Denise Costa1, Filippo Ceccato2,3, Rosa Lauretta4, Valeria Mercuri1, Tania D'Amico1, Corrado De Vito5, Carla Scaroni2, Marialuisa Appetecchia4, Patrizia Gargiulo6. 1. Department of Experimental Medicine, Endocrinology-Pituitary Disease, "Sapienza" University of Rome, Rome, Italy. 2. Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padua, Padua, Italy. 3. Department of Neuroscience DNS, University of Padua, Padua, Italy. 4. Oncological Endocrinology Unit, IRCCS, "Regina Elena" National Cancer Institute, Rome, Italy. 5. Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy. 6. Department of Experimental Medicine, Endocrinology-Pituitary Disease, "Sapienza" University of Rome, Rome, Italy. patrizia.gargiulo@uniroma1.it.
Abstract
BACKGROUND: Acromegaly is a rare disease due to chronic growth hormone (GH) excess and the consequent increase in insulin-like growth factor-1 (IGF-1) levels. Both GH and IGF-1 play a role in intermediate metabolism affecting glucose homeostasis. The association between hyperinsulinemia/impaired glucose tolerance and an increased risk of cancer has been clarified. Insulin has a mitogenic effect through its interaction with the IGF-1 receptor (IGF-1R) that also binds IGF-1. On the other hand, metformin, an anti-hyperglycemic drug that decreases serum levels of insulin and IGF-1, could have a protective role in the treatment of endocrine tumors. METHODS: A retrospective, observational, multicenter study in 197 acromegalic patients, receiving/not receiving metformin, was performed to assess whether the prevalence of neoplasms might be correlated with insulin resistance and could eventually be modified by metformin treatment. RESULTS: In general, the occurrence of secondary neoplasia among our patients was significantly (pV = 0.035) associated with a positive family history of malignancy and with disease duration; a trend towards significance was observed in patients aged > 50 years. Acromegalic subjects who had undergone surgery showed a lower probability of developing a malignant tumor, whereas a higher prevalence of malignancies was observed in obese patients. No significant statistical difference was found when comparing metformin-treated or -untreated subjects for the presence of a second tumor. More interestingly, a trend towards statistical significance (pV = 0.065) was demonstrated in the metformin-treated group for the onset of a benign neoplasm. CONCLUSION: Metformin could act directly on tumor cell metabolism and may have an adjuvant role in benign lesion progression.
BACKGROUND:Acromegaly is a rare disease due to chronic growth hormone (GH) excess and the consequent increase in insulin-like growth factor-1 (IGF-1) levels. Both GH and IGF-1 play a role in intermediate metabolism affecting glucose homeostasis. The association between hyperinsulinemia/impaired glucose tolerance and an increased risk of cancer has been clarified. Insulin has a mitogenic effect through its interaction with the IGF-1 receptor (IGF-1R) that also binds IGF-1. On the other hand, metformin, an anti-hyperglycemic drug that decreases serum levels of insulin and IGF-1, could have a protective role in the treatment of endocrine tumors. METHODS: A retrospective, observational, multicenter study in 197 acromegalicpatients, receiving/not receiving metformin, was performed to assess whether the prevalence of neoplasms might be correlated with insulin resistance and could eventually be modified by metformin treatment. RESULTS: In general, the occurrence of secondary neoplasia among our patients was significantly (pV = 0.035) associated with a positive family history of malignancy and with disease duration; a trend towards significance was observed in patients aged > 50 years. Acromegalic subjects who had undergone surgery showed a lower probability of developing a malignant tumor, whereas a higher prevalence of malignancies was observed in obesepatients. No significant statistical difference was found when comparing metformin-treated or -untreated subjects for the presence of a second tumor. More interestingly, a trend towards statistical significance (pV = 0.065) was demonstrated in the metformin-treated group for the onset of a benign neoplasm. CONCLUSION:Metformin could act directly on tumor cell metabolism and may have an adjuvant role in benign lesion progression.
Authors: Agata Bałdys-Waligórska; Anna Krzentowska; Filip Gołkowski; Grzegorz Sokołowski; Alicja Hubalewska-Dydejczyk Journal: Endokrynol Pol Date: 2010 Jan-Feb Impact factor: 1.582
Authors: Armel H Nwabo Kamdje; Paul F Seke Etet; Maulilio J Kipanyula; Lorella Vecchio; Richard Tagne Simo; Alfred K Njamnshi; Kiven E Lukong; Patrice N Mimche Journal: Front Endocrinol (Lausanne) Date: 2022-08-09 Impact factor: 6.055