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.

AKESO Prague 5 Czech Republic

Centro de Investigación Biomédica en Red de Enfermedades Raras Madrid 28029 Spain

Department of Endocrinology Diabetology and Clinical Nutrition University Hospital Zurich Zurich 8091 Switzerland

Department of Internal Medicine 1 Division of Endocrinology and Diabetes University Hospital University of Würzburg Würzburg 97080 Germany

Department of Internal Medicine 3 University Hospital Carl Gustav Carus Technische Universität Dresden Dresden 01307 Germany

Department of Medical Oncology and Hematology University Hospital Zurich 8091 Switzerland

Department of Medicine 4 University Hospital Ludwig Maximilians University Munich Munich 80336 Germany

Department of Otorhinolaryngology University Hospital Zurich 8091 Switzerland

Department of Visceral and Transplantation Surgery University Hospital Zurich 8091 Switzerland

Green Templeton College University of Oxford Oxford OX2 6HG UK

Hereditary Endocrine Cancer Group Spanish National Cancer Research Center Madrid 28029 Spain

Institute of Clinical Chemistry and Laboratory Medicine University Hospital Carl Gustav Carus Medical Faculty Carl Gustav Carus Technische Universität Dresden Dresden 01307 Germany

NET Unit ENETS Centre of Excellence Royal Free Hospital London NW3 2QG UK

The LOOP Zurich Medical Research Center Zurich 8044 Switzerland

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