Araujo-Castro Marta, Mínguez Ojeda César, García Centeno Rogelio, López-García María-Carmen, Lamas Cristina, Hanzu Felicia Alexandra, Mora Mireia, Del Castillo Tous María, Rodríguez de Vera Gómez Pablo, Parra Ramírez Paola, Alvarez-Escola Cristina, Blanco Carrera Concepción, Barahona San Millán Rebeca, Recasens Mónica, Valdés Nuria, Gracia Gimeno Paola, de Miguel Novoa Paz, Vicente Almudena, Manjón Laura, García Sanz Iñigo, Michalopoulou Theodora, Calatayud María
Endocrinology & Nutrition Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.
Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), Madrid, Spain.
Endocr Relat Cancer. 2022 Oct 7;29(12):645-655. doi: 10.1530/ERC-22-0218. Print 2022 Dec 1.
The objective of our study was to determine the prevalence of glycemic disorders (diabetes mellitus and prediabetes) in patients with pheochromocytomas and sympathetic paragangliomas (PPGLs) and identify risk factors for their development and the likelihood of their resolution after surgery. A multicentric retrospective study of patients with PPGLs submitted to surgery between 2000 and 2021 in 17 Spanish hospitals was performed. Diabetes-specific data were collected at diagnosis, in the immediate- and long-term postsurgical follow-up. A total of 229 patients with PPGLs were included (218 with pheochromocytomas and 11 with sympathetic paragangliomas). Before surgery, glycemic disorders were diagnosed in 35.4% of the patients (n = 81): 54 with diabetes and 27 with prediabetes. The variables independently associated with a higher risk of glycemic disorders were sporadic PPGL (odds ratio (OR) = 3.26 (1.14-9.36)) and hypertension (OR = 3.14 (1.09-9.01)). A significant decrease in fasting plasma glucose and HbA1c levels was observed after surgery, in the short-term and long-term follow-up (P < 0.001). After a median follow-up of 48.5 months (range 3.3-168.9), after surgery, 52% of diabetic and 68% of prediabetic patients experienced a complete resolution. Lower body mass index (BMI) (P = 0.001), lower glucose levels (P = 0.047) and shorter duration of diabetes prior to surgery (P = 0.021) were associated with a higher probability of diabetes resolution. In conclusion, glycemic disorders in patients with PPGLs are present in more than a third of them at diagnosis. Sporadic PPGLs and hypertension are risk factors for their development. More than 50% of cases experience a complete resolution of the glycemic disorder after resection of the PPGLs.
我们研究的目的是确定嗜铬细胞瘤和交感神经节旁神经瘤（PPGLs）患者中血糖紊乱（糖尿病和糖尿病前期）的患病率，识别其发生的危险因素以及手术后病情缓解的可能性。对2000年至2021年期间在17家西班牙医院接受手术的PPGLs患者进行了一项多中心回顾性研究。在诊断时、术后近期和长期随访中收集糖尿病相关数据。共纳入229例PPGLs患者（218例嗜铬细胞瘤和11例交感神经节旁神经瘤）。手术前，35.4%的患者（n = 81）被诊断为血糖紊乱：54例患有糖尿病，27例患有糖尿病前期。与血糖紊乱风险较高独立相关的变量是散发性PPGL（比值比（OR）= 3.26（1.14 - 9.36））和高血压（OR = 3.14（1.09 - 9.01））。在短期和长期随访中，术后空腹血糖和糖化血红蛋白水平显著下降（P < 0.001）。在中位随访48.5个月（范围3.3 - 168.9个月）后，术后52%的糖尿病患者和68%的糖尿病前期患者病情完全缓解。较低的体重指数（BMI）（P = 0.001）、较低的血糖水平（P = 0.047）和手术前较短的糖尿病病程（P = 0.021）与糖尿病缓解的较高可能性相关。总之，PPGLs患者在诊断时超过三分之一存在血糖紊乱。散发性PPGLs和高血压是其发生的危险因素。超过50%的病例在切除PPGLs后血糖紊乱完全缓解。
