Behaviour of the long-term clinical and analytical characteristics of a series of cases with hypopituitarism

Roberto Añez; Alejandra Rivas; Percovich Juan Carlos; Jose Atencia; Bettina Weber; Noemí Brox; María Miguélez; Laura Gonzalez; Diego Muñoz; Susana Monereo; Centeno Rogelio García

doi:10.1530/endoabs.70.EP347

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Endocrine Abstracts (2020) 70 EP347 | DOI: 10.1530/endoabs.70.EP347

ECE2020 ePoster Presentations Pituitary and Neuroendocrinology (94 abstracts)

Behaviour of the long-term clinical and analytical characteristics of a series of cases with hypopituitarism

Roberto Añez , Alejandra Rivas , Juan Carlos Percovich , Jose Atencia , Bettina Weber , Noemí Brox , María Miguélez , Laura Gonzalez , Diego Muñoz , Susana Monereo & Rogelio García Centeno
H Gregorio Marañon , Endocrinology , Madrid & Spain

Err

Aim: To describe the clinical and analytical characteristics of patients with hypopituitarism in the Endocrinology Department.

Materials and methods: This was a descriptive, retrospective study with 70 patients diagnosed with hypopituitarism in the Endocrinology Department´s outpatient consultations with a follow-up of up to 44 years. The qualitative variables were expressed in frequencies and the quantitative variables showed a normal distribution expressed in means ± S.D.

Results: Out of the 70 patients, 44.3% were women and 90% Spanish. The age at diagnosis was 42.94 ± 21.79 years with an average follow-up of 11.79 ± 10.56 years. The BMI mean was 28.56 ± 5.04 kg/m²; of which 42.1% were obese, 31.6% overweight and 26.3% normal weight. The most frequent cause was non-functioning macroadenoma surgery with 47.1%. The most prevalent hormonal deficits were TSH with 92.9%, ACTH 91.4%, FSH/LH 87.1%, GH/IGF-1 54.3%, and ADH 45.7%. The following means were observed in the last blood sample: Glucose 88.59 ± 27.30 mg/dl; HbA1c 5.86 ± 0.73%; Cholesterol 180.27 ± 37.47 mg/dl; HDL 57.35 ± 19.47 mg/dl; LDL 100.57 ± 31.22 mg/dl; TAG 138.51 ± 65.37 mg/dl; T4L 1.02 ± 0.21 ng/dl; IGF1 99.40 ± 58.39 ng/ml. Hydrocortisone daily mean was 21.09 ± 6.93 mg, and a dosage of three times a day was 67.2%. The average dose of levothyroxine according to weight in subjects under 65 years was 1.30 ± 0.32 mg/kg/day and in subjects 65 years or older 1.04 ± 0.31 mg/kg/day. The number of drugs used as chronic treatment was 6.75 ± 3.16. Regarding comorbidities, dyslipidemia was observed in 60% of patients, hypertension 37.1%, and diabetes mellitus 15.7%. Alterations in bone densitometry were observed in 42.8% (osteopenia 25.7% and osteoporosis 17.1%). The majority was asymptomatic (68.1%) in the last visit and 21.7% reported asthenia. After diagnosis, 54.3% had readmissions (24.3% more than 3 times). The mortality was 7.1%, being the most frequent oncologic cause.

Conclusions: Surgery on the selar area represents an important cause of hypopituitarism. Most of them had excess weight, dyslipidemia, and decreased bone mass. Mortality was mainly secondary to oncological causes.

Keywords: hypopituitarism, pituitary, adenoma.