Carotid atheromatic plaque is commonly associated with hypopituitary men

Abstract

Hypopituitarism increases the risks of many cardiovascular conditions and therefore, patients with this disease are more prone to cardiovascular disease. To our knowledge, there have been few studies on carotid artery plaque in male patients with hypopituitarism in assessing cardiovascular risks. The aim of this study was to specifically compare carotid artery plaque while examining other major cardiovascular risk factors between male patients with hypopituitarism and control subjects. Forty male patients aged 30-70 years with hypopituitarism and forty age, sex-matched control subjects were recruited at the Yonsei University Severance Hospital, Seoul, Korea. Carotid intima media thickness (IMT) and atheromatous plaque, anthropometry, lipid profile, and pituitary hormones were assessed. Atheromatous plaque in the carotid arteries was observed more frequently in patients with hypopituitarism than age-and sex-matched control subjects (59.5% vs. 2.5%, P \ 0.01) without differences of carotid IMTs. Patients with hypopituitarism also exhibited higher waist circumference, waist to hip ratio, total cholesterol and LDL cholesterol than control subjects. In subgroup analysis in male patients with hypopituitarism including GH deficiency, lower testosterone levels were associated with higher waist circumference (r = 0.446, P = 0.033).In conclusion, hypopituitary males exhibit an increased incidence of carotid artery plaque without differences of carotid IMTs, central obesity and higher total cholesterol level. Lower testosterone levels were associated with central obesity-a strong component of a metabolic syndrome, and unsubstituted testosterone deficiency might be an important cardiovascular risk factor in patients with hypopituitarism.

Assessment of anthropometric and physical health indicators before and after pituitary surgery in patients with nonfunctioning pituitary adenomas, acromegaly, and Cushing disease

“…These numbers are higher than in the general population and similar to that of Deepak et al[23] who evaluated 152 adults with hypothalamic-pituitary disease, 89 with nonfunctioning adenomas and adenomas associated with acromegaly and Cushing's disease, and reported obesity in 50% of the sample and overweight in 30.8%. Kim et al[24] evaluated 40 men with hypopituitarism, and 70% of them had pituitary adenoma. They reported an average BMI of 25.3, close to our finding of 27.5.…”

“…The presence of hypopituitarism did not interfere with the results of WC and WHR in the current series, although the small number of hypopituitary patients (13) may be a limiting factor of this analysis. Kim et al[24] observed higher WC (87.5 ± 0.77) e WHR (0.91 ± 0.01) values in patients with hypopituitarism than in healthy controls.…”

Excess Mortality Associated With Hypopituitarism in Adults: A Meta-Analysis of Observational Studies

“…Carotid artery atheromatous plaques were observed more frequently in hypopituitary subjects than age-and sex-matched controls (59⅐5% vs. 2⅐5%, P Ͻ 0⅐01) (23). Significantly higher proportion of patients with hypopituitarism also had metabolic syndrome compared to the normal population, making them more prone to develop premature atherosclerosis (23,24). Increased risk of atherosclerosis and strokes had been demonstrated in patients who had cranial irradiation for other reasons (25,26).…”

Sheehan syndrome: Cardiovascular and metabolic comorbidities

“…In addition over-replacement with GC (29, 30) and sex steroid deficiency contribute to impaired metabolic parameters and atherogenesis in such patients (15). In a large study, atherosclerotic plaques in carotid arteries were present in half of the patients with hypopituitarism (31). Coronary flow reserve (CFR), as measured by transthoracic color echocardiography is a simple measurement of blood flow in coronary arteries, is impaired in subjects with GH deficiency, and corelates with serum IGF-1 concentration (32).…”