High prevalence of metabolic syndrome features in patients previously treated for nonfunctioning pituitary macroadenoma.

<h4>Objective</h4>Patients treated for nonfunctioning pituitary macroadenoma (NFMA) with suprasellar extension show disturbed sleep characteristics, possibly related to hypothalamic dysfunction. In addition to hypopituitarism, both structural hypothalamic damage and sleep restriction per...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Sjoerd D Joustra, Kim M J A Claessen, Olaf M Dekkers, André P van Beek, Bruce H R Wolffenbuttel, Alberto M Pereira, Nienke R Biermasz
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/acffa1a69b6d4cc3b2c3078a1bc72ce9
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:acffa1a69b6d4cc3b2c3078a1bc72ce9
record_format	dspace
spelling	oai:doaj.org-article:acffa1a69b6d4cc3b2c3078a1bc72ce92021-11-18T08:29:09ZHigh prevalence of metabolic syndrome features in patients previously treated for nonfunctioning pituitary macroadenoma.1932-620310.1371/journal.pone.0090602https://doaj.org/article/acffa1a69b6d4cc3b2c3078a1bc72ce92014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24608862/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>Patients treated for nonfunctioning pituitary macroadenoma (NFMA) with suprasellar extension show disturbed sleep characteristics, possibly related to hypothalamic dysfunction. In addition to hypopituitarism, both structural hypothalamic damage and sleep restriction per se are associated with the metabolic syndrome. However, the prevalence of the metabolic syndrome in patients with NFMA is not well established. Our objective was to study the prevalence and risk factors for (components of) the metabolic syndrome in patients treated for NFMA.<h4>Design</h4>The metabolic syndrome (NCEP-ATP III criteria) was studied in an unselected cohort of 145 NFMA patients (aged 26-88yr, 44% female) in long-term remission after treatment, receiving adequate stable hormone replacement for any pituitary deficiencies. The results were compared to population data of 63,995 Dutch inhabitants by standardization (LifeLines cohort study).<h4>Results</h4>NFMA patients showed increased risk for reduced HDL-cholesterol (SMR 1.59, 95% CI 1.13-2.11), increased triglyceride levels (SMR 2.31, 95% CI 1.78-2.90) and the metabolic syndrome (SMR 1.60, 95% CI 1.22-2.02), but not for increased blood pressure, waist circumference or hyperglycemia. Preoperative visual field defects independently affected the risk for increased blood pressure (OR 6.5, 95% CI 1.9-22.2), and hypopituitarism was associated with a body mass index - dependent risk for increased waist circumference (OR 1.6, 95% CI 1.2-2.2) and the metabolic syndrome (OR 1.4, 95% CI 1.0-1.9).<h4>Conclusions</h4>Patients treated for NFMA are increased at risk for developing the metabolic syndrome, mainly due to decreased HDL-cholesterol and increased triglycerides. Risk factors included hypopituitarism and preoperative visual field defects. Hypothalamic dysfunction may explain the metabolic abnormalities, in addition to intrinsic imperfections of hormone replacement therapy. Additional research is required to explore the relation between derangements in circadian rhythmicity and metabolic syndrome in these patients.Sjoerd D JoustraKim M J A ClaessenOlaf M DekkersAndré P van BeekBruce H R WolffenbuttelAlberto M PereiraNienke R BiermaszPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 3, p e90602 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sjoerd D Joustra Kim M J A Claessen Olaf M Dekkers André P van Beek Bruce H R Wolffenbuttel Alberto M Pereira Nienke R Biermasz High prevalence of metabolic syndrome features in patients previously treated for nonfunctioning pituitary macroadenoma.
