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01-02-2020 | Original Scientific Report

Surgical Resection of Pheochromocytomas and Paragangliomas is Associated with Lower Cholesterol Levels

Authors: Meghan L. Good, Parisa Malekzadeh, Samantha M. Ruff, Shreya Gupta, Amy Copeland, Karel Pacak, Naris Nilubol, Electron Kebebew, Dhaval Patel

Published in: World Journal of Surgery | Issue 2/2020

Abstract

Background

Catecholamine excess in patients with pheochromocytomas or paragangliomas (PPGLs) can lead to hypertension, diabetes and hyperlipidemia. The aim was to investigate the prevalence of hyperlipidemia and the effect of surgical resection.

Methods

One hundred and thirty-two patients with PPGLs underwent an operation at the National Institutes of Health from 2009 to 2016, of which 54 patients met the inclusion criteria. Clinical demographics, BMI, genetic mutations, tumor size, perioperative catecholamine levels and perioperative lipid panels were retrospectively reviewed. Spearman correlation between catecholamines and lipid levels was evaluated. Paired Wilcoxon and paired t test were used to analyze differences in pre- and postoperative lipid levels.

Results

Preoperatively, 51 patients (94.4%) had elevated catecholamines, thirteen (24.1%) had elevated total cholesterol (TC) (>200 mg/dL), nine (16.6%) had elevated LDL (>130 mg/dL) and ten (18.5%) had elevated triglycerides (>150 mg/dL). Serum and urinary metanephrine levels were positively associated with TC (r = 0.2792, p = 0.0372 and r = 0.4146, p = 0.0031, respectively) and LDL levels (r = 0.2977, p = 0.0259 and r = 0.4434, p = 0.0014, respectively). Mean TC decreased from 176.4 to 166.3 mg/dL (p = 0.0064) and mean HDL decreased from 56.7 to 53.2 mg/dL (p = 0.0253) after PPGL resection (median 3.1 months (range 1.3–50.2) between lipid panels). Most patients with elevated TC (76.9%) had improvement with mean TC decreasing from 225 to 200.2 mg/dL (p = 0.0230). Of patients with elevated LDL, 66.7% had improvement with mean LDL decreasing from 149 to 131.1 mg/dL (p = 0.0313).

Conclusions

The prevalence of hyperlipidemia in patients with PPGLs is 46%. Future prospective studies are needed to determine whether surgical resection improves TC and/or LDL levels.

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Title: Surgical Resection of Pheochromocytomas and Paragangliomas is Associated with Lower Cholesterol Levels
Authors: Meghan L. Good
Parisa Malekzadeh
Samantha M. Ruff
Shreya Gupta
Amy Copeland
Karel Pacak
Naris Nilubol
Electron Kebebew
Dhaval Patel
Publication date: 01-02-2020
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 2/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-05175-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Surgical Resection of Pheochromocytomas and Paragangliomas is Associated with Lower Cholesterol Levels

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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