Long-term depot specific changes in adipose tissue after treatment of acromegaly.

IF 5.3 1区医学 Q1 ENDOCRINOLOGY & METABOLISM European Journal of Endocrinology Pub Date : 2024-03-02 DOI:10.1093/ejendo/lvae016

Camilla M Falch, Kristin Godang, Tove Lekva, Thor Ueland, Ansgar Heck, Jens Bollerslev, Nicoleta C Olarescu

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Abstract

Context: Patients with active acromegaly present a decreased adipose tissue (AT) mass, and short-term studies show that treatment leads to AT depot-specific gain. However, it remains unclear if the increase is persistent in the long-term perspective and/or is sex-dependent.

Design: To characterize the depot-specific changes of AT after treatment of acromegaly and identify contributing factors.

Methods: Adipose tissue, including visceral (VAT), subcutaneous (SAT), and total (TAT), and android to gynoid ratio (A/G ratio) were measured by dual energy X-ray absorptiometry at diagnosis (n = 62), and after treatment at short-term (median (IQR) 1.9 (1.5-2.3)) and long-term 5.5 (3.9-9.5) years, and correlated to clinical and biochemical measurements. Growth hormone (GH), insulin-like growth factor 1 (IGF-1), glucose and HbA1c levels, gonadal status, and the presence of diabetes mellitus were recorded. Remission status was assessed at the long-term visit (IGF-1/ULN ≤ 1.3). Differences in the temporal course of AT from baseline to short- and long-term follow-up according to sex, diabetes, gonadal, and remission status were evaluated by mixed model analysis, adjusted for age.

Results: Despite a stable body mass index, VAT and A/G ratio increased at both time points, whereas SAT mainly increased at short-term, plateauing afterwards (P < .05 for all). Visceral adipose tissue and A/G ratio were higher in men (P = .035 and P < .001), and the A/G ratio increased more than in women (P = .003). Glucose and HbA1c decreased short-term (P < .05) and remained stable at long-term. The increase in AT depots correlated with the decrease of disease activity at long-term. Remission status had no effect on changes in AT mass during follow-up.

Conclusion: Treatment of acromegaly leads to an increase in AT mass in a depot- and sex-specific manner both at short-term and long-term follow-up. Glucose metabolism improves rapidly after disease control and persists.

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治疗肢端肥大症后脂肪组织的长期车厂特异性变化。

背景：活动性肢端肥大症患者的脂肪组织（AT）质量下降，短期研究显示，治疗会导致AT的特定增加。然而，这种增加是否长期持续和/或与性别有关仍不清楚：设计：描述肢端肥大症治疗后脂肪组织的特异性变化，并确定诱因：方法：通过双能 X 射线吸收测定法（DXA）测量确诊时（62 人）和治疗后短期（中位数（IQR）1.9（1.5-2.3））和长期 5.5（3.9-9.5）年的脂肪组织，包括内脏脂肪组织（VAT）、皮下脂肪组织（SAT）、总脂肪组织（TAT）和甲状腺与雌激素比率（A/G 比率），并与临床和生化测量结果相关联。记录了生长激素（GH）、胰岛素样生长因子 I（IGF-1）、血糖和 HbA1c 水平、性腺状态以及是否患有糖尿病。在长期就诊时评估缓解状态（IGF-1/ULN≤1.3）。根据性别、糖尿病、性腺和缓解状态，通过混合模型分析评估了AT从基线到短期和长期随访的时间进程差异，并对年龄进行了调整：结果：尽管体重指数保持稳定，但增值税和A/G比值在两个时间点均有所增加，而SAT主要在短期内增加，之后趋于平稳（p）：肢端肥大症的治疗会导致肢端肥大症患者的体重在短期和长期随访中都出现增加，而且增加的方式与肢端肥大症患者的性别有关。葡萄糖代谢在疾病控制后迅速改善，并持续存在。

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

European Journal of Endocrinology 医学-内分泌学与代谢

CiteScore

9.80

自引率

3.40%

发文量

354

审稿时长

1 months

期刊介绍： European Journal of Endocrinology is the official journal of the European Society of Endocrinology. Its predecessor journal is Acta Endocrinologica. The journal publishes high-quality original clinical and translational research papers and reviews in paediatric and adult endocrinology, as well as clinical practice guidelines, position statements and debates. Case reports will only be considered if they represent exceptional insights or advances in clinical endocrinology. Topics covered include, but are not limited to, Adrenal and Steroid, Bone and Mineral Metabolism, Hormones and Cancer, Pituitary and Hypothalamus, Thyroid and Reproduction. In the field of Diabetes, Obesity and Metabolism we welcome manuscripts addressing endocrine mechanisms of disease and its complications, management of obesity/diabetes in the context of other endocrine conditions, or aspects of complex disease management. Reports may encompass natural history studies, mechanistic studies, or clinical trials. Equal consideration is given to all manuscripts in English from any country.