description	<h4>Objective</h4>Patients treated for nonfunctioning pituitary macroadenoma (NFMA) with suprasellar extension show disturbed sleep characteristics, possibly related to hypothalamic dysfunction. In addition to hypopituitarism, both structural hypothalamic damage and sleep restriction per se are associated with the metabolic syndrome. However, the prevalence of the metabolic syndrome in patients with NFMA is not well established. Our objective was to study the prevalence and risk factors for (components of) the metabolic syndrome in patients treated for NFMA.<h4>Design</h4>The metabolic syndrome (NCEP-ATP III criteria) was studied in an unselected cohort of 145 NFMA patients (aged 26-88yr, 44% female) in long-term remission after treatment, receiving adequate stable hormone replacement for any pituitary deficiencies. The results were compared to population data of 63,995 Dutch inhabitants by standardization (LifeLines cohort study).<h4>Results</h4>NFMA patients showed increased risk for reduced HDL-cholesterol (SMR 1.59, 95% CI 1.13-2.11), increased triglyceride levels (SMR 2.31, 95% CI 1.78-2.90) and the metabolic syndrome (SMR 1.60, 95% CI 1.22-2.02), but not for increased blood pressure, waist circumference or hyperglycemia. Preoperative visual field defects independently affected the risk for increased blood pressure (OR 6.5, 95% CI 1.9-22.2), and hypopituitarism was associated with a body mass index - dependent risk for increased waist circumference (OR 1.6, 95% CI 1.2-2.2) and the metabolic syndrome (OR 1.4, 95% CI 1.0-1.9).<h4>Conclusions</h4>Patients treated for NFMA are increased at risk for developing the metabolic syndrome, mainly due to decreased HDL-cholesterol and increased triglycerides. Risk factors included hypopituitarism and preoperative visual field defects. Hypothalamic dysfunction may explain the metabolic abnormalities, in addition to intrinsic imperfections of hormone replacement therapy. Additional research is required to explore the relation between derangements in circadian rhythmicity and metabolic syndrome in these patients.
format	article
author	Sjoerd D Joustra Kim M J A Claessen Olaf M Dekkers André P van Beek Bruce H R Wolffenbuttel Alberto M Pereira Nienke R Biermasz
author_facet	Sjoerd D Joustra Kim M J A Claessen Olaf M Dekkers André P van Beek Bruce H R Wolffenbuttel Alberto M Pereira Nienke R Biermasz
author_sort	Sjoerd D Joustra
title	High prevalence of metabolic syndrome features in patients previously treated for nonfunctioning pituitary macroadenoma.
title_short	High prevalence of metabolic syndrome features in patients previously treated for nonfunctioning pituitary macroadenoma.
title_full	High prevalence of metabolic syndrome features in patients previously treated for nonfunctioning pituitary macroadenoma.
title_fullStr	High prevalence of metabolic syndrome features in patients previously treated for nonfunctioning pituitary macroadenoma.
title_full_unstemmed	High prevalence of metabolic syndrome features in patients previously treated for nonfunctioning pituitary macroadenoma.
title_sort	high prevalence of metabolic syndrome features in patients previously treated for nonfunctioning pituitary macroadenoma.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/acffa1a69b6d4cc3b2c3078a1bc72ce9
work_keys_str_mv	AT sjoerddjoustra highprevalenceofmetabolicsyndromefeaturesinpatientspreviouslytreatedfornonfunctioningpituitarymacroadenoma AT kimmjaclaessen highprevalenceofmetabolicsyndromefeaturesinpatientspreviouslytreatedfornonfunctioningpituitarymacroadenoma AT olafmdekkers highprevalenceofmetabolicsyndromefeaturesinpatientspreviouslytreatedfornonfunctioningpituitarymacroadenoma AT andrepvanbeek highprevalenceofmetabolicsyndromefeaturesinpatientspreviouslytreatedfornonfunctioningpituitarymacroadenoma AT brucehrwolffenbuttel highprevalenceofmetabolicsyndromefeaturesinpatientspreviouslytreatedfornonfunctioningpituitarymacroadenoma AT albertompereira highprevalenceofmetabolicsyndromefeaturesinpatientspreviouslytreatedfornonfunctioningpituitarymacroadenoma AT nienkerbiermasz highprevalenceofmetabolicsyndromefeaturesinpatientspreviouslytreatedfornonfunctioningpituitarymacroadenoma
_version_	1718421761234567168

High prevalence of metabolic syndrome features in patients previously treated for nonfunctioning pituitary macroadenoma.

Ejemplares similares