肢端肥大症的垂体腺瘤继发糖尿病的相关因素分析

Analysis of factors related to diabetes secondary to pituitary adenoma with acromegaly

目的探讨肢端肥大症的垂体腺瘤病人继发糖尿病的相关因素。方法回顾性分析继发与未继发糖尿病的84例肢端肥大症垂体腺瘤病人在发病年龄、性别、时间、瘤体大小、术前血生长激素(GH)及激素免疫组化方面的不同,采用二分类多因素Logistic回归分析肢端肥大症垂体腺瘤病人继发糖尿病的相关因素。结果与未继发糖尿病比较,继发糖尿病的肢端肥大症垂体腺瘤病人的发病时间更短,术前血GH更高,促甲状腺激素(TSH)免疫反应阳性率更高(P<0.05)。Logistic回归分析统计结果显示:发病时间、术前血GH水平及TSH免疫阳性率的Exp(B)值分别为0.212、1.160、93.392(P<0.05)。结论发病时间、术前血GH及TSH免疫阳性是肢端肥大症垂体腺瘤继发糖尿病的相关因素,TSH免疫阳性是主要因素;肿瘤分泌的TSH可能参与肢端肥大症垂体腺瘤继发糖尿病的病理生理过程。

Objective To explore the factors related to diabetes secondary to pituitary adenoma with acromegaly. Methods Clinical data of 84 acromegalic pituitary adenoma patients with or without secondary diabetes were analyzed retrospectively. The differences were compared between patients with and without secondary diabetes in the age, sex, occurrence time, tumor size, preoperative blood growth hormone（GH） level and tumor immune response. The factors related to diabetes secondary to acromegalic pituitary adenoma were analyzed by two classification of multifactor logistic regression. Results Compared with the patients without diabetes, the occurrence time was shorter, the preoperative blood GH and percentage of positive thyroid stimulation hormone（TSH） immunoreactivity were higher（P〈0.05） in the patients with diabetes. Logistic regression results showed that Exp（B） of the occurrence time, preoperative blood GH and percentage of positive TSH immunoreactivity were 0.212, 1.160, 93.392（P〈0.05）. Conclusions The occurrence time,preoperative blood GH and TSH positive immune response rate are the factors related to diabetes secondary to acromegalic pituitary adenoma. TSH positive immune response is the main factor. TSH secreted by tumor cells may be involved in the pathological and physiological process of acromegalic pituitary adenoma with secondary diabetes.