Surgical outcomes and predictors of glucose metabolism alterations for growth hormone-secreting pituitary adenomas: a hospital-based study of 151 cases

AbstractPurposeThe surgical outcome on glucose metabolism in acromegaly patients is not fully understood. We aimed to investigate the impact of surgery on glucose metabolism and identify key factors that influence alterations of glucose metabolic status in acromegaly patients.MethodsOral glucose tolerance test was performed in 151 newly diagnosed acromegaly patients before and 3 –12 months after surgery. Insulin resistance and insulin secretion was assessed. Patients were grouped as cured, discordant, and having active disease according to postoperative growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels. Receiver-operating characteristic curves were gener ated to determine the optimal cut-off points to predict the impact of surgery on glucose metabolism.ResultsAt baseline, 32.5%, 41.7%, and 25.8% patients were categorized as having normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and diabetes mellitus (DM), respectively. After surgery, improved glucose tolerance was observed in 87.3% patients with IGT and 66.7% patients with DM. Deterioration was observed in 14.3% patients with NGT. Glucose tolerance improved in patients with lower preoperative FBG, 2  h-BG, and HbA1c and higher HOMA-β and IGI/IR. The proportion of NGT was significantly increased in surgically cured patients (28.3% vs. 79.2%,P 
Source: Endocrine - Category: Endocrinology Source Type: research

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Authors: Chanson P, Vialon M, Caron P Abstract INTRODUCTION: As pregnancy is rare in women with acromegaly, only case reports and few series have been published. Areas covered: All case reports and publications dealing with pregnancy in patients with acromegaly were collated. Information concerning the effects of acromegaly on pregnancy outcomes, the impact of pregnancy on GH/IGF-I measurements, acromegaly comorbidity and pituitary adenoma size, the effects of treatment of acromegaly on fetus outcomes were retrieved and analyzed. Expert commentary: Based on the small number of reported cases, pregnancy is generally...
Source: Expert Review of Endocrinology and Metabolism - Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research
This article highlights the role of this novel class for the management of diabetes in patients with acromegaly.
Source: Trends in Endocrinology and Metabolism - Category: Endocrinology Source Type: research
This article highlights the role of this novel class for the management of diabetes in patients with acromegaly. PMID: 30587461 [PubMed - as supplied by publisher]
Source: Trends in Endocrinology and Metabolism: TEM - Category: Endocrinology Authors: Tags: Trends Endocrinol Metab Source Type: research
ConclusionsIn acromegaly,GSTP1 gene methylation associates with resistance to SSA treatment, especially in patients carrying also theAHR rs2066853 variant, and with increased prevalence of colonic polyps and diabetes mellitus.
Source: Journal of Endocrinological Investigation - Category: Endocrinology Source Type: research
Authors: Gadelha MR, Kasuki L, Lim DS, Fleseriu M Abstract Acromegaly is a chronic systemic disease with many complications and is associated with increased mortality when not adequately treated. Significant advances in acromegaly treatment, as well as in the treatment of many of its complications, mainly diabetes mellitus, heart failure and arterial hypertension, were achieved in the last decades. These developments allowed change in both prevalence and severity of some acromegaly complications and furthermore resulted in a reduction of mortality. Nowadays, mortality seems to be similar to the general population i...
Source: Endocrine Reviews - Category: Endocrinology Tags: Endocr Rev Source Type: research
AbstractPurposeEpidemiological data are pivotal for the estimation of disease burden in populations.AimOf the study was to estimate the incidence and prevalence of acromegaly in Italy along with the impact of comorbidities and hospitalization rates as compared to the general population.MethodsRetrospective epidemiological study (from 2000 to 2014) and case control-study. Data were extracted from the Health Search Database (HSD). HSD contains patient records from about 1000 general practitioners (GPs) throughout Italy, covering a population of more than 1 million patients. It includes information about patient demographics ...
Source: Endocrine - Category: Endocrinology Source Type: research
Abstract OBJECTIVE: to assess the efficacy and safety after 48 weeks of treatment with pasireotide long-acting-release (PAS-LAR) alone or in combination with pegvisomant in patients with acromegaly. In addition, we assessed the relation between insulin secretion and pasireotide-induced hyperglycemia. DESIGN: The PAPE extension study is a prospective follow-up study until 48 weeks after the core study of 24 weeks. METHODS: 59 out of 61 patients entered the extension study. Efficacy was defined as the percentage of patients achieving IGF-I normalization (≤ 1.2 x the Upper Limit of Normal (ULN)) at 48-we...
Source: European Journal of Endocrinology - Category: Endocrinology Authors: Tags: Eur J Endocrinol Source Type: research
Authors: Shen M, Wang M, He W, He M, Qiao N, Ma Z, Ye Z, Zhang Q, Zhang Y, Yang Y, Cai Y, ABuDuoReYiMu Y, Lu Y, Lu B, Shou X, Wang Y, Ye H, Li Y, Li S, Zhao Y, Cao X, Zhang Z Abstract Purpose: To evaluate the change in glucose tolerance in treatment-naïve patients with acromegaly after administration of SSA and to identify predictive factors of glucose impairment during SSA therapy. Methods: Oral glucose tolerance testing (OGTT) was performed on 64 newly diagnosed and treatment-naïve patients with acromegaly both at pretreatment and 3 months after initiation of treatment with long-acting SSA. Insulin ...
Source: International Journal of Endocrinology - Category: Endocrinology Tags: Int J Endocrinol Source Type: research
In this study, we aimed to evaluate the presence of glucose metabolism abnormalities and their impact on IGF-1 levels in patients with acromegaly. Ninety-three patients with acromegaly (n=93; 52 males/41 females) were included in this study. Patients were separated into three groups such as; normal glucose tolerance (n=23, 25%), prediabetes (n=38, 41%), and diabetes mellitus (n=32, 34%). Insulin resistance was calculated with homeostasis model assessment (HOMA). HOMA-IR> 2.5 or ≤2.5 were defined as insulin resistant or noninsulin resistant groups, respectively. Groups were compared in terms of factors that may...
Source: Hormone and Metabolic Research - Category: Endocrinology Authors: Tags: Endocrine Care Source Type: research
AbstractPurpose1) To compare the retinal, choroidal, Haller ’s layer, and Sattler’s/choriocapillaris thicknesses of untreated acromegaly patients without chiasm compression or diabetes mellitus and healthy controls. 2) To evaluate the correlations of retinal and choroidal thicknesses with serum growth hormone (GH) and insulin-like growth factor 1 (IGF) b urden.MethodsThis prospective, case-control study included 27 untreated acromegaly patients and 27 sex-matched and age-matched controls. Subfoveal choroidal, Haller ’s layer and Sattler’s/choriocapillaris thicknesses were determined by enhanced-dept...
Source: Endocrine - Category: Endocrinology Source Type: research
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