Endocrine Abstracts

The aim: To study of functional status of hypothalamic–hypophysis–gonads axis men in reproductive age with obesity and different pituitary adenomas (PA).

Materials and methods: We examined 44 males with obesity 1–3 degrees with associated pathology (11 of them – pro and 33 – retrospectively). Mean age of patients was 22.9 years old. Control group constituted by 20 healthy men with different age.

All patients underwent clinical and biochemical evaluations including endocrine check, lipids profile, hormonal profile (LH, FSH, prolactin, sex steroid binding globulin, and free testosterone), genitalia ultrasonography, height, body mass, waist circumference (WC), hip circumference (HC), waist–hip ratio, questioning, and other studies.

Results: On the base of etiology of adenoma we found following: non-functional PA, 34 patients (77.3%); corticotropinoma, 5 (11.4%); craniofaryngioma, 4 (9.0%); and somatotropinoma, 1 (2.3%).

Among complaints we found headache (66%), giddiness (38%), decreasing of vision (25%), irritability (20%), pain in heart (20%), heartbeats (14%), disorders of sleep (11%), growth retardation (9.5%), etc.

The frequency of neuroendocrine and metabolic disorders was: revealed endocrine encephalopathy (60%), arterial hypertension (41%), secondary hypogonadism (2%), osteopeniya (20%), dislipidemiya (20%), polydipsiya (20%), poliuriya (18%), panhypopituitarism (16%), diabetes insipidus (11%), secondary hypocorticism (9.5%), heart ishmemic disease (6.8%), osteoporosis (6.8%), erectyle disfunction (6.8%), bitemporal hemianopsiya (4.5%), nefrolitiasis (4.5%), hepergonadotrop hypogonadism (2.3%), etc.

Hormonal profile showed hypogonadotropic hypogonadism in 43 patients (98%; mean LH ranged 2.5 mIU/l, FSH 3.08 mIU/l) and significantly low total testosterone levels (mean 6.24 ng/ml), free testosterone – 12.5 ng/ml, sex-steroid-coupled globuline – 36.6 nmol/l, STH – 0.56 nmol/l, IGF1 – 64.78 nmol/l, ACTH–51.6 pg/ml, thyroxine – 121.5 nmol/l, cortisol – 504 nmol/l. Most of the patients had central obesity with BMI >35 kg/m². WC was in normal range 104.3±7.4 cm, HC=85.6±5.3 cm, whereas waist–hip ratio >1.22. Blood tests showed dyslipidemia in all patients (100%).

Conclusions: i) For patients with different pituitary adenomas and obesity more distinctive deficiency of STH, IGF1, and hypogonadotropic-hypogonadism (98%). ii) The risk of development of metabolic disorders is very high (WC >104 cm).