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. 2018 Apr 15;58(4):147-155.
doi: 10.2176/nmc.oa.2017-0215. Epub 2018 Feb 23.

Postoperative Changes in Metabolic Parameters of Patients with Surgically Controlled Acromegaly: Assessment of New Stringent Cure Criteria

Masanori Yonenaga  1 , Shingo Fujio  1 , Mika Habu  1 , Hiroshi Arimura  2 , Takaaki Hiwatari  1 , Shunichi Tanaka  1 , Yasuyuki Kinoshita  3 , Hiroshi Hosoyama  1 , Hirofumi Hirano  1 , Kazunori Arita  1
Affiliations

Postoperative Changes in Metabolic Parameters of Patients with Surgically Controlled Acromegaly: Assessment of New Stringent Cure Criteria

Masanori Yonenaga et al. Neurol Med Chir (Tokyo). .

Abstract

The criteria for surgical cure of acromegaly have become more stringent during the past decades and a change from Cortina to new consensus criteria has recently been proposed. However, the superiority of the new consensus over Cortina criteria with respect to postoperative metabolic parameters remains to be ascertained. We retrospectively assessed metabolic parameters, the body habitus, and other health-related parameters of 48 patients with surgically controlled acromegaly who met the Cortina criteria [normalized insulin-like growth factor-1 (IGF-1) level and nadir growth hormone (GH) level <1.0 ng/ml during postoperative oral glucose tolerance test]. The 48 patients were divided into two groups. Group A (n = 33) met the new consensus criteria (normalized IGF-1 and nadir GH level <0.4 ng/ml). Group B (n = 15) met Cortina criteria, but their nadir GH ranged from 0.4 to 1.0 ng/ml. In both groups, the level of triglyceride and homeostasis model assessment-insulin resistance (HOMA-IR) was significantly decreased 1 year after the operation (P < 0.05). High-density lipoprotein cholesterol showed a significant increase only in group B (P = 0.02). However, the two groups did not differ with respect to the postoperative improvement rate of these parameters and the other health-related parameters including body mass index, blood pressure, anterior pituitary function, and self-estimated quality of life scale. In conclusion, our findings show that with respect to changes in metabolic parameters and the body habitus assessed 1 year after surgery, the stricter consensus criteria seemed not to be superior to Cortina criteria.

Keywords: Cortina criteria; acromegaly; metabolic parameters; new consensus criteria; surgical cure.

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Conflict of interest statement

Conflicts of Interest Disclosure

We declare that each of us participated sufficiently in the work to take public responsibility for this paper content. Moreover, we declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the paper reported. All authors who are members of The Japan Neurological Society have registered online self-reported COI Disclosure Statement Forms through the JNS member website.

Figures

Fig. 1.
Fig. 1.
Rate of improvement in metabolic parameters in all (n = 48), group A (n = 33), and group B patients (n = 15). There was no significant difference between groups A and B. The LDL improvement rate tended to be higher in group B than group A (P = 0.08, Student t-test). BMI: body mass index, HDL: high-density lipoprotein, HOMA-IR: homeostasis model assessment-insulin resistance, LDL: low-density lipoprotein, T-chol: total cholesterol, TG: triglyceride.
Fig. 2.
Fig. 2.
Postoperative changes in the blood pressure of all (n = 48), group A (n = 33), and group B patients (n = 15). The systolic and diastolic pressure was reduced significantly in both groups (P < 0.03, paired t-test). There was no difference in the improvement rate of the two groups.
See this image and copyright information in PMC

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