Endocrine Abstracts

Objective: To assess the prevalence of obesity and metabolic disorders in patients with non-functional pituitary adenomas (NFPA)

Patients and methods: A retrospective descriptive study of 35 patients followed for NFPA between 2000 and 2022. Metabolic syndrome was established according to the National Cholesterol Education Program Adult Treatment Panel III criteria.

Results: The mean age was 52.1±11.4 years, with a male predominance (61.3%). Ninety percent were macroadenomas. The mean weight was 76.8±15 kg corresponding to a mean BMI of 28.3±5 kg/m². Obesity (40%) or overweight (26.7%) was frequently reported. The majority of obese patients were classified as grade 1 (66.7%). The mean waist circumference was 99.8±13.4 cm with an android distribution of fat in 54.5% of the patients with NFPAs. The frequency of hypertension was 16.1%. Glucose metabolism disorders were diagnosed in 34.5% of patients with a mean fasting blood glucose level of 5.7±2.4 mmol/l. Lipid metabolism was disturbed in 53.8% of cases. HypoHDLaemia and hypertriglyceridemia were observed in 36.4% and 11.5% of cases, respectively. Mixed hyperlipidemia affected 15.4% of patients. The overall prevalence of metabolic syndrome in our series is estimated at 16.7%.

Discussion: The mass effect of NFPAs is thought to be the cause of numerous hypothalamic dysregulations altering the biological circadian rhythm (waking-sleep, hunger-satiety, energy balance, etc\..). These hypothalamic disturbances aggravate the metabolic risk in this population, who is particularly exposed to obesity and dyslipidemia. This situation would be further exacerbated by physiologically imperfect (glucocorticoids) or neglected (GH substitution) hormone substitutions.

References: 1. Zheng, Xin, et al. “Metabolic abnormalities in pituitary adenoma patients: a novel therapeutic target and prognostic factor.” Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 8 (2015): 357.

2. Di Somma, C., et al. “Is there any gender difference in epidemiology, clinical presentation, and co-morbidities of non-functioning pituitary adenomas? A prospective survey of a National Referral Center and review of the literature.” Journal of Endocrinological Investigation 44.5 (2021): 957–968.