Association between diabetes mellitus and short-term outcomes after transsphenoidal surgery for pituitary tumor: Evidence from the Taiwan Pituitary Tumor Registry 2009-2019.

IF 3.3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Pub Date : 2026-10-06 DOI:10.1007/s12020-026-04785-3

Yi-Hsien Kuo, Ying-Yun Chen, Kuan-Hao Fu, Chia-Hsien Yang, Pin-Yuan Chen, Jiun-Lin Yan

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引用次数: 0

Abstract

Purpose: Diabetes mellitus (DM) may affect postoperative recovery, but evidence in pituitary tumor surgery remains limited. We investigated the association between DM and short-term outcomes after transsphenoidal surgery for pituitary tumors.

Methods: We retrospectively analyzed adults in the Taiwan Pituitary Tumor Registry who underwent transsphenoidal surgery for benign pituitary tumors between 2009 and 2019. Patients were categorized into DM and non-DM groups. Associations between DM, prolonged length of hospital stays (LOS), 14-day readmission rate, and complications were determined using regression analyses. Tumor-type stratified analyses and receiver operating characteristic (ROC) analyses of glycated hemoglobin (HbA1c), fasting glucose, and random glucose were also performed.

Results: Data of 970 patients were analyzed, of whom 144 (15%) had DM. DM was not significantly associated with prolonged LOS or 14-day readmission, but was significantly associated with higher odds of CSF leak (adjusted odds ratio [aOR] = 3.35, 95% confidence interval [CI]: 1.18-9.51, p = 0.023) and antibiotic use for ≥ 7 days (aOR = 5.41, 95% CI: 1.13-25.87, p = 0.034) in age-adjusted analysis. In the non-functioning tumor subgroup, the association with antibiotic use for ≥ 7 days persisted (aOR 7.37, 95% CI 1.46-37.12), whereas the association with CSF leak was not statistically significant. Among patients with DM and non-functioning tumors, glycemic markers showed apparent discrimination for postoperative infection and CSF leak, with area under the curve values ranging from 0.83 to 0.93.

Conclusions: DM was associated with selected short-term complications after transsphenoidal surgery, particularly CSF leak and prolonged antibiotic use. These exploratory findings require confirmation in larger prospective studies with comprehensive surgical data.

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垂体瘤经蝶窦手术后糖尿病与短期预后的关系：来自台湾垂体瘤登记2009-2019的证据

目的：糖尿病（DM）可能影响垂体肿瘤手术后的恢复，但相关证据仍然有限。我们研究了DM与经蝶窦手术治疗垂体肿瘤后短期预后的关系。方法：我们回顾性分析台湾省垂体肿瘤登记处2009年至2019年间接受经蝶窦手术治疗良性垂体肿瘤的成年人。患者分为糖尿病组和非糖尿病组。通过回归分析确定糖尿病、延长住院时间（LOS）、14天再入院率和并发症之间的关系。还进行了肿瘤类型分层分析和糖化血红蛋白（HbA1c）、空腹血糖和随机血糖的受试者工作特征（ROC）分析。结果：970例患者的数据被分析，其中144例（15%）患有糖尿病。糖尿病与延长的LOS或14天再入院无显著相关性，但与CSF泄漏的较高几率（校正优势比[aOR] = 3.35, 95%可信区间[CI]: 1.18-9.51, p = 0.023）和抗生素使用≥7天（aOR = 5.41, 95% CI: 1.13-25.87, p = 0.034）显著相关。在无功能肿瘤亚组中，与抗生素使用≥7天的相关性持续存在（aOR 7.37, 95% CI 1.46-37.12），而与脑脊液泄漏的相关性无统计学意义。在糖尿病和非功能性肿瘤患者中，血糖指标对术后感染和脑脊液泄漏有明显的鉴别作用，曲线下面积在0.83 ~ 0.93之间。结论：DM与经蝶窦手术后的短期并发症有关，特别是脑脊液泄漏和长期使用抗生素。这些探索性发现需要在更大的前瞻性研究中得到全面的外科数据的证实。

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 ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

5.40%

发文量

295

审稿时长

1.5 months

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.