Markers of Metabolic Syndrome in Patients with Pituitary Adenoma: A Case Series of 303 Patients

Abstract

To assess the demographic characteristics and hormonal status of patients who presented to our clinic with pituitary adenoma and to demonstrate the presence, prevalence, and relationship of metabolic syndrome parameters in these patients. The study included 303 patients with known or newly diagnosed pituitary adenoma and 52 age- and sex-matched healthy controls. The patients were classified into 3 groups; acromegaly (ACRO) (n=54),prolactinoma (PRLoma) (n=163), and non-functional adenoma (NFA) (n=86). in 55.6% (n=172) and 52% (n=163) of the patients, respectively. The waist circumference of all patients (p<0.001) and body mass index (BMI) of patients with PRLoma (p=0.03) and ACRO (p<0.001) were found to be significantly higher than in the controls. The HbA1c, insulin and HOMA-IR values were significantly higher in the ACRO and PRLoma groups, whereas the insulin and HOMA-IR values were significantly higher in the NFA group compared with the control group (p<0.001 and p<0.001, respectively). When the 3 patient groups were compared, waist circumference and BMI were significantly higher in the ACRO group than in the PRLoma group (p=0.04 and p=0.03, respectively). In patients developing pituitary failure after treatment, age, waist circumference, plasma glucose, low-density lipoproteins and triglyceride values were significantly increased when compared with those without pituitary failure after treatment (p<0.001). In our study, it was found that there was increased metabolic and cardiovascular risk in functional pituitary adenoma and NFA.

Immunoendocrine Dysregulation during Gestational Diabetes Mellitus: The Central Role of the Placenta

“…Pregnancy is considered a physiologically hyperprolactinemic state, in where PRL potentiates glucose-stimulated insulin secretion and β-cell mass. However, exacerbated hyperprolactinemia, as occurs with a prolactinoma, is related to insulin resistance [ 102 ]. In GDM, blood levels of hPL are higher than in normal pregnancies and correlate with increased placental weight, macrosomia, hyperglycemia, insulin resistance, and altered values in an Oral Glucose Tolerance Test (OGTT) [ 103 , 104 ].…”

Vascular anomalies in patients with growth hormone-secreting pituitary adenomas: illustrative case report and systematic review of the literature

“…As broadly described in the literature and implemented in the diagnostic workup and treatment concepts of acromegalic patients, systemic diseases affecting, among others, the cardiovascular system occur due to GH over-secretion [1]. To determine the causes of the pathological changes, some authors present subclinical changes in the vessels based on ultrasound diagnostics [6][7][8][9][10][11][12]. In addition to these risk factors for the course of anesthesia, the anatomic vascular variations of the internal carotid artery pose particular challenges to the neurosurgeon for intraoperative management.…”

“…On the one hand, the increased release of growth hormone through a pleiotropic effect results in increased morbidity due to cardiovascular disorders (arterial hypertension, systolic/ diastolic dysfunction, valvulopathies, cardiac arrhythmias, cardiomyopathy, myocardial infarction), cerebrovascular (stroke), metabolic disorders (diabetes mellitus, impaired glucose tolerance, and dyslipidemia) and respiratory disorders (obstructive sleep apnea syndrome, macroglossia, airway obstruction) [5][6][7][8][9][10][11]. Vascular endothelial dysfunction can be detected at the subclinical level (flowmediated dilatation (FMD), carotid intima-media thickness, pulse-wave velocity, elastic modulus, epicardial adipose tissue thickness, the augmentation index [6,[12][13][14][15], as well.…”

Metabolic effects of prolactin

“…Indeed, epicardial adipose tissue thickness, considered a surrogate marker of visceral fat and a novel cardiovascular risk indicator, has been recently discovered to be higher in patients with prolactinoma as compared to healthy controls, even if similar cardiac systolic and diastolic functions were observed between the two groups ( 58 ). In a recent study focusing on the metabolic impact of pituitary adenomas, patients with prolactinoma have been confirmed to show significantly higher BMI and waist circumference as compared to healthy controls, whereas no significant anthropometric difference between patients with prolactinoma and other pituitary adenomas was found, neither non-functioning nor secreting other pituitary tropins ( 59 ). These findings led to the conclusion that obesity is very common in presence of PRL excess, raising the question of whether the achievement of PRL control by DAs or surgery can restore metabolic impairment.…”