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Urinary calcium excretion and insulin resistance in patients with acromegaly

  • Nephrology – Original Paper
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Abstract

Background

Renal complications in acromegaly include glomerular hyperfiltration, insulin resistance, hypercalciuria and urolithiasis. The aim of this study was to investigate whether urinary calcium (UCa) excretion is a direct consequence of growth hormone secretion or secondary to hyperfiltration and/or insulin resistance.

Methods

We performed a cross-sectional study of 58 patients diagnosed with acromegaly. Demographic data were obtained, serum analysis was performed, including insulin-like growth factor (IGF)-1, and 24-h urine collection, to measure urinary protein excretion, UCa and phosphate excretion, as well as fractional excretion of sodium and potassium. We also calculated the homeostasis model assessment of insulin resistance (HOMA-IR).

Results

Patients were predominantly male (60.3%), and their mean age was 45.9 ± 14 years. Hypercalciuria was present in 24% of patients. Patients with higher HOMA-IR had higher IGF-1 levels, a trend toward higher body mass index and higher UCa excretion. In univariate analysis, UCa excretion was associated with HOMA-IR (r = 0.472, P = 0.001), phosphaturia (r = 0.457, P = 0.001), IGF-1 (r = 0.398, P = 0.002) and creatinine clearance (r = 0.394, P = 0.001). HOMA-IR and phosphaturia were independently associated with UCa excretion. No independent associations were found between phosphaturia and HOMA-IR or IGF-1.

Conclusions

The present study revealed an association between hypercalciuria and insulin resistance in patients with acromegaly. Further studies are required to fully understand the pathogenesis of these abnormalities in patients with acromegaly.

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Authors and Affiliations

  1. Division of Nephrology, Hospital Geral de Fortaleza, Fortaleza, Ceará, Brazil

    Alexandre Braga Libório, Ivna Aguiar Porto, José Ítalo Soares Mota & Elizabeth Daher

  2. Department of Public Health, University of Fortaleza, Fortaleza, Ceará, Brazil

    Alexandre Braga Libório

  3. School of Medicine, Health Sciences Center, University of Fortaleza, Fortaleza, Ceará, Brazil

    Alexandre Braga Libório, Geraldo B. Silva Junior & José Ítalo Soares Mota

  4. Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil

    Patrícia R. L. Figueiredo, Renan M. Montenegro Junior, Renan M. Montenegro, Manoel R. A. Martins, Geraldo B. Silva Junior & Elizabeth Daher

  5. Av. Abolição 4043 ap 1203, no 1198, CEP 60165-082, Fortaleza, Ceará, Brazil

    Alexandre Braga Libório

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  1. Alexandre Braga Libório
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  2. Patrícia R. L. Figueiredo
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  3. Renan M. Montenegro Junior
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  4. Renan M. Montenegro
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  5. Manoel R. A. Martins
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  6. Geraldo B. Silva Junior
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  8. José Ítalo Soares Mota
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Correspondence to Alexandre Braga Libório.

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Libório, A.B., Figueiredo, P.R.L., Montenegro Junior, R.M. et al. Urinary calcium excretion and insulin resistance in patients with acromegaly. Int Urol Nephrol 44, 1473–1477 (2012). https://doi.org/10.1007/s11255-011-0116-6

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  • DOI: https://doi.org/10.1007/s11255-011-0116-6

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