Predictors of growth hormone level on postoperative day one in patients with acromegaly.

IF 3.7 3区医学 Q2 Medicine

Endocrine Pub Date : 2024-12-20 DOI:10.1007/s12020-024-04130-6

Haixiang Li, Ziqi Li, Tianshun Feng, Yuyang Chen, Jiansheng Zhong, Liangfeng Wei, Shousen Wang

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引用次数: 0

Abstract

Purpose: The growth hormone (GH) level on postoperative day one (POD1), i.e., POD1GH, holds significant value in assessing surgical efficacy and predicting long-term remission in patients with acromegaly. This study aims to explore the factors that influence the GH level of POD1 after microscopic transsphenoidal surgery (mTSS) in patients with acromegaly, providing insights for preoperative clinical decisions.

Methods: A total of 85 acromegaly patients undergoing mTSS were included in this study. Sex; age; body mass index (BMI); preoperative serum hormone levels and tumor characteristics were assessed for their correlation with POD1GH levels. POD1GH level non-remission, defined as POD1GH > 2.5 ng/mL, was considered an outcome.

Results: The patients with acromegaly were divided into two groups: adult males (43 cases) and adult females (42 cases), with mean ages of 43.33 ± 11.92 years and 47.02 ± 14.18 years, respectively. Correlation and multivariate linear regression analyses revealed positive correlations of preoperative GH and prolactin (PRL) levels in females with POD1GH levels, while preoperative FT3 and TT levels in males were negatively correlated with POD1GH levels. Binary logistic regression and receiver operating characteristic (ROC) analyses identified preoperative GH levels ≥30.25 ng/mL (OR = 2.236, 95%CI = 1.402-3.567, p < 0.001), FT3 levels ≤4.415 pmol/L (OR = 0.329, 95%CI = 0.167-0.648, p < 0.001), and age ≤51 years (OR = 0.566, 95%CI = 0.352-0.911, p = 0.019) as independent risk factors for POD1GH level non-remission.

Conclusions: Preoperative GH, FT3, TT, and PRL levels are correlated with POD1GH levels, with variations observed between sex. Age, preoperative GH, and FT3 levels can predict POD1GH level non-remission. Therefore, the comprehensive consideration of multiple hormone axes is necessary for predicting postoperative efficacy.

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肢端肥大症患者术后第一天生长激素水平的预测因素。

目的：肢端肥大症患者术后第一天生长激素（growth hormone， GH）水平（POD1），即POD1GH，对评估手术疗效和预测远期缓解有重要价值。本研究旨在探讨肢端肥大症患者显微经蝶手术（mTSS）后POD1 GH水平的影响因素，为术前临床决策提供参考。方法：85例肢端肥大症患者行mTSS手术。性;年龄;体重指数（BMI）；评估术前血清激素水平和肿瘤特征与POD1GH水平的相关性。POD1GH水平未缓解，定义为POD1GH > 2.5 ng/mL，被认为是一个结果。结果：肢端肥大症患者分为成年男性（43例）和成年女性（42例），平均年龄分别为43.33±11.92岁和47.02±14.18岁。相关分析和多元线性回归分析显示，女性术前GH、催乳素（PRL）水平与POD1GH水平呈正相关，男性术前FT3、TT水平与POD1GH水平呈负相关。二元logistic回归和受试者工作特征（ROC）分析发现术前GH水平≥30.25 ng/mL （OR = 2.236, 95%CI = 1.302 ~ 3.567, p）结论：术前GH、FT3、TT、PRL水平与POD1GH水平相关，且存在性别差异。年龄、术前GH、FT3水平可预测POD1GH水平未缓解。因此，在预测术后疗效时，需要综合考虑多个激素轴。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.