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