Khaire Suhas S, Gada Jugal V, Varthakavi Premlata K, Bhagwat Nikhil M
Department of Endocrinology, Bai Yamunabai Laxman (BYL) Nair Charitable Hospital and Topiwala National Medical College, Mumbai, Maharashtra, India.
Department of Endocrinology, Bai Yamunabai Laxman (BYL) Nair Charitable Hospital and Topiwala National Medical College, Mumbai, Maharashtra, India.
Growth Horm IGF Res. 2021 Aug;59:101394. doi: 10.1016/j.ghir.2021.101394. Epub 2021 Apr 30.
Aims The aim of the study was to evaluate the prevalence and predictors of abnormal glucose tolerance (Diabetes + Prediabetes) and its resolution in Acromegaly.
Retrospective observational study.
Ninety patients with acromegaly and followed up post operatively for 1 year were included. The study cohort was divided into two groups: Group A: abnormal glucose tolerance [AGT: Diabetes + prediabetes (n = 40)] and Group B: normal glucose tolerance (NGT) (n = 50).The impact of the following parameters: age, sex, Waist Circumference(WC), Body Mass Index (BMI), duration of acromegaly, Growth Hormone (GH) levels, Insulin like Growth Factor 1 (IGF1) levels, pituitary tumour size, hypertension, and family history of diabetes as predictors for diabetes were studied pre surgery and post-surgery at 3 months and 1 year affecting glycaemia. Unpaired t-test, chi-square test and binary logistic regression analysis were used for statistical analysis.
The prevalence of AGT in our cohort was 44.44% (Diabetes 37.77%, prediabetes 6.66%).Patients with AGT were older (44.2 ± 12.21 years vs. 34.92 ± 11.62 years; p = 0.00040) and had higher WC (in cm) (91.35 ± 7.87 vs.87.12 ± 6.07; p = 0.005) than NGT. Hypertension and family history of diabetes were significantly more frequent in patients with AGT. GH and IGF1 levels were not significantly different between the groups. On binary logistic regression, Sex (p = 0.0105) (OR = 6.0985), waist circumference (p = 0.0023) (OR = 1.2276) and hypertension (p = 0.0236) (OR = 1.632) were found to be significant predictors of AGT in acromegaly. After surgery 42.5% and 62.5% patients became normoglycemic at 3 months and 1 year respectively. On binary logistic regression there were no predictors for achieving normoglycemia at 3 months or 1 year, however the delta change in GH, BMI and tumour size were significant.
The prevalence of AGT was 44.44%. Female sex, WC and hypertension were found to be significant predictors of AGT in acromegaly. Post-surgery normoglycemia was achieved in 42.5% at 3 months and 62.5% at 1 year with no predictors for normalisation of AGT.
本研究旨在评估肢端肥大症患者中糖耐异常（糖尿病+糖尿病前期）的患病率、预测因素及其缓解情况。
回顾性观察性研究。
纳入90例肢端肥大症患者，术后随访1年。研究队列分为两组：A组：糖耐异常[AGT：糖尿病+糖尿病前期（n = 40）]和B组：糖耐正常（NGT）（n = 50）。研究术前、术后3个月和1年时以下参数：年龄、性别、腰围（WC）、体重指数（BMI）、肢端肥大症病程、生长激素（GH）水平、胰岛素样生长因子1（IGF1）水平、垂体肿瘤大小、高血压和糖尿病家族史作为糖尿病预测因素对血糖的影响。采用独立样本t检验、卡方检验和二元逻辑回归分析进行统计分析。
我们队列中AGT的患病率为44.44%（糖尿病37.77%，糖尿病前期6.66%）。AGT患者年龄较大（44.2±12.21岁 vs. 34.92±11.62岁；p = 0.00040），WC（以厘米计）更高（91.35±7.87 vs. 87.12±6.07；p = 0.005）。AGT患者中高血压和糖尿病家族史更为常见。两组之间GH和IGF1水平无显著差异。二元逻辑回归分析显示，性别（p = 0.0105）（OR = 6.0985）、腰围（p = 0.0023）（OR = 1.2276）和高血压（p = 0.0236）（OR = 1.632）是肢端肥大症患者AGT的显著预测因素。术后3个月和1年时分别有42.5%和62.5%的患者血糖恢复正常。二元逻辑回归分析显示，术后3个月或1年血糖恢复正常无预测因素，但GH、BMI和肿瘤大小的变化具有显著意义。
AGT的患病率为44.44%。女性、WC和高血压是肢端肥大症患者AGT的显著预测因素。术后3个月时42.5%的患者血糖恢复正常，1年时62.5%的患者血糖恢复正常，AGT恢复正常无预测因素。
