Distinct pituitary hormone levels of 184 Chinese children and adolescents with multiple pituitary hormone deficiency: a single-centre study

Abstract

BackgroundPituitary tumors and/or their treatment are associated with multiple pituitary hormone deficiency (MPHD) in adults, but the distinct pituitary hormone profile of MPHD in Chinese children and adolescents remains unclear.MethodsPatients with MPHD were divided into four groups according to their MRI results: 1) pituitary stalk interruption syndrome (PSIS); 2) hypoplasia; 3) normal; and 4) tumor survivor.ResultsAmong the 184 patients, 93 patients (50.5%) were with PSIS, 24 (13.0%) had hypoplastic pituitary gland, 10 (5.4%) patients were normal, and 57 (31.0%) were tumor survivors. There was an association between abnormal fetal position and PSIS (P ≤ 0.001). The CA/BA in PSIS, hypoplasia, normal, tumor survivor groups were 2.27 ± 1.05, 1.48 ± 0.39, 1.38 ± 0.57, 1.49 ± 0.33, and HtSDS were − 3.94 ± 1.39, − 2.89 ± 1.09, − 2.50 ± 1.05, − 1.38 ± 1.63. Patients in PSIS group had the largest CA/BA (P ≤ 0.001 vs. hypoplasia group, P = 0.009 vs. normal group, P ≤ 0.001 vs. tumor survivors) and lowest HtSDS (P ≤ 0.001 vs. hypoplasia group, P = 0.003 vs. normal group, P ≤ 0.001 vs. tumor survivors). The levels of TSH in the PSIS, hypoplasia, normal, and tumor survivor groups were 1.03 ± 1.08 (P = 0.149 vs. tumor survivors), 1.38 ± 1.47 (P = 0.045 vs. tumor survivors), 2.49 ± 1.53 (P < 0.001 vs. tumor survivors), and 0.76 ± 1.15 μIU/ml. The levels of GH peak in PSIS, hypoplasia, normal, tumor survivor groups were 1.37 ± 1.78, 1.27 ± 1.52, 3.36 ± 1.79, 0.53 ± 0.52 ng/ml and ACTH were 27.50 ± 20.72, 25.05 ± 14.64, 34.61 ± 59.35, 7.19 ± 8.63 ng/ml. Tumor survivors had the lowest levels of GH peak (P ≤ 0.001 vs. PSIS group, P = 0.002 vs. hypoplasia group, P ≤ 0.001 vs. normal group) and ACTH (all the P ≤ 0.001 vs. the other three groups).ConclusionThe frequency of PSIS is high among children and adolescents with MPHD. The severity of hormone deficiencies in patients with MPHD was more important in the tumor survivor group compared with the other groups.

Growth and Adult Height during Human Growth Hormone Treatment in Chinese Children with Multiple Pituitary Hormone Deficiency Caused by Pituitary Stalk Interruption Syndrome: A Single Centre Study

“…Various anterior pituitary hormone deficiencies and clinical presentations are common in PSIS patients. To date, studies on the growth of children and adolescents with PSIS during the course of hGH treatment are sparse and continuous follow-up to adult age is rarely reported (5). In this retrospective study, measurements were performed in 74 patients with PSIS.…”

“…Serum fT4, TSH, ACTH, COR, FSH and LH were measured using chemiluminescence assays (Siemens Healthcare Diagnostics, USA). All patients underwent the same testing protocol and all tests were performed after overnight fasting (5).…”

“…Height was measured in centimeters (cm) in the morning by the same medical team. Height measurements were standardized for age and sex and expressed as standard deviation scores (HtSDS) relative to chronological age (CA) according to Growth Charts for Chinese Children and Adolescents (2009) (5,11). The GV during hGH treatment was analyzed each year and was calculated in cm through the difference in previously recorded height.…”

“…Body mass index (BMI) was calculated using the standard formula of weight (kg) divided by height squared (meters). BMI values were transformed into BMI-SDS, based on Normative Values for Chinese Children and Adolescents (2009) (5,11) to adjust for the confounding effects of age and sex.…”

“…It is a rare congenital disease associated with multiple pituitary hormone deficiencies (MPHD). MPHD, by definition, represents an impaired production of one or more anterior pituitary hormones in addition to growth hormone (GH) and is a chronic, lifelong condition (2,3,4,5).…”