The Effect of Metformin Treatment on Disease Control in Patients with Acromegaly

Abstract

background: The increase in portal insulin levels has been shown to upregulate growth hormone receptor expression in the liver, leading to increased insulin-like growth hormone-1 levels. Metformin inhibits hepatic gluconeogenesis and reduces fasting insulin. objective: We evaluated the effect of metformin treatment in patients with acromegaly on growth hormone, insulin-like growth hormone-1, and pituitary adenoma size. method: Patients who were followed up with the diagnosis of acromegaly in Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty were evaluated. The patients were divided into three groups after pituitary adenectomy as those who received somatostatin receptor ligand and metformin treatment (group A), somatostatin receptor ligand treatment only (group B), and those who received metformin treatment only (group C). Groups A and B were compared with each other, and patients in group C were compared among themselves. result: Insulin-like growth factor-1 levels were significantly lower in group A than in group B (p=0.020). There was no significant difference in post-treatment growth hormone levels and residual adenoma sizes between groups A and B (p>0.005). In group C, there was no significant difference in growth hormone values pre-and post-metformin treatment (p=0.078); however, post-metformin treatment insulin-like growth factor-1 values were significantly lower than pre-treatment insulin-like growth factor-1 values (p=0.027). conclusion: Due to the effect of metformin treatment on insulin-like growth factor-1 values in patients with acromegaly, it can be used in disease control, as well as a diabetes treatment