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糖尿病对肢端肥大症患者生存的影响。

The impact of diabetes mellitus on the survival of patients with acromegaly.

作者信息

Wen-Ko Chiou, Szu-Tah Chen, Feng-Hsuan Liu, Chen-Nen Chang, Ming-Hsu Wang, Jen-Der Lin

机构信息

Department of Industrial Design, Healthy Aging Research Centre, Chang Gung University, Taiwan.

出版信息

Endokrynol Pol. 2016;67(5):501-506. doi: 10.5603/EP.a2016.0031. Epub 2016 Feb 17.

Abstract

INTRODUCTION

An increased risk of mortality in patients with uncontrolled acromegaly has been reported in several studies. We aimed to assess the impact of co-morbidities on the survival of patients with acromegaly after long-term treatment and follow-up.

MATERIAL AND METHODS

A retrospective analysis was performed for 285 patients with active acromegaly, who were admitted to the Chang Gung Memorial Hospital, Taiwan between 1978 and 2012. Of these patients, 106 (37.2%) were diagnosed with diabetes mellitus (DM). During the follow-up period, 21 cases of histological proved malignant in acromegalic patients, and DM with acromegaly had a higher incidence of malignancy (13.2% vs. 3.8%; p < 0.01). The 5-, 10-, and 20-year survival rates were 93.1%, 86.9%, and 84.7% for the DM group, respectively, and 96.5%, 96.5%, and 96.5% for the non-DM group, respectively. After a mean follow-up of 15.1 ± 0.6 years, age, DM, coronary heart disease, and malignancy were found to be significant factors of mortality. Control of growth hormone and IGF-1 levels also conferred a marginal survival benefit.

CONCLUSIONS

DM and malignancy significantly influence the survival of patients with acromegaly; thus, these patients need close follow-up and appropriate therapy. (Endokrynol Pol 2016; 67 (5): 501-506).

摘要

引言

多项研究报道,肢端肥大症控制不佳的患者死亡风险增加。我们旨在评估合并症对肢端肥大症患者长期治疗及随访后生存情况的影响。

材料与方法

对1978年至2012年间收治于台湾长庚纪念医院的285例活动性肢端肥大症患者进行回顾性分析。其中,106例(37.2%)被诊断为糖尿病(DM)。在随访期间,21例肢端肥大症患者经组织学证实为恶性肿瘤,合并糖尿病的肢端肥大症患者恶性肿瘤发生率更高(13.2%对3.8%;p<0.01)。糖尿病组的5年、10年和20年生存率分别为93.1%、86.9%和84.7%,非糖尿病组分别为96.5%、96.5%和96.5%。平均随访15.1±0.6年后,发现年龄、糖尿病、冠心病和恶性肿瘤是死亡的重要因素。生长激素和IGF-1水平的控制也带来了一定的生存益处。

结论

糖尿病和恶性肿瘤显著影响肢端肥大症患者的生存;因此,这些患者需要密切随访和适当治疗。(《波兰内分泌学》2016年;67(5):501 - 506)

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