Chronic Glycemic Dysregulation After Pheochromocytoma or Paraganglioma Resection
Overview
This study demonstrates that patients with a history of pheochromocytoma or paraganglioma (PPGL) exhibit persistent hyperglycemic disorders and elevated HbA1c levels long after surgical tumor resection. Compared to controls with nonfunctioning adrenal adenomas, these patients maintain a higher cardiometabolic risk profile despite similar age and BMI.
Background
Pheochromocytomas and paragangliomas are rare neuroendocrine tumors that often secrete catecholamines, causing significant cardiometabolic complications including hyperglycemia and hypertension. While surgical resection reduces catecholamine levels and improves some cardiac functions, the long-term persistence of metabolic disturbances remains unclear. Given the high heritability and metastatic potential of PPGLs, understanding post-surgical cardiometabolic risk is critical for patient management.
Data Highlights
Group
Sample Size (n)
Mean HbA1c (%)
Prevalence of Hyperglycemic Disorders
History of PPGL (≥12 months post-surgery)
113
5.63 (SD 0.43)
Significantly higher (P < .001)
Control Group (Nonfunctioning adrenal adenomas)
76
5.45 (SD 0.40)
Lower prevalence
Key Findings
Patients with a history of PPGL have a significantly higher prevalence of hyperglycemic disorders compared to asymptomatic pathogenic variant carriers (P = .013).
Mean HbA1c remains elevated in patients at least 12 months post-PPGL resection compared to controls (5.63% vs 5.45%, P = .004).
Glycemic disturbances persist long-term despite tumor removal and normalization of catecholamine levels.
Cardiometabolic risk factors such as dyslipidemia and BMI were assessed but glycemic status showed the most significant persistent abnormality.
Metastatic PPGL patients and those with pathogenic variants without tumor history showed differing cardiometabolic profiles.
Clinical Implications
Clinicians should be aware that glycemic dysregulation may persist in patients even after successful PPGL resection, necessitating ongoing monitoring and management of glucose metabolism. Long-term cardiometabolic follow-up may be warranted to mitigate risks of diabetes and related complications in this population.
Conclusion
This study highlights the chronic nature of glycemic abnormalities in patients with a history of PPGL, underscoring the need for continued surveillance and tailored cardiometabolic care post tumor resection.
References
ProsPheo Study/ENS@T Registry/2024 -- Chronic Glycemic Dysregulation in Individuals With a History of Pheochromocytoma or Paraganglioma
by Alessa Fischer, Hanna Remde, Christina Pamporaki, Ulrich Dischinger, Nicole Bechmann, Mercedes Robledo, Katharina Wang, Diana Vetter, José Oberholzer, Grégoire B Morand, Simon Andreas Mueller, Alexander Huber, Ralph Fritsch, Sven Gruber, Constanze Hantel, Kathrin Zitzmann, Martin Reincke, Christoph J Auernhammer, Karel Pacak, Ashley B Grossman, Felix Beuschlein, Svenja Nölting
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