Correlation between plasma catecholamines, weight, and diabe
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Pheochromocytomas and paragangliomas (PCC/PGL) are neuroendocrine tumors with discrete catecholamine profiles that cause incompletely understood metabolic and physiologic changes.

The objective was to evaluate relationships between plasma catecholamines, body weight, and hemoglobin A1C (HA1C). Researchers hypothesized that individual catecholamines would correlate negatively with weight and glucose control.

A retrospective cohort study was performed. Wilcoxon rank-sum tests compared non-parametric, continuous variables; mixed-effect linear modeling (MEM) evaluated relationships between catecholamines and weight or HA1C. The median study duration was 54.2 months (IQR: 19.0–95.1).

360 patients were identified prospectively by referral to our center for management or surveillance of PCC/PGL. The median age was 59 years (IQR: 45–67) and 56.4% (N=203) were female. The primary and secondary outcomes were weight and HA1C, respectively.

-- On multivariable MEM, norepinephrine negatively correlated with weight when all catecholamines and their derivatives were tried in the model, and normetanephrine correlated when only metanephrines were included.

-- In the surgical cohort (N=272), normetanephrine decreased postoperatively and was inversely associated with weight.

-- Elevated norepinephrine or normetanephrine at the study termination, indicative of metastatic and/or recurrent disease (MRD), correlated with weight loss.

-- Norepinephrine and normetanephrine directly correlated with HA1C.

Conclusively, plasma norepinephrine and its metabolite directly correlate with HA1C and inversely correlate with weight in PCC/PGL. After resection, declining normetanephrine levels correlate with improving HA1C despite an increase in patient body weight. Persistently elevated catecholamines and decreasing weight are observed in MRD.