Front Endocrinol (Lausanne). 2022;13:854931.

Diabetes Mellitus Predicts Weight Gain After Surgery in Patients With Acromegaly.

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제1저자 장한나 · 교신저자 김정희

PMID 35355553 PMC8959539 DOI 10.3389/fendo.2022.854931 IF 5.7 내분비대사내과

소속 (3)

Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea.
Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea.
Pituitary Center, Seoul National University Hospital, Seoul, South Korea.

Abstract

OBJECTIVE Metabolic complications are common in patients with acromegaly. However, this occasionally does not improve post-surgery and may be related to postoperative weight gain. We aimed to investigate the postoperative weight change and factors associated with postoperative weight gain in patients with acromegaly.

DESIGN AND METHODS Overall, 113 consecutive patients with body weight records pre- and 3-6 months post-surgery between October 2009 and March 2021 were enrolled. Patients were divided into three groups: weight loss (weight decrease ≥3%), stable, and weight gain (weight increase ≥3%). Hormone status, metabolic comorbidities, and anthropometric parameters were compared between the groups.

RESULTS Among 113 patients, 29 (25.7%) and 26 (23.0%) patients lost and gained weight, respectively, post-surgery. There were no significant differences in baseline characteristics, including age at diagnosis, sex, body mass index, and growth hormone levels among the three groups. The prevalence of diabetes mellitus at diagnosis was significantly higher in the weight gain group than in the other groups. Patients with diabetes (n=22) had a 5.2-fold higher risk of postoperative weight gain than those with normal glucose tolerance (n=37) (P=0.006). In the diabetes mellitus group, the percentage lean mass decreased (-4.5 [-6.6-2.0]%, P=0.002), and the percentage fat mass significantly increased post-surgery (18.0 [4.6-36.6]%, P=0.003), whereas the normal glucose tolerance group did not show body composition changes post-surgery.

CONCLUSION In patients with acromegaly, 23% experienced ≥3% weight gain post-surgery. Diabetes mellitus at diagnosis is a significant predictor of weight and fat gain post-surgery.

Keywords

acromegalyadipokinefat metabolismgrowth hormoneinsulin resistance

Figures

**Figure 1** Correlation analysis between percent weight change and other parameters. The correlation between percent weight change and clinical parameters was analyzed by Pearson and Spearman correlation analysis. **(A)** Age at diagnosis, **(B)** baseline HbA1c, **(C)** FPG, **(D)** PP1, and **(E)** PP2 were significantly positively correlated with percentage weight change in acromegalic patients. FPG, fasting plasma glucose; PP1, 1hr-postprandial plasma glucose; PP2, 2hr-postprandial plasma glucose.

**Figure 2** Comparison of **(A)** weight and **(B)** weight change according to the glycemic status at baseline. Acromegaly patients were divided into NGT, prediabetes, and diabetes groups. **(A)** Body weight before and after surgery was compared by paired t-test, and **(B)** postoperative weight change (%) were compared by one-way analysis of variance. There was a significant weight gain after surgery only in the diabetes group. Postoperative weight gain (%) was significantly greater in the diabetes group than in the NGT and prediabetes groups, respectively. *P < 0.05 between each group. NGT, normal glucose tolerance.

그림 출처: PubMed Central 공개 논문 (PMC8959539)

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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