Glucose metabolism outcomes after pituitary surgery in patients with acromegaly
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Glucose metabolism outcomes after pituitary surgery in patients with acromegalyAuthor(s)
Date
2024-06-28Citation
Pascual-Corrales E, Biagetti B, Marazuela M, Asensio-Wandosel D, Rodríguez Berrocal V, Irigaray Echarri A, et al. Glucose metabolism outcomes after pituitary surgery in patients with acromegaly. 2024 Jun 28. Epub ahead of print.
Abstract
[Abstract] 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.
Keywords
Acromegaly
Pituitary adenoma
Remission
Somatotropinoma
Diabetes mellitus
Glucose levels
HbA1c
Pituitary adenoma
Remission
Somatotropinoma
Diabetes mellitus
Glucose levels
HbA1c
Editor version
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This version of the article has been accepted for publication, after peer review and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at Springer Link.
ISSN
1386-341X
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