Abstract
Metabolic impairment is the common cause for mortality in acromegalic patients. In this study, long-term improvements of metabolic parameters were evaluated according to 2 different remission criteria. This was an observational cohort study before and up to 1 year after transsphenoidal adenomectomy (TSA). Participants were 187 patients with acromegaly. At 6 months after TSA, remitted patients with age-and sex-matched normalized IGF-1 were divided into 2 groups: remission 1 (R1), nadir growth hormone (GH) below 0.4ng/mL; and remission 2 (R2), nadir GH between 0.4 and 1.0ng/mL in oral glucose tolerance test (OGTT). Metabolic parameters during serial OGTTs were evaluated for 12 months. Remission was achieved in 157 (R1-136; R2-21) patients. Immediate postoperative metabolic parameters including body weight, body mass index, glucose, insulin, and free fatty acid in OGTT were all significantly improved in R1 and R2. HOMA-%b and HOMA-IR scores also improved in both R1 and R2. These improvements persisted for duration (12 months) of this study. However, no difference was present in metabolic parameters between R1 and R2. Although the patients with preoperative adrenal insufficiency presented significantly increased HOMA scores before TSA, there was no difference between classifications of deficient pituitary axes and changes of metabolic parameters after TSA. Remitted patients exhibited rapid restoration of metabolic parameters immediate postoperative period. Long-term improvements in metabolic parameters were not different between the 2 different nadir GH cut-offs, 0.4 and 1.0ng/mL.
| Original language | English |
|---|---|
| Article number | e3808 |
| Journal | Medicine (United States) |
| Volume | 95 |
| Issue number | 24 |
| DOIs | |
| Publication status | Published - 2016 Jun 21 |
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All Science Journal Classification (ASJC) codes
- Medicine(all)
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No differences in metabolic outcomes between nadir GH 0.4 and 1.0 ng/mL during OGTT in surgically cured acromegalic patients (observational study). / Ku, Cheol Ryong; Choe, Eun Yeong; Hong, Jae Won; Kim, Eui Hyun; Park, Se Hee; Kim, Sun Ho; Lee, Eun Jig.
In: Medicine (United States), Vol. 95, No. 24, e3808, 21.06.2016.Research output: Contribution to journal › Article
TY - JOUR
T1 - No differences in metabolic outcomes between nadir GH 0.4 and 1.0 ng/mL during OGTT in surgically cured acromegalic patients (observational study)
AU - Ku, Cheol Ryong
AU - Choe, Eun Yeong
AU - Hong, Jae Won
AU - Kim, Eui Hyun
AU - Park, Se Hee
AU - Kim, Sun Ho
AU - Lee, Eun Jig
PY - 2016/6/21
Y1 - 2016/6/21
N2 - Metabolic impairment is the common cause for mortality in acromegalic patients. In this study, long-term improvements of metabolic parameters were evaluated according to 2 different remission criteria. This was an observational cohort study before and up to 1 year after transsphenoidal adenomectomy (TSA). Participants were 187 patients with acromegaly. At 6 months after TSA, remitted patients with age-and sex-matched normalized IGF-1 were divided into 2 groups: remission 1 (R1), nadir growth hormone (GH) below 0.4ng/mL; and remission 2 (R2), nadir GH between 0.4 and 1.0ng/mL in oral glucose tolerance test (OGTT). Metabolic parameters during serial OGTTs were evaluated for 12 months. Remission was achieved in 157 (R1-136; R2-21) patients. Immediate postoperative metabolic parameters including body weight, body mass index, glucose, insulin, and free fatty acid in OGTT were all significantly improved in R1 and R2. HOMA-%b and HOMA-IR scores also improved in both R1 and R2. These improvements persisted for duration (12 months) of this study. However, no difference was present in metabolic parameters between R1 and R2. Although the patients with preoperative adrenal insufficiency presented significantly increased HOMA scores before TSA, there was no difference between classifications of deficient pituitary axes and changes of metabolic parameters after TSA. Remitted patients exhibited rapid restoration of metabolic parameters immediate postoperative period. Long-term improvements in metabolic parameters were not different between the 2 different nadir GH cut-offs, 0.4 and 1.0ng/mL.
AB - Metabolic impairment is the common cause for mortality in acromegalic patients. In this study, long-term improvements of metabolic parameters were evaluated according to 2 different remission criteria. This was an observational cohort study before and up to 1 year after transsphenoidal adenomectomy (TSA). Participants were 187 patients with acromegaly. At 6 months after TSA, remitted patients with age-and sex-matched normalized IGF-1 were divided into 2 groups: remission 1 (R1), nadir growth hormone (GH) below 0.4ng/mL; and remission 2 (R2), nadir GH between 0.4 and 1.0ng/mL in oral glucose tolerance test (OGTT). Metabolic parameters during serial OGTTs were evaluated for 12 months. Remission was achieved in 157 (R1-136; R2-21) patients. Immediate postoperative metabolic parameters including body weight, body mass index, glucose, insulin, and free fatty acid in OGTT were all significantly improved in R1 and R2. HOMA-%b and HOMA-IR scores also improved in both R1 and R2. These improvements persisted for duration (12 months) of this study. However, no difference was present in metabolic parameters between R1 and R2. Although the patients with preoperative adrenal insufficiency presented significantly increased HOMA scores before TSA, there was no difference between classifications of deficient pituitary axes and changes of metabolic parameters after TSA. Remitted patients exhibited rapid restoration of metabolic parameters immediate postoperative period. Long-term improvements in metabolic parameters were not different between the 2 different nadir GH cut-offs, 0.4 and 1.0ng/mL.
UR - http://www.scopus.com/inward/record.url?scp=84976435856&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84976435856&partnerID=8YFLogxK
U2 - 10.1097/MD.0000000000003808
DO - 10.1097/MD.0000000000003808
M3 - Article
C2 - 27310957
AN - SCOPUS:84976435856
VL - 95
JO - Medicine (United States)
JF - Medicine (United States)
SN - 0025-7974
IS - 24
M1 - e3808
ER -