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

Han Na Jang,Jung Hee Kim,Yong Hwy Kim

doi:10.3389/fendo.2022.854931

Han Na Jang, Jung Hee Kim + Show 1 more

Open Access

https://doi.org/10.3389/fendo.2022.854931

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Abstract

ObjectiveMetabolic 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 MethodsOverall, 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.ResultsAmong 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.ConclusionIn 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.

Highlights

Is caused by excessive growth hormone (GH) secretion, mainly by pituitary adenomas [1]
There were no significant differences in age, sex, preoperative weight and body mass index (BMI) among the three groups
There were no significant differences in tumor characteristics, including tumor size, GH, and insulin-like growth factor-1 (IGF-1) levels (× ULN), among the three groups

Summary

Introduction

Is caused by excessive growth hormone (GH) secretion, mainly by pituitary adenomas [1]. Weight Gain in Acromegaly (DM) are associated with increased adiposity, patients with acromegaly exhibit increased insulin resistance despite a decrease in fat mass and increased muscle mass. It was expected that complications related to acromegaly would improve when GH levels normalized after surgery. Several studies have reported improvements in hypertension, cardiomyopathy, and DM after treatment [10–12]. The lack of improvement in postoperative metabolic complications may be related to weight gain after surgery [14]. In this regard, several studies have reported that body weight and fat mass increase after acromegaly treatment [15–19]. Some studies have shown stable weight after treatment in patients with acromegaly [10]

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