Glucose metabolism outcomes after pituitary surgery in patients with acromegaly.

Autor: Pascual-Corrales E; Endocrinology & Nutrition Department, Hospital Universitario Ramón y Cajal, Colmenar Viejo Street km 9, Madrid, 28034, Spain., Biagetti B; Endocrinology & Nutrition Department, Hospital Universitario Vall de Hebrón. CIBERER U747 (ISCIII), ENDO-ERN, Barcelona, Spain., Marazuela M; Endocrinology & Nutrition Department, Hospital Universitario La Princesa Madrid. Instituto de Investigación Sanitaria Princesa, Universidad Autónoma de Madrid, and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER GCV14/ER/12), Madrid, Spain., Asensio-Wandosel D; Endocrinology & Nutrition Department, Hospital Universitario e Instituto de investigación Germans Trias i Pujol, CIBERER group 747, Badalona, Cataluña, Spain., Rodríguez Berrocal V; Neurosurgery Department, Hospital Universitario Ramón y Cajal, Madrid, Spain., Irigaray Echarri A; Endocrinology & Nutrition Department, Hospital Universitario de Navarra, Pamplona, Spain., Novo-Rodríguez C; Endocrinology & Nutrition Department, Hospital Universitario Virgen de las Nieves, Granada, Spain., Calatayud M; Endocrinology & Nutrition Department, Hospital Universitario 12 de Octubre, Madrid, Spain., Bernabéu I; Endocrinology & Nutrition Department, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, Spain., Alvarez-Escola C; Endocrinology & Nutrition Department, Hospital Universitario La Paz, Madrid, Spain., Tenorio-Jiménez C; Endocrinology & Nutrition Department, Hospital Universitario Virgen de las Nieves, Granada, Spain., González Molero I; Endocrinology & Nutrition Department, Hospital Regional Universitario de Málaga, IBIMA Plataforma BIONAND, Málaga, Spain., Iglesias P; Endocrinology & Nutrition Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain., Blanco C; Endocrinology & Nutrition Department, Hospital Universitario Príncipe de Asturias, Madrid, Spain., de Miguel P; Endocrinology & Nutrition Department, Hospital Clínico San Carlos, Madrid, Spain., López Mezquita E; Endocrinology & Nutrition Department, Hospital Universitario Clínico San Cecilio, Granada, Spain., Lamas C; Endocrinology & Nutrition Department, Hospital Universitario De Albacete, Albacete, Spain., Aulinas A; Endocrinology & Nutrition Department, Hospital de la Santa Creu i Sant Pau, IR-SANT PAU, CIBERER U747 (ISCIII), ENDO-ERN, Barcelona, Spain., Gracia P; Endocrinology & Nutrition Department, Hospital Royo Villanova, Zaragoza, Spain., Recio-Córdova JM; Endocrinology & Nutrition Department, Hospital Universitario de Salamanca, Salamanca, Spain., Sampedro-Nuñez M; Endocrinology & Nutrition Department, Hospital Universitario La Princesa Madrid. Instituto de Investigación Sanitaria Princesa, Universidad Autónoma de Madrid, and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER GCV14/ER/12), Madrid, Spain., Paja M; Endocrinology & Nutrition Department, OSI Bilbao-Basurto. Hospital Universitario de Basurto, University of the Basque Country UPV/EHU, Bilbao, Spain., Moure Rodríguez MD; Endocrinology & Nutrition Department, Hospital de Cruces, Bilbao, Spain., Fajardo-Montañana C; Endocrinology & Nutrition Department, Hospital Universitario de La Ribera, Valencia, Spain., Cordido F; Endocrinology & Nutrition Department, Hospital Universitario de A Coruña, A Coruña, Spain., Menéndez Torre E; Endocrinology & Nutrition Department, Hospital Universitario Central de Asturias/University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain., Percovich JC; Endocrinology & Nutrition Department, Hospital Universitario Gregorio Marañón, Madrid, Spain., García-Centeno R; Endocrinology & Nutrition Department, Hospital Universitario Gregorio Marañón, Madrid, Spain., Cámara R; Endocrinology & Nutrition Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain., Hanzu FA; Endocrinology & Nutrition Department, Hospital Clinic Barcelona, University Barcelona, IDIBAPS, Barcelona, Spain., Vicente Delgado A; Endocrinology & Nutrition Department, Hospital Universitario de Toledo, Toledo, Spain., González Fernández L; Endocrinology & Nutrition Department, Hospital Universitario Gregorio Marañón, Madrid, Spain., Guerrero-Pérez F; Endocrinology & Nutrition Department, Hospital Universitario de Bellvitge (L'Hospitalet de Llobregat), Barcelona, Spain., Ollero García-Agulló MD; Endocrinology & Nutrition Department, Hospital Universitario de Navarra, Pamplona, Spain., Novoa-Testa I; Endocrinology & Nutrition Department, Hospital Universitario de A Coruña, A Coruña, Spain., Villar-Taibo R; Endocrinology & Nutrition Department, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, Spain., Benítez Valderrama P; Endocrinology & Nutrition Department, Hospital Universitario La Paz, Madrid, Spain., Abellán Galiana P; Endocrinology & Nutrition Department, Hospital General Universitario de Castellón, Valencia, Spain.; Department of Medicine and Surgery, Universidad Cardenal Herrera-CEU, CEU Universities, Castellón, Spain., Venegas Moreno E; Endocrinology & Nutrition Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain., Vidal-Ostos De Lara F; Endocrinology & Nutrition Department, Hospital Universitario Príncipe de Asturias, Madrid, Spain., Enseñat J; Neurosurgery Department, Hospital Clinic Barcelona, University Barcelona, Barcelona, Spain., Aznar S; Endocrinology & Nutrition Department, Hospital Universitario De Albacete, Albacete, Spain., Asla Q; Endocrinology & Nutrition Department, Hospital de la Santa Creu i Sant Pau, IR-SANT PAU, CIBERER U747 (ISCIII), ENDO-ERN, Barcelona, Spain., Aviles-Pérez MD; Endocrinology & Nutrition Department, Hospital Universitario Clínico San Cecilio, Granada, Spain., Puig-Domingo M; Endocrinology & Nutrition Department, Hospital Universitario e Instituto de investigación Germans Trias i Pujol, CIBERER group 747, Badalona, Cataluña, Spain., Araujo-Castro M; Endocrinology & Nutrition Department, Hospital Universitario Ramón y Cajal, Colmenar Viejo Street km 9, Madrid, 28034, Spain. marta.araujo@salud.madrid.org.
Jazyk: angličtina
Zdroj: Pituitary [Pituitary] 2024 Oct; Vol. 27 (5), pp. 497-506. Date of Electronic Publication: 2024 Jun 28.
DOI: 10.1007/s11102-024-01415-x
Abstrakt: Aim: To investigate the impact of pituitary surgery on glucose metabolism and to identify predictors of remission of diabetes after pituitary surgery in patients with acromegaly.
Methods: A 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.
Results: A 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).
Conclusion: Glucose 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.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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