Hypopituitarism and mortality in pituitary adenoma
| Autor: | Kirstine Stochholm, S. Juul, Anders Kruse, Claus Hagen, Peter Laurberg, Per Bjerre, Jörgen Lindholm, J. Sandahl Christiansen, Jens Otto Lunde Jørgensen, E. Husted Nielsen |
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| Rok vydání: | 2006 |
| Předmět: |
Adenoma
Adult Male medicine.medical_specialty Hypophysectomy Adolescent Endocrinology Diabetes and Metabolism medicine.medical_treatment Population Hypopituitarism Pituitary neoplasm Growth hormone deficiency Sex Factors Endocrinology Pituitary adenoma Internal medicine medicine Humans Pituitary Neoplasms education Aged Aged 80 and over education.field_of_study business.industry Middle Aged medicine.disease Magnetic Resonance Imaging Standardized mortality ratio Growth Hormone Regression Analysis Female Tomography X-Ray Computed business |
| Zdroj: | Lindholm, J, Nielsen, E H, Bjerre, P, Christiansen, J S, Hagen, C, Juul, S, Jørgensen, J, Kruse, A, Laurberg, P & Krag, K S 2006, ' Hypopituitarism and mortality in pituitary adenoma ', Clinical Endocrinology, vol. 65, no. 1, pp. 51-8 . |
| ISSN: | 1365-2265 0300-0664 |
| DOI: | 10.1111/j.1365-2265.2006.02545.x |
| Popis: | Summary Background and objective Previous studies on hypopituitarism and mortality have concluded that insufficient pituitary function is associated with decreased survival. For several reasons the results are difficult to compare ‐ particularly because definitions and treatment of hypopituitarism have varied and various underlying disorders have been included. The purpose was to assess the relationship between mortality and pituitary function. Patients and design One hundred and sixty consecutive patients (99 men and 61 women) with functionless, suprasellar pituitary adenoma. All were operated on transsphenoidally during the period 1985 ‐1996. Additional radiotherapy was given to 29 patients. Mortality was calculated 12·4 years (median, range 8·1‐19·9) after operation. Postoperative hormonal deficits were treated in most, though GH substitution was given only to a minority of patients. Results Postoperatively 30% of the patients had normal pituitary function (normal adrenocortical, thyroid and gonadal function), 26% were panhypopituitary and 36% had partial pituitary insufficiency. Forty-one patients had died (34·7 expected) yielding a standard mortality ratio (SMR) of 1·18 (95% confidence limits (CI) 0·87‐ 1·60). SMR was significantly increased in women (1·97, CI 1·20 ‐3·21) but not in men (0·83, CI 0·55 ‐1·26). SMR in patients with normal pituitary function, panhypopituitarism and partial insufficiency were not different from that in the general population. SMR in hypopituitary women was substantially higher than in men with pituitary insufficiency. Treatment with growth hormone in GH-deficient patients did not influence survival. Conclusion Pituitary surgery for nonfunctioning adenoma and subsequent pituitary insufficiency had no effect on mortality in men, but was associated with significantly increased mortality in women. Suboptimal hormonal substitution in women may play a role. |
| Databáze: | OpenAIRE |
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