{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T10:48:51Z","timestamp":1764240531649,"version":"3.41.2"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T00:00:00Z","timestamp":1646784000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001321","name":"National Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Metabolic 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and Methods<\/jats:title><jats:p>Overall, 113 consecutive patients with body weight records pre- and 3\u20136 months post-surgery between October 2009 and March 2021 were enrolled. Patients were divided into three groups: weight loss (weight decrease \u22653%), stable, and weight gain (weight increase \u22653%). Hormone status, metabolic comorbidities, and anthropometric parameters were compared between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 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\u20132.0]%, P=0.002), and the percentage fat mass significantly increased post-surgery (18.0 [4.6\u201336.6]%, P=0.003), whereas the normal glucose tolerance group did not show body composition changes post-surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with acromegaly, 23% experienced \u22653% weight gain post-surgery. Diabetes mellitus at diagnosis is a significant predictor of weight and fat gain post-surgery.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2022.854931","type":"journal-article","created":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T08:14:47Z","timestamp":1646813687000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Diabetes Mellitus Predicts Weight Gain After Surgery in Patients With Acromegaly"],"prefix":"10.3389","volume":"13","author":[{"given":"Han Na","family":"Jang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong Hwy","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung Hee","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1038\/s41572-019-0071-6","article-title":"Acromegaly","volume":"5","author":"Colao","year":"2019","journal-title":"Nat Rev Dis Primers"},{"key":"B2","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1007\/s11102-017-0797-7","article-title":"Complications of Acromegaly: Cardiovascular, Respiratory and Metabolic Comorbidities","volume":"20","author":"Pivonello","year":"2017","journal-title":"Pituitary"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.93.4.800","article-title":"Differential Cardiac Effects of Growth Hormone and Insulin-Like Growth Factor-I in the Rat. A Combined In Vivo and In Vitro Evaluation","volume":"93","author":"Cittadini","year":"1996","journal-title":"Circulation"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M011647200","article-title":"Demonstration of Direct Effects of Growth Hormone on Neonatal Cardiomyocytes","volume":"276","author":"Lu","year":"2001","journal-title":"J Biol Chem"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1210\/edrv-17-5-423","article-title":"Growth Hormone, the Insulin-Like Growth Factor System, and the Kidney","volume":"5","author":"Feld","year":"1996","journal-title":"J Clin Endocrinol Metab"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1210\/er.2002-0022","article-title":"Systemic Complications of Acromegaly: Epidemiology, Pathogenesis, and Management","volume":"25","author":"Colao","year":"2004","journal-title":"Endocr Rev"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.2000.00986.x","article-title":"Impaired Beta-Cell Function in the Presence of Reduced Insulin Sensitivity Determines Glucose Tolerance Status in Acromegalic Patients","volume":"52","author":"Kasayama","year":"2000","journal-title":"Clin Endocrinol (Oxf)"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1210\/er.2008-0027","article-title":"Effects of Growth Hormone on Glucose, Lipid, and Protein Metabolism in Human Subjects","volume":"30","author":"Moller","year":"2009","journal-title":"Endocr Rev"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2016.04.014","article-title":"Current and Emerging Aspects of Diabetes Mellitus in Acromegaly","volume":"27","author":"Frara","year":"2016","journal-title":"Trends Endocrinol Metab"},{"key":"B10","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1530\/eje.0.1480193","article-title":"Impact of Successful Transsphenoidal Surgery on Cardiovascular Risk Factors in Acromegaly","volume":"148","author":"Jaffrain-Rea","year":"2003","journal-title":"Eur J Endocrinol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.86.4.7376","article-title":"Is the Acromegalic Cardiomyopathy Reversible? Effect of 5-Year Normalization of Growth Hormone and Insulin-Like Growth Factor I Levels on Cardiac Performance","volume":"86","author":"Colao","year":"2001","journal-title":"J Clin Endocrinol Metab"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.endinu.2017.05.010","article-title":"Glucose Metabolism Before and After Treatment in Patients With Acromegaly","volume":"64","author":"Ernaga Lorea","year":"2017","journal-title":"Endocrinolog\u00eda Diabetes y Nutrici\u00f3n (English ed)"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2018-00325","article-title":"Persistence of Diabetes and Hypertension After Multimodal Treatment of Acromegaly","volume":"103","author":"Gonzalez","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-3072","article-title":"A Comprehensive Study of Clinical, Biochemical, Radiological, Vascular, Cardiac, and Sleep Parameters in an Unselected Cohort of Patients With Acromegaly Undergoing Presurgical Somatostatin Receptor Ligand Therapy","volume":"98","author":"Annamalai","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-2259","article-title":"Prospective Study of Surgical Treatment of Acromegaly: Effects on Ghrelin, Weight, Adiposity, and Markers of CV Risk","volume":"99","author":"Reyes-Vidal","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-1704","article-title":"Comparison Between Six-Year Therapy With Long-Acting Somatostatin Analogs and Successful Surgery in Acromegaly: Effects on Cardiovascular Risk Factors","volume":"91","author":"Ronchi","year":"2006","journal-title":"J Clin Endocrinol Metab"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-1917","article-title":"Adipose Tissue Redistribution and Ectopic Lipid Deposition in Active Acromegaly and Effects of Surgical Treatment","volume":"100","author":"Reyes-Vidal","year":"2015","journal-title":"J Clin