糖尿病预测肢端肥大症患者手术后体重增加。

Diabetes Mellitus Predicts Weight Gain After Surgery in Patients With Acromegaly.

机构信息

Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea.

Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea.

出版信息

Front Endocrinol (Lausanne). 2022 Mar 9;13:854931. doi: 10.3389/fendo.2022.854931. eCollection 2022.

DOI:10.3389/fendo.2022.854931

PMID:35355553

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8959539/

Abstract

OBJECTIVE

Metabolic complications are common in patients with acromegaly. However, this occasionally does not improve post-surgery and may be related to postoperative weight gain. We aimed to investigate the postoperative weight change and factors associated with postoperative weight gain in patients with acromegaly.

DESIGN AND METHODS

Overall, 113 consecutive patients with body weight records pre- and 3-6 months post-surgery between October 2009 and March 2021 were enrolled. Patients were divided into three groups: weight loss (weight decrease ≥3%), stable, and weight gain (weight increase ≥3%). Hormone status, metabolic comorbidities, and anthropometric parameters were compared between the groups.

RESULTS

Among 113 patients, 29 (25.7%) and 26 (23.0%) patients lost and gained weight, respectively, post-surgery. There were no significant differences in baseline characteristics, including age at diagnosis, sex, body mass index, and growth hormone levels among the three groups. The prevalence of diabetes mellitus at diagnosis was significantly higher in the weight gain group than in the other groups. Patients with diabetes (n=22) had a 5.2-fold higher risk of postoperative weight gain than those with normal glucose tolerance (n=37) (P=0.006). In the diabetes mellitus group, the percentage lean mass decreased (-4.5 [-6.6-2.0]%, P=0.002), and the percentage fat mass significantly increased post-surgery (18.0 [4.6-36.6]%, P=0.003), whereas the normal glucose tolerance group did not show body composition changes post-surgery.

CONCLUSION

In patients with acromegaly, 23% experienced ≥3% weight gain post-surgery. Diabetes mellitus at diagnosis is a significant predictor of weight and fat gain post-surgery.

摘要

目的

肢端肥大症患者常伴有代谢并发症。然而，这些并发症在术后有时并不会改善，且可能与术后体重增加有关。本研究旨在探讨肢端肥大症患者术后体重的变化及其与术后体重增加的相关因素。

方法

回顾性分析 2009 年 10 月至 2021 年 3 月间术后有体重记录的 113 例肢端肥大症患者的临床资料，根据术后 3-6 个月体重与术前相比的变化将患者分为体重减轻组（体重下降≥3%）、稳定组和体重增加组（体重增加≥3%）。比较三组患者的激素状态、代谢合并症和人体测量学参数。

结果

113 例患者中，术后体重减轻 29 例（25.7%），体重增加 26 例（23.0%）。三组患者的基线特征，包括诊断时的年龄、性别、体重指数和生长激素水平等均无显著差异。体重增加组患者的糖尿病患病率显著高于其他两组。与糖耐量正常的患者（n=37）相比，糖尿病患者（n=22）术后发生体重增加的风险增加 5.2 倍（P=0.006）。在糖尿病组中，术后瘦组织百分比下降（-4.5[-6.6-2.0]%，P=0.002），脂肪组织百分比显著增加（18.0[4.6-36.6]%，P=0.003），而糖耐量正常组术后体成分无变化。