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肢端肥大症患者的治疗前血清生长激素水平与心血管代谢合并症;来自伊朗垂体肿瘤登记处的数据分析

Pretreatment serum GH levels and cardio-metabolic comorbidities in acromegaly; analysis of data from Iran Pituitary Tumor Registry.

作者信息

Hedayati Zafarghandi Leila, Khamseh Mohammad Ebrahim, Fooladgar Milad, Mohseni Shahrzad, Qorbani Mostafa, Madani Nahid Hashemi, Hemmatabadi Mahboobeh, Mohajeri-Tehrani MohammadReza, Shirzad Nooshin

机构信息

Internal Medicine, Medicine Faculty, Tehran University of Medical Sciences, Tehran, Iran.

Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran.

出版信息

J Diabetes Metab Disord. 2020 Apr 5;19(1):319-325. doi: 10.1007/s40200-020-00512-5. eCollection 2020 Jun.

Abstract

BACKGROUND

Acromegaly is a rare chronic disabling disorder, in which growth hormone (GH) excess is associated with a range of clinical features and systemic complications. The present study aims to evaluate the association between pretreatment basal GH levels as well as GH levels after oral glucose tolerance test (OGTT) and cardio-metabolic comorbidities, including diabetes mellitus (DM), left ventricular hypertrophy (LVH) and hypertension (HTN) in patients with active acromegaly.

METHODS

A retrospective study of the medical records regarding 113 patients with acromegaly registered at two main centers of Iran Pituitary Tumor Registry during 2011-2018.

RESULTS

The mean age of the patients was 42.76 ± 11.6 (range: 21-72) years. Mean GH level at baseline was 21 ng/ml while nadir GH levels at 60 and 120 min after glucose were 6.95 and 9.05 ng/ml, respectively. There was a negative correlation between age and basal serum GH level (r= -0.196, p = 0.038). Hypertension and diabetes mellitus were detected in 26.8% and 19.7% of the patients. A positive correlation was detected between serum GH values and systolic blood pressure. There was not any significant difference in basal GH and GH post OGTT regarding DM, Diastolic blood pressure and LVH.

CONCLUSIONS

Our findings suggest that pretreatment basal GH levels are higher in younger patients with acromegaly. Furthermore, higher GH values (0, 60 and 120 min) during OGTT are associated with higher systolic blood pressure. A comprehensive evaluation of this population regarding comorbidities should be performed.

摘要

背景

肢端肥大症是一种罕见的慢性致残性疾病,其中生长激素(GH)分泌过多与一系列临床特征和全身并发症相关。本研究旨在评估活动性肢端肥大症患者治疗前基础GH水平以及口服葡萄糖耐量试验(OGTT)后GH水平与心血管代谢合并症之间的关联,这些合并症包括糖尿病(DM)、左心室肥厚(LVH)和高血压(HTN)。

方法

对2011年至2018年期间在伊朗垂体肿瘤登记处两个主要中心登记的113例肢端肥大症患者的病历进行回顾性研究。

结果

患者的平均年龄为42.76±11.6(范围:21 - 72)岁。基线时平均GH水平为21 ng/ml,而葡萄糖负荷后60分钟和120分钟时的最低GH水平分别为6.95 ng/ml和9.05 ng/ml。年龄与基础血清GH水平呈负相关(r = -0.196,p = 0.038)。26.8%的患者检测出高血压,19.7%的患者检测出糖尿病。血清GH值与收缩压呈正相关。在DM、舒张压和LVH方面,基础GH和OGTT后GH水平无显著差异。

结论

我们的研究结果表明,年轻的肢端肥大症患者治疗前基础GH水平较高。此外,OGTT期间较高的GH值(0、60和120分钟)与较高的收缩压相关。应对该人群的合并症进行全面评估。

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Current and Emerging Aspects of Diabetes Mellitus in Acromegaly.肢端肥大症中糖尿病的现状和新进展。
Trends Endocrinol Metab. 2016 Jul;27(7):470-483. doi: 10.1016/j.tem.2016.04.014. Epub 2016 May 24.

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