Early carbohydrate metabolism disorders (ECMDs) and diabetes mellitus (DM) are frequently associated with acromegaly. We aimed to assess the prevalence of ECMDs in patients with acromegaly and to compare the results with those in adults without acromegaly using two population-based epidemiologic surveys. We evaluated 97 patients with acromegaly in several phases of their disease (mean age, 56 years and estimated duration of acromegaly, 12.5 years). An oral glucose tolerance test was done in those not yet diagnosed with DM to reveal asymptomatic DM or ECMDs (impaired glucose tolerance+impaired fasting glucose). Comparisons were made between patients with acromegaly and participants from the general adult population (n=435) and an adult population with multiple type 2 diabetes risk factors (n=314), matched for gender, age and BMI. DM was diagnosed in 51 patients with acromegaly (52.5%) and 14.3% of the general population (P<0.001). The prevalence of ECMDs was also higher in patients with acromegaly than in the general population and in the high-risk group; only 22% of patients with acromegaly were normoglycaemic. The prevalence of newly diagnosed ECMDs or DM was 1.3–1.5 times higher in patients with acromegaly compared with the high-risk group. Patients with acromegaly having ECMDs or DM were older, more obese and had longer disease duration and higher IGF1 levels (Z-score). Logistic regression showed that the severity of glucose derangement was predicted by age, BMI and IGF1 levels. In patients with acromegaly, the prevalence of DM and ECMDs considerably exceeds that of the general population and of a high-risk group, and development of DM depends on age, BMI and IGF1 levels.

To estimate the prevalence of diabetes mellitus (DM) among the patients with acromegaly residing in the Moscow region (MR). A total of 93 patients aged from 48.0 to 64.5 (mean 57.5) years presenting with acromegaly from 7.5 to 20.25 (mean 13.0) years in duration were available for the examination. Twenty seven of these patients developed diabetes mellitus prior to acromegaly. Oral glucose tolerance test (OGTT) for diagnostics of DM was performed in 66 patients. The overall prevalence of diabetes mellitus among the patients with acromegaly was estimated at 51.6% which is higher than that in the general population of the Moscow region and worldwide (2.3% and 8.3% respectively). The prevalence of DM among women was higher than in men (55.1% and 33.5% respectively; p<0.05). It increased with age (from 14.3% in the patients aged between 36 and 45 years to 48.3% at the age above 56 years) and with duration of acromegaly (from 40.6% in the patients with the duration of the disease up to 8 years to 60.5% in those with acromegaly during more than 15 years; p<0.05). Asymptomatic diabetes was diagnosed in 34.8% of the 69 patients which is also higher than the prevalence of asymptomatic type 2 diabetes mellitus in a random sample from the adult population of MR and in the group with the enhanced risk of DM2. The prevalence of DM among the patients in the controllable and uncontrolled phases of acromegaly was 57.1% and 49.2% respectively (p>0.05). The prevalence of DM2 among the patients with acromegaly is significantly higher than in the world's general population; it depends on the patients' age and sex and as well as on the duration of acromegaly.

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Известно, что нарушения углеводного обмена (НУО) часто осложняют течение акромегалии, и их распространенность при активном скрининге до-стигает 78,4% [25,8 и 52,6% -сахарный диабет (СД) и ранние нарушения углеводного обмена (РНУО)] [1, 2], что значительно превышает распространен-ность НУО в популяции [3]. Можно выделить два класса факторов риска развития СД при акромега-лии: общепопуляционные (возраст, женский пол, наличие артериальной гипертензии, отягощенный анамнез по СД 2-го типа (СД2) и др.) [2,[4][5][6] и специфические для акромегалии (длительность и *e-mail: trigolosova_ira@mail.ru © Коллектив авторов, 2015 активность заболевания, проводимое лечение и т.п.) [2,7,8]. Основной метод лечения акромегалии -хирургический, который, по данным современных исследований [9,10], является не только наиболее эффективным, но и оказывает положительное влия-ние на состояние углеводного обмена. При невоз-можности хирургического лечения или его неэф-фективности назначается медикаментозная терапия аналогами соматостатина (АСС) пролонгированно-го действия. Действие АСС на углеводный обмен при акромегалии неоднозначно: с одной стороны, они уменьшают диабетогенное действие сомато-