Preoperative HbA1c and postoperative day 1 fasting plasma glucose are associated with early glycemic improvement after transsphenoidal surgery in patients with acromegaly and preoperative dysglycemia: a retrospective cohort study.
4 affiliations
- 1Department of Nursing, Huashan Hospital, Fudan University, Shanghai, 200040, China.
- 2Department of Anesthesiology, Huashan Hospital, Fudan University, Shanghai, 200040, China.
- 3Department of Anesthesiology, Huashan Hospital, Fudan University, Shanghai, 200040, China. [email protected].
- 4Department of Nursing, Huashan Hospital, Fudan University, Shanghai, 200040, China. [email protected].
Abstract
Background
Dysglycemia is common in acromegaly and may improve after transsphenoidal surgery, but factors associated with early postoperative glycemic improvement are unclear. We aimed to identify perioperative factors associated with glycemic improvement at first follow-up, focusing on preoperative HbA1c and postoperative day 1 fasting plasma glucose (POD1 FPG).Methods
This retrospective cohort study included 175 acromegaly patients with preoperative dysglycemia who underwent transsphenoidal surgery (2019-2024). The primary outcome was early glycemic improvement (normalization or downgrading from diabetes to prediabetes) at ~ 1 month post-surgery. Logistic regression and restricted cubic spline analyses were performed.Results
Glycemic improvement occurred in 84 patients (48.0%). Higher preoperative HbA1c (OR 0.60, 95% CI 0.42-0.85, P = 0.005) and higher POD1 FPG (OR 0.67, 95% CI 0.50-0.89, P = 0.007) were independently associated with lower odds of improvement. Improvement rates decreased across HbA1c tertiles (69.5%, 39.7%, 34.5%; P for trend < 0.001). Patients with POD1 FPG in the optimal range (5.5-7.0 mmol/L) had higher improvement rates than those outside this range (61.9% vs. 35.2%; adjusted OR 0.38, 95% CI 0.20-0.74, P = 0.004).Conclusions
In acromegaly patients with preoperative dysglycemia, both preoperative HbA1c and POD1 FPG were independently associated with early postoperative glycemic improvement. These glycemic markers may improve short-term risk stratification beyond broad preoperative glycemic categories.Clinical trial number
Not applicable.
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BibTeX
@article{chen2026preoperative,
title = {{Preoperative HbA1c and postoperative day 1 fasting plasma glucose are associated with early glycemic improvement after transsphenoidal surgery in patients with acromegaly and preoperative dysglycemia: a retrospective cohort study.}},
author = {Jiajun Chen and Qing Shen and Meimei Chen and Lei Jin and Mengqiang Luo and Ying Huang},
journal = {BMC endocrine disorders},
year = {2026},
month = aug,
doi = {10.1186/s12902-026-02459-9},
url = {https://europepmc.org/article/MED/42963766},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Preoperative HbA1c and postoperative day 1 fasting plasma glucose are associated with early glycemic improvement after transsphenoidal surgery in patients with acromegaly and preoperative dysglycemia: a retrospective cohort study.
AU - Jiajun Chen
AU - Qing Shen
AU - Meimei Chen
AU - Lei Jin
AU - Mengqiang Luo
AU - Ying Huang
PY - 2026
DA - 2026/08/04
JO - BMC endocrine disorders
DO - 10.1186/s12902-026-02459-9
UR - https://europepmc.org/article/MED/42963766
AB - Background Dysglycemia is common in acromegaly and may improve after transsphenoidal surgery, but factors associated with early postoperative glycemic improvement are unclear. We aimed to identify perioperative factors associated with glycemic improvement at first follow-up, focusing on preoperative HbA1c and postoperative day 1 fasting plasma glucose (POD1 FPG).Methods This retrospective cohort study included 175 acromegaly patients with preoperative dysglycemia who underwent transsphenoidal surgery (2019-2024). The primary outcome was early glycemic improvement (normalization or downgrading from diabetes to prediabetes) at ~ 1 month post-surgery. Logistic regression and restricted cubic spline analyses were performed.Results Glycemic improvement occurred in 84 patients (48.0%). Higher preoperative HbA1c (OR 0.60, 95% CI 0.42-0.85, P = 0.005) and higher POD1 FPG (OR 0.67, 95% CI 0.50-0.89, P = 0.007) were independently associated with lower odds of improvement. Improvement rates decreased across HbA1c tertiles (69.5%, 39.7%, 34.5%; P for trend < 0.001). Patients with POD1 FPG in the optimal range (5.5-7.0 mmol/L) had higher improvement rates than those outside this range (61.9% vs. 35.2%; adjusted OR 0.38, 95% CI 0.20-0.74, P = 0.004).Conclusions In acromegaly patients with preoperative dysglycemia, both preoperative HbA1c and POD1 FPG were independently associated with early postoperative glycemic improvement. These glycemic markers may improve short-term risk stratification beyond broad preoperative glycemic categories.Clinical trial number Not applicable.
SN - 1472-6823
ER -