ECEESPE2025 Poster Presentations Endocrine Related Cancer (76 abstracts)
Long-term persistence of glycemic dysregulation in patients with a history of pheochromocytoma/paraganglioma
Alessa Fischer 1 , Hanna Remde 2 , Christina Pamporaki 3 , Ulrich Dischinger 2 , Nicole Bechmann 4 , Mercedes Robledo 5 , 6 , Katharina Wang 7 , Diana Vetter 8 , José Oberholzer 8 , Gregoire Morand 9 , Simon Mueller 9 , Alexander Huber 9 , Ralph Fritsch 10 , Sven Gruber 1 , Constanze Hantel 1 , 3 , Kathrin Zitzmann 7 , Martin Reincke 7 , Christoph Auernhammer 7 , Karel Pacak 11 , Ashley B. Grossman 12 , 13 , Felix Beuschlein 1 7 14 & Svenja Noelting & 7
1University Hospital Zurich (USZ), Department of Endocrinology, Diabetology and Clinical Nutrition, Zurich, Switzerland; 2University Hospital, University of Würzburg, Department of Internal Medicine I, Würzburg, Germany; 3University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Department of Internal Medicine III, Dresden, Germany; 4University Hospital Carl Gustav Carus, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Institute of Clinical Chemistry and Laboratory Medicine, Dresden, Germany; 5Spanish National Cancer Research Center (CNIO), Hereditary Endocrine Cancer Group, Madrid, Spain; 6Centro de Investigación Biomédica en Red de Enfermedades Raras, Madrid, Spain; 7University Hospital, Ludwig-Maximilians-University Munich, Department of Medicine IV, Munich, Germany; 8University Hospital Zurich (USZ), Department of Visceral and Transplantation Surgery, Zurich, Switzerland; 9University Hospital Zurich (USZ), Department of Otorhinolaryngology, Zurich, Switzerland; 10University Hospital Zurich (USZ), Department of Medical Oncology and Hematology, Zurich, Switzerland; 11AKESO, Prague 5, Prague, Czech Republic; 12University of Oxford, Green Templeton College, Oxford, United Kingdom; 13Royal Free Hospital, NET Unit, ENETS Centre of Excellence, London, United Kingdom; 14The LOOP Zurich - Medical Research Center, Zurich, Switzerland
JOINT88
Introduction: Pheochromocytomas and paragangliomas (PPGLs) are relatively rare endocrine tumours often characterized by excess catecholamine production. Catecholamine-induced cardiometabolic complications substantially contribute to increased morbidity and mortality in PPGL patients prior to surgical resection. Hyperglycemia driven by catecholamines can lead to the onset or worsening of diabetes mellitus, while elevated plasma norepinephrine levels have been associated with higher HbA1c and reduced body weight in PPGL patients. Despite these acute findings, the long-term cardiometabolic outcomes following PPGL resection remain insufficiently studied. This study aimed to explore biomarkers indicative of a persistent higher cardiometabolic risk in PPGL patients.
Methods: We conducted a retrospective analysis of a multicentre cohort of patients with PPGLs enrolled in the prospective ProsPheostudy and the ENS@T registry. Cardiometabolic risk factors including glycemic status, dyslipidemia and BMI, were evaluated at the time of PPGL diagnosis and during follow-up. To further assess long-term outcomes after successful PPGL resection, patients with a history of resected PPGL (without recurrence) were compared to a control group of individuals with non-functioning adrenal adenomas (NFAA) [with normal aldosterone-renin ratios, normal 1 mg dexamethasone suppression testing, and non-elevated plasma levels of (nor)metanephrines and 3-methoxytyramine].
Results: A total of 259 individuals were included: patients with a present PPGL or a history of PPGL (n = 188), a metastatic PPGL (n = 27), or a pathogenic variant in a PPGL susceptibility gene without prior PPGL history (n = 44). Mean HbA1c levels were lowest in the susceptibility gene carrier group (5. 4%, SD 0. 5%) and similar in patients with a present PPGL (5. 6%, SD 0. 6%), a history of PPGL (5. 6%, SD 0. 4%) or metastatic PPGL (5. 6%, SD 0. 8%). In patients with a history of PPGL (without recurrence) and ≥12 months post-surgery follow-up (n = 113), mean HbA1c levels (5. 6%, SD 0. 4%) and the prevalence of hyperglycemic disorders were significantly higher than in a control group with non-functioning adrenal adenomas (NFAA; n = 76) of similar age and BMI (HbA1c 5. 5%, SD 0. 4%; P = 0. 004). Pre-surgery HbA1c was higher in catecholamine-secreting PPGLs compared to non-secreting PPGLs (5. 8% vs. 5. 3%; P = 0. 02), but this difference was not observed during follow-up (5. 6% vs. 5. 5%; P = 0. 56). No significant differences were found between groups regarding other cardiometabolic risk factors or laboratory parameters, including BMI, cholesterol, triglycerides, eGFR, and NT-proBNP levels.
Conclusions: The primary conclusion of this study is that chronic hyperglycemia persists long-term following successful PPGL resection.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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