# Insulin Resistance Among Patients With Multiple Endocrine Neoplasia Type 1: A Systemic Review and Meta-Analysis

## TL;DR

This study finds that people with a genetic disorder called MEN1 are much more likely to have insulin resistance, which could lead to heart disease and shorter lifespans.

## Contribution

This is the first meta-analysis to quantify insulin resistance prevalence in multiple endocrine neoplasia type 1 patients.

## Key findings

- Patients with MEN1 had 5.58 times higher odds of insulin resistance compared to controls.
- No heterogeneity was observed across the five included studies.
- Early screening for glucose tolerance is recommended for MEN1 patients to prevent cardiovascular events.

## Abstract

Multiple endocrine neoplasia type 1 (MEN1) is a hereditary syndrome characterized by predisposition to tumors of parathyroid, pituitary, and enteropancreatic cells. Multiple studies previously showed increased prevalence of insulin resistance and incidence of cardiovascular diseases, decreased life expectancy in patients with MEN1. In this meta-analysis, we aim to further evaluate the extent of insulin resistance among individuals with MEN1.

We systematically searched PubMed, Embase, Scopus, Web of Science Core Collection, and the Cochrane Central Register of Controlled Trials (CENTRAL). Studies involving at least 5 patients with MEN1 and reporting on insulin resistance were included. Primary outcome designated as prevalence of insulin resistance. Meta-analyses done and odds ratios were calculated via the random effects model.

Out of 1453 studies, 5 met the inclusion criteria, involving 606 patients with MEN1 and 4431 controls were included in the meta-analysis. Patients with MEN1 had a significantly higher prevalence of insulin resistance with an odds ratio of 5.58 (95% confidence interval [4.02, 7.74]. No heterogeneity was observed (Tau2 = 0, P = 0.4552). Sensitivity analyses confirmed the robustness of findings.

To our best knowledge, this represents the first meta-analysis on MEN1 and insulin resistance. We have identified a higher prevalence of insulin resistance among individuals with MEN1 compared to controls, independent of age, sex, or body mass index. Given these findings, we recommend that patients with MEN1 should be screened early in the disease course for impaired glucose tolerance, as this may help prevent future cardiovascular events and enhance life expectancy.