What metabolic change is associated with acromegaly due to increased insulin-like growth factor-1 (IGF-1)?

In acromegaly, growth hormone (GH) levels are elevated, leading to increased production of insulin-like growth factor-1 (IGF-1). One significant metabolic change associated with elevated IGF-1 is increased hepatic gluconeogenesis.

This increase occurs for several reasons: IGF-1 enhances the hepatic capacity to produce glucose from non-carbohydrate sources, contributing to an overall increase in blood glucose levels. This is particularly notable as it counteracts the insulin-sensitizing effects that would normally regulate blood sugar levels, resulting in metabolic disturbances.

Additionally, the elevated GH and IGF-1 levels are known to induce insulin resistance, which further promotes glucose production from the liver. This metabolic state can lead to hyperglycemia and has implications for the development of diabetes, as the body becomes less effective at utilizing glucose due to the opposing effects of GH and IGF-1 on insulin action.

Thus, the metabolic change with acromegaly characterized by increased hepatic gluconeogenesis reflects the hormonal balance being tipped towards higher glucose production, contributing to the complications often seen in this condition.