Glucose metabolism outcomes after pituitary surgery in patients with acromegaly

被引：0

作者：

Pascual-Corrales, Eider ^{[1
]}

Biagetti, Betina ^{[2
]}

Marazuela, Monica ^{[3
,4
]}

Asensio-Wandosel, Diego ^{[5
]}

Berrocal, Victor Rodriguez ^{[6
]}

Echarri, Ana Irigaray ^{[7
]}

Novo-Rodriguez, Cristina ^{[8
]}

Calatayud, Maria ^{[9
]}

Bernabeu, Ignacio ^{[10
]}

Alvarez-Escola, Cristina ^{[11
]}

Tenorio-Jimenez, Carmen ^{[8
]}

Molero, Inmaculada Gonzalez ^{[12
]}

Iglesias, Pedro ^{[13
]}

Blanco, Concepcion ^{[14
]}

de Miguel, Paz ^{[15
]}

Mezquita, Elena Lopez ^{[16
]}

Lamas, Cristina ^{[17
]}

Aulinas, Anna ^{[18
]}

Gracia, Paola ^{[19
]}

Recio-Cordova, Jose Maria ^{[20
]}

Sampedro-Nunez, Miguel ^{[3
,4
]}

Paja, Miguel ^{[21
]}

Rodriguez, Maria Dolores Moure ^{[22
]}

Fajardo-Montanana, Carmen ^{[23
]}

Cordido, Fernando ^{[24
]}

Torre, Edelmiro Menendez ^{[25
]}

Percovich, Juan Carlos ^{[26
]}

Garcia-Centeno, Rogelio ^{[26
]}

Camara, Rosa ^{[27
]}

Hanzu, Felicia Alexandra ^{[28
]}

Delgado, Almudena Vicente ^{[29
]}

Fernandez, Laura Gonzalez ^{[26
]}

Guerrero-Perez, Fernando ^{[30
]}

Garcia-Agullo, Maria Dolores Ollero ^{[7
]}

Novoa-Testa, Iria ^{[24
]}

Villar-Taibo, Rocio ^{[10
]}

Valderrama, Pamela Benitez ^{[11
]}

Galiana, Pablo Abellan ^{[31
,32
]}

Moreno, Eva Venegas ^{[33
]}

De Lara, Fernando Vidal-Ostos ^{[14
]}

Ensenat, Joaquim ^{[34
]}

Aznar, Silvia ^{[17
]}

Asla, Queralt ^{[18
]}

Aviles-Perez, Maria Dolores ^{[16
]}

Puig-Domingo, Manel ^{[5
]}

Araujo-Castro, Marta ^{[1
]}

机构：

[1] Hosp Univ Ramon y Cajal, Endocrinol & Nutr Dept, Colmenar Viejo St Km 9, Madrid 28034, Spain

[2] Hosp Univ Vall de Hebron, Dept Endocrinol & Nutr, CIBERER U747 ISCIII, ENDO ERN, Barcelona, Spain

[3] Univ Autonoma Madrid, Hosp Univ La Princesa Madrid, Endocrinol & Nutr Dept, Inst Invest Sanit Princesa, Madrid, Spain

[4] Ctr Invest Biomed Red Enfermedades Raras CIBERER G, Madrid, Spain

[5] Hosp Univ Germans Trias i Pujol, Gastroenterol & Hepatol Dept, Badalona, Spain

[6] Hosp Univ Ramon y Cajal, Dept Pathol, Madrid, Spain

[7] Hosp Univ Navarra, Dept Endocrinol & Nutr, Pamplona, Spain

[8] Hosp Univ Virgen Nieves, Dept Neurol, Granada, Spain

[9] Hosp Univ 12 Octubre, Endocrinol & Nutr Dept, Madrid, Spain

[10] Hosp Univ Santiago de Compostela, Complejo Hosp Univ Santiago de Compostela, Dept Endocrinol & Nutr, Santiago De Compostela, Spain

[11] Hosp Univ La Paz, Endocrinol & Nutr Dept, Madrid, Spain

[12] Hosp Reg Univ Malaga, Dept Endocrinol & Nutr, Inst IBIMA Plataforma BIONAND, Malaga 29010, Spain

