Endocrine Abstracts

Several studies have pointed to increased morbidity and mortality in patients with hypopituitarism, particularly from cardiovascular diseases, regardless of the application of the substitution therapy. The aim of this study was to present clinical characteristics and cardiovascular risk of our patients with hypopituitarism during 20 years of follow-up.

Methods: Sixty patients with hypopituitarism without patients with acromegaly and Cushing disease were analysed retrospectively/prospectively. The investigated group consisted of 32 men and 28 women, of the average age of 52.18±17.51.

Results: Mean BMI values were 27.78±6.53 kg/m². The average age of the examinees at the time of diagnosis was 40.20±18.69. The most common causes of hypopituitarism were pituitary macroadenomas (53.33%) and craniopharyngeoma (21.66%). Partial hypopituitarism with lesion of two and more functions was present in 64.41%, panhypopituitarism in 28.81%, and 6.78% had an isolated deficiency of one adenopituitary hormone. Patients were treated with substitution therapy L-thyroxine, hydrocortisone, growth hormone, sexual steroids, while diabetes insipidus was treated with desmopressin. 6.66% of subjects treated with dietary nutrition regime had diabetes mellitus type 2. The therapy of hypopituitarism was followed by insignificant reduction in systolic and diastolic blood pressure. Elevated values of total cholesterol over the course of therapy significantly decreased (P≤0.009) as well as values of LDL cholesterol (P≤ 0.005). The values of HDL cholesterol and triglycerides were not significantly changed during treatment. Cardiovascular incidents were recorded in only 11.66% of the subjects, and a lethal outcome in one patient due to sepsis.

Conclusion: The results indicate that the middle aged people are most prone to the risk developing hypopituitarism, mostly due to a tumor in the sellar region and its treatment. Cardiovascular risk factors are present in untreated hypopituitarism. Despite substitution therapy, the ofteness of cardiovascular incidents is present.