%0 Journal Article
%T Glucose metabolism outcomes after pituitary surgery in patients with acromegaly.
%A Pascual-Corrales E
%A Biagetti B
%A Marazuela M
%A Asensio-Wandosel D
%A Rodríguez Berrocal V
%A Irigaray Echarri A
%A Novo-Rodríguez C
%A Calatayud M
%A Bernabéu I
%A Alvarez-Escola C
%A Tenorio-Jiménez C
%A González Molero I
%A Iglesias P
%A Blanco C
%A de Miguel P
%A López Mezquita E
%A Lamas C
%A Aulinas A
%A Gracia P
%A Recio-Córdova JM
%A Sampedro-Nuñez M
%A Paja M
%A Moure Rodríguez MD
%A Fajardo-Montañana C
%A Cordido F
%A Menéndez Torre E
%A Percovich JC
%A García-Centeno R
%A Cámara R
%A Hanzu FA
%A Vicente Delgado A
%A González Fernández L
%A Guerrero-Pérez F
%A Ollero García-Agulló MD
%A Novoa-Testa I
%A Villar-Taibo R
%A Benítez Valderrama P
%A Abellán Galiana P
%A Venegas Moreno E
%A Vidal-Ostos De Lara F
%A Enseñat J
%A Aznar S
%A Asla Q
%A Aviles-Pérez MD
%A Puig-Domingo M
%A Araujo-Castro M
%J Pituitary
%V 0
%N 0
%D 2024 Jun 28
%M 38940859
%F 3.599
%R 10.1007/s11102-024-01415-x
%X <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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).<BR><B>CONCLUSIONS: </B>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.