颅咽管瘤术后垂体功能减退患者糖代谢异常危险因素研究

Study on the risk factors of abnormal glucose metabolism in patients with hypopituitarism after craniopharyngioma surgery

目的研究颅咽管瘤术后垂体功能减退患者糖代谢异常的危险因素。方法收集2008年3月至2020年7月天津医科大学总医院住院的49例颅咽管瘤术后垂体功能减退患者首次入院资料, 根据1999年世界卫生组织(WHO)公布的糖尿病诊断标准, 将49例患者分为糖代谢异常组(糖尿病患者和糖耐量减低患者)和糖代谢正常组。收集患者的一般资料、术后并发症、实验室检验结果等进行病例回顾性分析。结果 (1)糖代谢异常组18例, 其中11例为糖尿病, 7例为糖耐量异常。(2)糖代谢异常组体重指数(BMI)、合并脂肪肝比例及甘油三酯水平显著高于糖代谢正常组。(3)二元logistic回归分析发现, 超重、肥胖是颅咽管瘤术后垂体功能减退患者糖代谢异常的独立危险因素, BMI截断值为27.25 kg/m2。结论颅咽管瘤术后患者糖代谢异常比例较高, 超重肥胖是其独立危险因素。

Objective To study the risk factors of abnormal glucose metabolism in patients with hypopituitarism after craniopharyngioma operation.Methods The first admission data of 49 patients with hypopituitarism after craniopharyngioma were collected from March 2008 to July 2020 in the General Hospital of Tianjin Medical University.According to the diagnostic criteria of diabetes published by the World Health Organization(WHO)in 1999,49 patients were divided into the group with abnormal glucose metabolism(diabetic patients and patients with impaired glucose tolerance)and the group with normal glucose metabolism.The general information,postoperative complications and laboratory results of these patients were retrospectively analyzed.Results(1)There were 18 cases in the group with abnormal glucose metabolism,among which 11 cases were diagnosed with diabetes,and 7 cases were diagnosed with impaired glucose tolerance.(2)The body mass index(BMI),the percentage of fatty liver and the level of triglyceride of the group with abnormal glucose metabolism were much higher than the control group.(3)Overweight and obesity were independent risk factors for abnormal glucose metabolism in postoperative patients with craniopharyngioma,and the cut-off value of BMI was 27.25 kg/m2.Conclusion The proportion of patients with abnormal glucose metabolism after craniopharyngioma is high and overweight and obesity are independent risk factors for abnormal glucose metabolism in postoperative patients with craniopharyngioma.