We considered that HOMA-IR may not be able to accurately assess the severity of insulin resistance in the high GH/IGF-1 state, and subsequent expansion of sample size and hyperinsulinemic-euglycemic clamp tests and in vitro studies are needed to further investigate the relationship between GH/IGF-1 and UA levels and insulin resistance in GHPA patients. This evidence concerns the gene GH1 and Insulin resistance.