Li Haixiang, Li Ziqi, Feng Tianshun, Chen Yuyang, Zhong Jiansheng, Wei Liangfeng, Wang Shousen
Department of Neurosurgery, Dongfang Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Fujian Provincial Clinical Medical Research Center for Minimally Invasive Diagnosis and Treatment of Neurovascular Diseases, Fuzhou, China.
Endocrine. 2025 Apr;88(1):249-261. doi: 10.1007/s12020-024-04130-6. Epub 2024 Dec 20.
The growth hormone (GH) level on postoperative day one (POD1), i.e., POD1GH, holds significant value in assessing surgical efficacy and predicting long-term remission in patients with acromegaly. This study aims to explore the factors that influence the GH level of POD1 after microscopic transsphenoidal surgery (mTSS) in patients with acromegaly, providing insights for preoperative clinical decisions.
A total of 85 acromegaly patients undergoing mTSS were included in this study. Sex; age; body mass index (BMI); preoperative serum hormone levels and tumor characteristics were assessed for their correlation with POD1GH levels. POD1GH level non-remission, defined as POD1GH > 2.5 ng/mL, was considered an outcome.
The patients with acromegaly were divided into two groups: adult males (43 cases) and adult females (42 cases), with mean ages of 43.33 ± 11.92 years and 47.02 ± 14.18 years, respectively. Correlation and multivariate linear regression analyses revealed positive correlations of preoperative GH and prolactin (PRL) levels in females with POD1GH levels, while preoperative FT3 and TT levels in males were negatively correlated with POD1GH levels. Binary logistic regression and receiver operating characteristic (ROC) analyses identified preoperative GH levels ≥30.25 ng/mL (OR = 2.236, 95%CI = 1.402-3.567, p < 0.001), FT3 levels ≤4.415 pmol/L (OR = 0.329, 95%CI = 0.167-0.648, p < 0.001), and age ≤51 years (OR = 0.566, 95%CI = 0.352-0.911, p = 0.019) as independent risk factors for POD1GH level non-remission.
Preoperative GH, FT3, TT, and PRL levels are correlated with POD1GH levels, with variations observed between sex. Age, preoperative GH, and FT3 levels can predict POD1GH level non-remission. Therefore, the comprehensive consideration of multiple hormone axes is necessary for predicting postoperative efficacy.
术后第1天（POD1）的生长激素（GH）水平，即POD1GH，在评估肢端肥大症患者的手术疗效和预测长期缓解方面具有重要价值。本研究旨在探讨影响肢端肥大症患者显微经蝶窦手术（mTSS）后POD1GH水平的因素，为术前临床决策提供依据。
本研究共纳入85例行mTSS的肢端肥大症患者。评估性别、年龄、体重指数（BMI）、术前血清激素水平和肿瘤特征与POD1GH水平的相关性。POD1GH水平未缓解定义为POD1GH＞2.5 ng/mL，并将其视为一个结局。
肢端肥大症患者分为两组：成年男性（43例）和成年女性（42例），平均年龄分别为43.33±11.92岁和47.02±14.18岁。相关性和多变量线性回归分析显示，女性术前GH和催乳素（PRL）水平与POD1GH水平呈正相关，而男性术前FT3和TT水平与POD1GH水平呈负相关。二元逻辑回归和受试者工作特征（ROC）分析确定术前GH水平≥30.25 ng/mL（OR = 2.236，95%CI = 1.402 - 3.567，p＜0.001）、FT3水平≤4.415 pmol/L（OR = 0.329，95%CI = 0.167 - 0.648，p＜0.001）和年龄≤51岁（OR = 0.566，95%CI = 0.352 - 0.911，p = 0.019）是POD1GH水平未缓解的独立危险因素。
术前GH、FT3、TT和PRL水平与POD1GH水平相关，且存在性别差异。年龄、术前GH和FT水平可预测POD1GH水平未缓解。因此，预测术后疗效需要综合考虑多个激素轴。
