Long-Term Persistence of Glycemic Dysregulation in Patients With a History of Pheochromocytoma/Paraganglioma

Journal article

Context: Pheochromocytomas and paragangliomas (PPGLs) are rare endocrine tumors that frequently produce catecholamines. Catecholamine-induced cardiometabolic complications substantially contribute to increased morbidity and mortality in PPGL patients prior to surgical resection. Objective: To determine whether markers of elevated cardiometabolic risk persist in patients following PPGL resection. Methods: In this retrospective analysis of a multicenter cohort of patients with PPGLs participating in the prospective ProsPheo study and the ENS@T registry, cardiometabolic risk factors, including glycemic status, dyslipidemia, and body mass index (BMI), were assessed in patients with PPGL at diagnosis and during follow-up. Patients with a history of resected PPGL were compared to a control group with nonfunctioning adrenal adenomas from the ENS@T registry. Results: Patients with a present PPGL or a history of PPGL (n = 188), a metastatic PPGL (n = 27), or a known susceptibility gene pathogenic variant (PV) for the development of PPGL without a history of PPGL (n = 44) were included. We compared the asymptomatic PV carriers to patients with a history of PPGL: those with a history of PPGL showed a significantly higher prevalence of hyperglycemic disorders (P = .013) compared with asymptomatic PV carriers. In patients with a history of PPGL and at least 12 months of follow-up post surgery (n = 113), the prevalence of hyperglycemic disorders (P < .001), as well as the mean HbA1c (5.63%, SD 0.43%), were significantly higher, compared to a control group with nonfunctioning adrenal adenomas (n = 76) of similar age and BMI (HbA1c 5.45%, SD 0.40%; P = .004). Conclusion: Glycemic disturbances persist long-term after the resection of PPGL.

Authors: Fischer, A; Remde, H; Pamporaki, C; Dischinger, U; Bechmann, N

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Oxford University Press
• Journal: The Journal of Clinical Endocrinology & Metabolism
• Volume: 110
• Issue: 9
• Pages: e2966-e2976
• Publication date: 2025-01-02
• DOI: 10.1210/clinem/dgae901
• EISSN: 1945-7197
• ISSN: 0021972X and 0021-972X
• Language: English
• Keywords: HbA1c; pheochromocytoma; diabetes; paraganglioma; cardiometabolic risk; glucose intolerance