Barcelona, Spain
ISCIII, Ctr Invest Biomed Red Enfermedades Raras CIBERER, Res Ctr Pituitary Dis, Barcelona, Spain
Univ Vic Cent Univ Catalonia UVic UCC, Fac Med, Vic, Spain
Casteras, A:
Univ Autonoma Barcelona, Diabet & Metab Res Unit, Vall DHebron Res Inst, Barcelona, Spain
Univ Autonoma Barcelona, CIBERDEM ISCIII, Barcelona, Spain
Perez-Hoyos, S:
Univ Barcelona, Vall DHebron Res Inst, Genet Microbiol & Stat Dept, Stat & Bioinformat Unit, Barcelona, Spain
Simo, R:
Univ Autonoma Barcelona, Diabet & Metab Res Unit, Vall DHebron Res Inst, Barcelona, Spain
Univ Autonoma Barcelona, CIBERDEM ISCIII, Barcelona, Spain
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