Table_1_Diabetes Mellitus Predicts Weight Gain After Surgery in Patients With Acromegaly.docx

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.

目标：肢端肥大症患者常伴有代谢并发症。然而，术后这些并发症有时并不改善，且可能与术后体重增加有关。本研究旨在探讨肢端肥大症患者术后体重变化及其与术后体重增加相关的因素。设计与方法：本研究共纳入了2009年10月至2021年3月期间，有术前及术后3-6个月体重记录的连续113名患者。患者被分为三组：体重减轻组（体重下降≥3%）、体重稳定组和体重增加组（体重增加≥3%）。比较了三组之间的激素状态、代谢合并症和体格参数。结果：在113名患者中，术后29名（25.7%）患者体重减轻，26名（23.0%）患者体重增加。三组在诊断时的年龄、性别、体重指数和生长激素水平等基线特征方面无显著差异。诊断时糖尿病的患病率在体重增加组显著高于其他组。患有糖尿病的患者（n=22）术后体重增加的风险是正常血糖耐量患者（n=37）的5.2倍（P=0.006）。在糖尿病组中，术后瘦体重的百分比降低（-4.5 [-6.6–2.0]%，P=0.002），而脂肪质量百分比显著增加（18.0 [4.6–36.6]%，P=0.003），而正常血糖耐量组术后未显示身体成分的变化。结论：在肢端肥大症患者中，23%的患者术后体重增加≥3%。诊断时的糖尿病是术后体重和脂肪增加的一个重要预测因素。