ECE2018 Poster Presentations: Pituitary and Neuroendocrinology Pituitary - Clinical (101 abstracts)
Pituitary intensity at magnetic resonance imaging is reduced in obese patients: results from the CHIASM study
Giulia Puliani 1 , Emilia Sbardella 1 , Alessia Cozzolino 1 , Carlotta Pozza 1 , Tiziana Feola 1 , Daniele Gianfrilli 1 , Carla Lubrano 1 , Marco Fiorelli 2 , Andrea Lenzi 1 & Andrea M Isidori 1
1Department of Experimental Medicine – Sapienza University, Rome, Italy; 2Department of Neurology and Psychiatry – Sapienza University, Rome, Italy.
Introduction: Even if obesity has been associated to several hormonal imbalances, pituitary appearance at Magnetic Resonance Imaging (MRI) in obese patients is understudied.
Aim: To measure pituitary signal intensity and homogeneity at MRI in obese subjects free of focal pituitary disease, in the context of the CHIasM study (Changes in the Hypotalamic-pItuitary region of patients with Metabolic syndrome and obesity).
Materials and methods: Seventy-eight patients were prospectively enrolled and underwent metabolic, hormonal, body composition (DEXA scan) and pituitary MR assessment. Patients were divided in two groups according to BMI (study group ≥ 30 kg/m2, 55 patients, control group < 30 kg/m2, 23 patients). Texture of the pituitary gland was quantified recording pixel density and distribution using ImageJ software. Two operators independently placed the region of interest to entirely cover the pituitary gland, calculating mean intensity and its standard deviation. All analyses were normalized for both white and grey brain matter intensity.
Results: In the study group, we demonstrated a statistically significant reduction in mean pituitary intensity in T1 weighted images both in basal (P=0.038) and contrast-enhanced sequences (P=0.002), trough analysis of covariance (ANCOVA). Moreover, pituitary intensity in T1-weighted basal and contrast-enhanced images was negatively correlated to truncal fat (P 0.008, P 0.011) and fibrinogen (P=0.011, P=0.005). Multiple regression analysis revealed that, after adjusting for age and sex, the percentage of truncal fat and fibrinogen were significant predictors of the mean intensity of coronal T1-weighted scans (P=0.001). The model explained up to 26% of variance of pituitary signal intensity, and in a step-wise R2 analysis fibrinogen itself accounted for 9.6% of the variance.
Conclusions: This study describes a quantitative reduction in pituitary intensity in T1-weighted sequences in obese patients, that seems related to visceral adiposity and low-grade inflammation. Data could be explained by a relative change in pituitary stromal tissue in this cohort of patients.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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