Endocrinol Metab"},{"key":"B18","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.ecl.2006.11.005","article-title":"Effects of Growth Hormone on Glucose and Fat Metabolism in Human Subjects","volume":"36","author":"Jorgensen","year":"2007","journal-title":"Endocrinol Metab Clin North Am"},{"key":"B19","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1111\/j.1365-2362.1993.tb00762.x","article-title":"Adipose Tissue and Muscle Volume Determination by Computed Tomography in Acromegaly, Before and 1 Year After Adenomectomy","volume":"23","author":"Brummer RJ","year":"1993","journal-title":"Eur J Clin Invest"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-018-0058-5","article-title":"A Consensus Statement on Acromegaly Therapeutic Outcomes","volume":"14","author":"Melmed","year":"2018","journal-title":"Nat Rev Endocrinol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgz096","article-title":"A Consensus on the Diagnosis and Treatment of Acromegaly Comorbidities: An Update","volume":"105","author":"Giustina","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1007\/BF00280883","article-title":"Homeostasis Model Assessment: Insulin Resistance and Beta-Cell Function From Fasting Plasma Glucose and Insulin Concentrations in Man","volume":"28","author":"Matthews","year":"1985","journal-title":"Diabetologia"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2017.04.141","article-title":"Outcome of Endoscopic Transsphenoidal Surgery for Acromegaly","volume":"104","author":"Kim","year":"2017","journal-title":"World Neurosurg"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2017-01210","article-title":"Body Composition and Ectopic Lipid Changes With Biochemical Control of Acromegaly","volume":"102","author":"Bredella","year":"2017","journal-title":"J Clin Endocrinol Metab"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-019-0280-9","article-title":"The Effects of Growth Hormone on Adipose Tissue: Old Observations, New Mechanisms","volume":"16","author":"Kopchick","year":"2020","journal-title":"Nat Rev Endocrinol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007-2780","article-title":"Lower Visceral and Subcutaneous But Higher Intermuscular Adipose Tissue Depots in Patients With Growth Hormone and Insulin-Like Growth Factor I Excess Due to Acromegaly","volume":"93","author":"Freda","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.52.12.2882","article-title":"Elevation of Free Fatty Acids Induces Inflammation and Impairs Vascular Reactivity in Healthy Subjects","volume":"52","author":"Devjit Tripathy","year":"2003","journal-title":"Diabetes"},{"key":"B28","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1186\/s12944-015-0123-1","article-title":"The Role of Fatty Acids in Insulin Resistance","volume":"14","author":"Sears","year":"2015","journal-title":"Lipids Health Dis"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8227(11)70014-6","article-title":"Insulin Effects in Muscle and Adipose Tissue","volume":"93","author":"Dimitriadis","year":"2011","journal-title":"Diabetes Res Clin Pract"},{"key":"B30","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1111\/j.1463-1326.2006.00686.x","article-title":"Insulin-Associated Weight Gain in Diabetes\u2013Causes, Effects and Coping Strategies","volume":"9","author":"Russell-Jones","year":"2007","journal-title":"Diabetes Obes Metab"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-013-0471-7","article-title":"Prevalence and Risk Factors of Impaired Glucose Tolerance and Diabetes Mellitus at Diagnosis of Acromegaly: A Study in 148 Patients","volume":"17","author":"Alexopoulou","year":"2014","journal-title":"Pituitary"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.2337\/db19-0514","article-title":"Understanding Metabolic Memory: A Tale of Two Studies","volume":"69","author":"Miller","year":"2020","journal-title":"Diabetes"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2016.02.004","article-title":"Imbalanced Insulin Action in Chronic Over Nutrition: Clinical Harm, Molecular Mechanisms, and a Way Forward","volume":"247","author":"Williams","year":"2016","journal-title":"Atherosclerosis"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8111874","article-title":"The Latest Insights Into Adipokines in Diabetes","volume":"8","author":"Kim","year":"2019","journal-title":"J Clin Med"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.3390\/ijms18010008","article-title":"Metabolic Adaptation in Obesity and Type II Diabetes: Myokines, Adipokines and Hepatokines","volume":"18","author":"Oh","year":"2016","journal-title":"Int J Mol Sci"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2016.02.005","article-title":"The Impact of Adipose Tissue on Insulin Resistance in Acromegaly","volume":"27","author":"Olarescu","year":"2016","journal-title":"Trends Endocrinol Metab"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/681612","article-title":"Adipokines as Drug Targets in Diabetes and Underlying Disturbances","volume":"2015","author":"Andrade-Oliveira","year":"2015","journal-title":"J Diabetes Res"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsps.2014.11.011","article-title":"Adiponectin Serum Levels Correlate With Insulin Resistance in Type 2 Diabetic Patients","volume":"23","author":"Aleidi","year":"2015","journal-title":"Saudi Pharm J"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-18-0925","article-title":"Patients\u2019 Perspectives on Acromegaly Diagnostic Delay: A Qualitative Study","volume":"180","author":"Sibeoni","year":"2019","journal-title":"Eur J Endocrinol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1111\/cpf.12152","article-title":"Contemporary Methods of Body Composition Measurement","volume":"35","author":"Fosbol","year":"2015","journal-title":"Clin Physiol Funct Imaging"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.854931\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T08:14:49Z","timestamp":1646813689000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.854931\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,9]]},"references-count":40,"alternative-id":["10.3389\/fendo.2022.854931"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2022.854931","relation":{},"ISSN":["1664-2392"],"issn-type":[{"type":"electronic","value":"1664-2392"}],"subject":[],"published":{"date-parts":[[2022,3,9]]},"article-number":"854931"}}