[13] Hosp Univ Puerta Hierro Majadahonda, Dept Endocrinol & Nutr, Madrid, Spain

[14] Hosp Univ Principe Asturias, Dept Endocrinol & Nutr, Madrid, Spain

[15] Hosp Clin San Carlos, Endocrinol & Nutr Dept, Madrid, Spain

[16] Hosp Univ Clin San Cecilio, Endocrinol & Nutr Dept, Granada, Spain

[17] Hosp Univ Albacete, Endocrinol & Nutr Dept, Albacete, Spain

[18] Hosp St Creu i Sant Pau, Endocrinol & Nutr Dept, IR SANT PAU, CIBERER U747 ISCIII,ENDO ERN, Barcelona, Spain

[19] Hosp Royo Villanova, Dept Psychiat, Zaragoza, Spain

[20] Hosp Univ Salamanca, Endocrinol & Nutr Dept, Salamanca, Spain

[21] Basurto Univ Hosp, Otorhinolaryngol Dept, Basque Hlth Serv Osakidetza, OSI Bilbao Basurto, Bilbao, Spain

[22] Hosp Cruces, Dept Nephrol, Bilbao, Spain

[23] Hosp Univ Ribera, Dept Gastroenterol, Valencia, Spain

[24] Hosp Univ A Coruna, Dept Endocrinol, La Coruna, Spain

[25] Univ Oviedo, Hosp Univ Cent Asturias, Serv Endocrinol & Nutr, Inst Invest Sanitaria Principado Asturias ISPA, Oviedo, Spain

[26] Hosp Univ Gregorio Maranon, Endocrinol & Nutr Dept, Madrid, Spain

[27] Hosp Univ & Politecn La Fe, Endocrinol & Nutr Dept, Valencia, Spain

[28] Univ Barcelona, Endocrinol & Nutr Dept, Hosp Clin Barcelona, IDIBAPS, Barcelona, Spain

[29] Hosp Univ Toledo, Dept Pediat Endocrinol, Toledo, Spain

[30] Hosp Univ Bellvitge Lhosp de Llobregat, Lhospitalet De Llobregat, Barcelona, Spain

[31] Consorcio Hosp Gen Univ, Valencia, Spain

[32] CEU Univ, Univ Cardenal Herrera CEU, Dept Med & Surg, Castellon de La Plana, Spain

[33] Hosp Univ Virgen Rocio, Serv Inmunol, Seville, Spain

[34] Univ Barcelona, Hosp Clin Barcelona, Dept Neurosurg, Barcelona, Spain

来源：

PITUITARY | 2024年 / 27卷 / 05期

关键词：

Acromegaly; Pituitary adenoma; Remission; Somatotropinoma; Diabetes mellitus; Glucose levels; HbA1c;

D O I：

暂无

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

AimTo investigate the impact of pituitary surgery on glucose metabolism and to identify predictors of remission of diabetes after pituitary surgery in patients with acromegaly.MethodsA national multicenter retrospective study of patients with acromegaly undergoing transsphenoidal surgery for the first time at 33 tertiary Spanish hospitals (ACRO-SPAIN study) was performed. Surgical remission of acromegaly was evaluated according to the 2000 and 2010 criteria.ResultsA total of 604 acromegaly patients were included in the study with a total median follow up of 91 months (interquartile range [IQR] 45-163). At the acromegaly diagnosis, 23.8% of the patients had diabetes mellitus (DM) with a median glycated hemoglobin (HbA1c) of 6.9% (IQR 6.4-7.9) [51.9 mmol/mol (IQR 46.4-62.8)]. In the multivariate analysis, older age (odds ratio [OR] 1.02, 95% CI 1.00-1.05), dyslipidemia (OR 5.25, 95% CI 2.81 to 9.79), arthropathy (OR 1.39, 95% CI 2.82 to 9.79), and higher IGF-I levels (OR 1.30, 95% CI 1.05 to 1.60) were associated with a greater prevalence of DM. At the last follow-up visit after surgery, 21.1% of the DM patients (56.7% of them with surgical remission of acromegaly) experienced diabetes remission. The cure rate of DM was more common in older patients (hazard ratio [HR] 1.77, 95% CI 1.31 to 2.43), when surgical cure was achieved (HR 2.10, 95% CI 1.01 to 4.37) and when anterior pituitary function was not affected after surgery (HR 3.38, 95% CI 1.17 to 9.75).ConclusionGlucose metabolism improved in patients with acromegaly after surgery and 21% of the diabetic patients experienced diabetes remission; being more frequent in patients of older age, and those who experienced surgical cure and those with preserved anterior pituitary function after surgery.

引用

页码：497 / 506

页数：10

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