{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T08:54:06Z","timestamp":1780649646122,"version":"3.54.1"},"reference-count":0,"publisher":"Oxford University Press (OUP)","issue":"6","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n<jats:title>Objective<\/jats:title>\n<jats:p>Neurosurgery is the first-line treatment for acromegaly. Whether metabolic disorders are reversible after neurosurgery is still debated. The meta-analysis aimed to address the following questions: (i) Does neurosurgery affect glycolipid metabolism? (ii) Are these effects related to disease control or follow-up length?<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Design<\/jats:title>\n<jats:p>A meta-analysis and systematic review of the literature.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Three reviewers searched databases until August 2019 for prospective trials reporting glycometabolic outcomes after neurosurgery. Three other extracted outcomes, all assessed the risk of bias.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Twenty studies were included. Neurosurgery significantly reduced fasting plasma glucose (FPG) (effect size (ES): \u22120.57 mmol\/L, 95% CI: \u22120.82 to \u22120.31; <jats:italic>P<\/jats:italic> &lt; 0.001), glucose load (ES: \u22121.10 mmol\/L, 95% CI: \u22121.66 to \u22120.53; <jats:italic>P<\/jats:italic> &lt; 0.001), glycosylated haemoglobin (HbA1c) (ES: \u22120.28%, 95% CI: \u22120.42 to \u22120.14; <jats:italic>P<\/jats:italic> &lt; 0.001), fasting plasma insulin (FPI) (ES: \u221210.53 mU\/L, 95% CI: \u221214.54 to \u22126.51; <jats:italic>P<\/jats:italic> &lt; 0.001), homeostatic model assessment of insulin resistance (HOMA-IR) (ES: \u22121.98, 95% CI: \u22123.24 to \u22120.72; <jats:italic>P<\/jats:italic> = 0.002), triglycerides (TGDs) (ES: \u22120.28 mmol\/L, 95% CI: \u22120.36 to \u22120.20; <jats:italic>P<\/jats:italic> &lt; 0.001) and LDL-cholesterol (LDLC) (ES: \u22120.23 mmol\/L, 95% CI: \u22120.45 to \u22120.02 mmol\/L); <jats:italic>P<\/jats:italic> = 0.030) and increased HDL-cholesterol (HDLC) (ES: 0.21 mmol\/L, 95% CI: 0.14 to 0.28; <jats:italic>P<\/jats:italic> &lt; 0.001). Meta-regression analysis showed that follow-up length \u2013 not disease control \u2013 had a significant effect on FPG, with the greatest reduction in the shortest follow-up (beta\u2009=\u20090.012, <jats:sc>s.e.<\/jats:sc>\u2009=\u20090.003; <jats:italic>P<\/jats:italic> = 0.001).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Neurosurgery improves metabolism with a significant decrease in FPG, glucose load, HbA1c, FPI, HOMA-IR, TGDs, and LDLC and increase in HDLC. The effect on FPG seems to be more related to follow-up length than to disease control.<\/jats:p>\n<\/jats:sec>","DOI":"10.1530\/eje-20-0497","type":"journal-article","created":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T15:56:57Z","timestamp":1600358217000},"page":"597-606","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-7","source":"Crossref","is-referenced-by-count":16,"title":["Metabolic complications in acromegaly after neurosurgery: a meta-analysis"],"prefix":"10.1093","volume":"183","author":[{"given":"Alessia","family":"Cozzolino","sequence":"first","affiliation":[{"name":"1Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Feola","sequence":"additional","affiliation":[{"name":"1Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy"},{"name":"2Neuroendocrinology, Neuromed Institute, IRCCS, Pozzilli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Simonelli","sequence":"additional","affiliation":[{"name":"3Medical Statistics and Information Technology, AFaR, Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Puliani","sequence":"additional","affiliation":[{"name":"1Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Hasenmajer","sequence":"additional","affiliation":[{"name":"1Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Minnetti","sequence":"additional","affiliation":[{"name":"1Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Giannetta","sequence":"additional","affiliation":[{"name":"1Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Gianfrilli","sequence":"additional","affiliation":[{"name":"1Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizio","family":"Pasqualetti","sequence":"additional","affiliation":[{"name":"3Medical Statistics and Information Technology, AFaR, Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Lenzi","sequence":"additional","affiliation":[{"name":"1Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea M","family":"Isidori","sequence":"additional","affiliation":[{"name":"1Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","container-title":["European Journal of Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/eje.bioscientifica.com\/view\/journals\/eje\/183\/6\/EJE-20-0497.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/eje.bioscientifica.com\/downloadpdf\/journals\/eje\/183\/6\/EJE-20-0497.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T16:15:08Z","timestamp":1676391308000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejendo\/article\/183\/6\/597\/6653831"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12]]},"references-count":0,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.1530\/eje-20-0497","relation":{},"ISSN":["0804-4643","1479-683X"],"issn-type":[{"value":"0804-4643","type":"print"},{"value":"1479-683X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12]]}}}