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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)

Authors
 Cheol Ryong Ku  ;  Eun Yeong Choe  ;  Jae Won Hong  ;  Eui Hyun Kim  ;  Se Hee Park  ;  Sun Ho Kim  ;  Eun Jig Lee 
Citation
 MEDICINE, Vol.95(24) : 3808, 2016 
Journal Title
 MEDICINE 
ISSN
 0025-7974 
Issue Date
2016
Keywords
free fatty acid ; gH-secreting pituitary adenoma ; hOMA ; insulin resistance ; oral glucose tolerance test
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.
Files in This Item:
T201604274.pdf Download
DOI
10.1097/MD.0000000000003808
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Ku, Cheol Ryong(구철룡) ORCID logo https://orcid.org/0000-0001-8693-9630
Kim, Sun Ho(김선호) ORCID logo https://orcid.org/0000-0003-0970-3848
Kim, Eui Hyun(김의현) ORCID logo https://orcid.org/0000-0002-2523-7122
Park, Se Hee(박세희)
Lee, Eun Jig(이은직) ORCID logo https://orcid.org/0000-0002-9876-8370
Choe, Eun Yeong(최은영)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152354
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