2024-03-29T12:43:11Zhttps://eprints.lib.hokudai.ac.jp/dspace-oai/requestoai:eprints.lib.hokudai.ac.jp:2115/672622022-11-17T02:08:08Zhdl_2115_20043hdl_2115_137Glucose tolerance is improved following surgery for silent somatotroph adenomaMiya, AikaNakamura, AkinobuMiyoshi, HideakiKameda, HirakuNomoto, HiroshiNagai, SoOmori, YukoHatanaka, Kanako C.Kobayashi, HiroyukiShimizu, ChikaraAtsumi, TatsuyaSilent somatotroph adenomaglucose toleranceoral glucose tolerance testinsulin sensitivity490Although the excessive secretion of GH leads to insulin resistance enhancement, the involvement of a silent somatotroph adenoma in abnormal glucose tolerance has not been elucidated. A 50 - year-old man was admitted with a headache and bitemporal hemianopia caused by a pituitary macroadenoma. He had no physical signs and symptoms of acromegaly nor hypopituitarism, and his base-line serum levels of GH and insulin - like growth factor-1 (IGF-1) were normal. However, a 75 - g oral glucose tolerance test (OGTT) showed unsuppressed GH concentrations as well as plasma glucose levels consistent with diabetes pattern. A transsphenoidal adenomectomy was performed, and we diagnosed the patient as having a silent somatotroph adenoma based on positive GH in the immunohistochemistry. Postoperative OGTT showed GH suppression and a normal pattern of plasma glucose levels after glucose loading. The post-surgery homeostasis model assessment insulin resistance index (HOMA - IR) and the Matsuda Index indicated improved insulin sensitivity in the absence of perioperative body-mass-index change. These observations suggest that reversible abnormal glucose tolerance is associated with a silent somatotroph adenoma in this patient.ClinMed International LibraryJournal Articleapplication/pdfhttp://hdl.handle.net/2115/67262https://eprints.lib.hokudai.ac.jp/dspace/bitstream/2115/67262/1/IJDCR-2-047.pdf2377-3634International Journal of Diabetes and Clinical Research260472015enginfo:doi/10.23937/2377-3634/1410047http://creativecommons.org/licenses/by/4.0/publisher