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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)
- Source :
- Medicine
- Publication Year :
- 2016
- Publisher :
- Wolters Kluwer Health, 2016.
-
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 0.4 ng/mL; and remission 2 (R2), nadir GH between 0.4 and 1.0 ng/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-%β 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 1.0 ng/mL.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
hOMA
Observational Study
030209 endocrinology & metabolism
oral glucose tolerance test
Gastroenterology
03 medical and health sciences
0302 clinical medicine
Internal medicine
insulin resistance
Acromegaly
medicine
Adrenal insufficiency
Glucose tolerance test
medicine.diagnostic_test
business.industry
Insulin
Retrospective cohort study
General Medicine
medicine.disease
Endocrinology
gH-secreting pituitary adenoma
business
Body mass index
030217 neurology & neurosurgery
Nadir (topography)
Cohort study
Research Article
free fatty acid
Subjects
Details
- Language :
- English
- ISSN :
- 15365964 and 00257974
- Volume :
- 95
- Issue :
- 24
- Database :
- OpenAIRE
- Journal :
- Medicine
- Accession number :
- edsair.doi.dedup.....b8764bf5d97acad1225d06f30dacc9ec