Top

Published in:

01-12-2024 | Pituitary Adenoma | Original Article

Improvement of metabolic syndrome and its components in patients who underwent transsphenoidal resection for pituitary adenoma

Authors: A. P. Cortés-Contreras, A. Salazar-Pigeon, J. A. González-Almazán, R. Flores-Rabasa, J. L. Navarro-Olvera, L. A. Méndez-García, J. D. Carrillo-Ruiz

Published in: Acta Neurochirurgica | Issue 1/2024

Abstract

Background

Pituitary adenomas (PA) are neoplasms of pituitary adenohypophyseal cell lineage, which are the third most common cause of brain tumors among adults. Due to hormone secretion, PAs are closely related to metabolic syndrome (MetS). However, the relationship between these two entities has been scarcely studied to date.

Purpose

This paper aims to evaluate changes in the metabolic status of patients with PA before and after surgical treatment and to look for differences in metabolic outcomes among patients according to the adenoma type and the surgery success rate.

Methods

We assessed patients with PA who went through transsphenoidal surgery for its treatment, documenting metabolic parameters before and after surgery, analyzed whole sample changes, and then stratified them according to adenoma type (nonfunctioning, somatotroph, lactotroph, and corticotroph), and surgery success (total resection, near-total resection, partial resection, subtotal resection).

Results

A total of 214 patients were enrolled for this study. The prevalence of MetS with AACE criteria went from 51.52% before surgery to 28.99% after surgery (P < 0.001). Hyperglycemia (HG) was the most beneficial component; it went from 56% pre-surgery to 40.51% post-surgery (P = 0.03). The total resection group had the best improvement, with a significant decrease of prevalence in MetS from 83 to 16% (P < 0.001), and every component, except hypoalphalipoproteinemia (HA): obesity went from 96 to 67% (P < 0.001), arterial hypertension (AH) 59 to 24% (P < 0.001), HG 74 to 23% (P < 0.001), and hypertriglyceridemia (HTG) from 81 to 54% (P < 0.001). According to MetS prevalence, there was no difference in the improvement according to PA type.

Conclusion

Surgical treatment in patients with PA is associated with MetS improvement.

Altuntaś SÇ, Evran M, Sert M, Tetiker T (2019) Markers of metabolic syndrome in patients with pituitary adenoma: a case series of 303 patients. Horm Metab Res. https://doi.org/10.1055/a-1020-3992CrossRefPubMed

American Diabetes Association (2020) Classification and diagnosis of diabetes: standards of medical care in diabetes. Diabetes Care 43(Supplement_1):S14–S31CrossRefMATH

Ausiello JC, Bruce JN, Freda PU (2008) Postoperative assessment of the patient after transsphenoidal pituitary surgery. Pituitary. https://doi.org/10.1007/s11102-008-0086-6CrossRefPubMed

Baba N, Kameda H, Nakamura A, Cho KY, Nomoto H, Mitsuhashi T, Atsumi T (2021) Silent pituitary adenoma and metabolic disorders: obesity, abnormal glucose tolerance, hypertension and dyslipidemia. Endocr J. https://doi.org/10.1507/endocrj.EJ20-0185CrossRefPubMed

Ben-Jonathan N, Hugo ER, Brandebourg TD, LaPensee CR (2006) Focus on prolactin as a metabolic hormone. TEM. https://doi.org/10.1016/j.tem.2006.02.005CrossRefPubMed

Bloomgarden ZT (2002) American Association of Clinical Endocrinologists (AACE) Consensus Conference on the Insulin Resistance Syndrome25–26 August 2002, Washington, DC. Diabetes Care. https://doi.org/10.2337/DIACARE.26.4.1297CrossRefPubMed

Cheng S, Al-Agha R, Araujo PB, Serri O, Asa SL, Ezzat S (2013) Metabolic glucose status and pituitary pathology portend therapeutic outcomes in acromegaly. PLoS ONE. https://doi.org/10.1371/journal.pone.0073543CrossRefPubMedPubMedCentral

Ciric I, Ragin A, Baumgartner C, Pierce D (1997) Complications of transsphenoidal surgery: results of a national survey, review of the literature, and personal experience. Neurosurgery. https://doi.org/10.1097/00006123-199702000-00001CrossRefPubMed

Fode NC, Laws ER, Northcutt RC (1983) Pituitary tumors and hypertension. J Neurosurg Nurs 15:33–35CrossRefPubMed

10.

Gutiérrez-Solis AL, Datta Banik S, Méndez-González RM (2017) Prevalence of metabolic syndrome in Mexico: a systematic review and meta-analysis. Metab Syndr Relat Disord. https://doi.org/10.1089/met.2017.0157CrossRefMATH

11.

Harbeck B, Danneberg S, Rahvar AH, Mönig H, Haas SC (2016) Prevalence and predictors of overweight and obesity in patients with pituitary dysfunctions. Endocr Metab Immune Disord Drug Targets. https://doi.org/10.2174/18715303166661611301608CrossRefPubMed

12.

Huang PL (2009) A comprehensive definition for metabolic syndrome. DMM. https://doi.org/10.1242/dmm.001180CrossRefPubMedPubMedCentralMATH

13.

Iglesias P, Villabona C, Díez JJ (2016) Concentraciones séricas de glucosa, colesterol y triglicéridos en varones con prolactinoma tratados con cabergolina. Med Clin. https://doi.org/10.1016/j.medcli.2016.05.025CrossRef

14.

Joustra SD, Claessen KM, Dekkers OM, van Beek AP, Wolffenbuttel BH, Pereira AM, Biermasz NR (2014) High prevalence of metabolic syndrome features in patients previously treated for nonfunctioning pituitary macroadenoma. PLoS One. https://doi.org/10.1371/journal.pone.0090602CrossRefPubMedPubMedCentral

15.

Leães CG, Fernandes MV, Alves L, Araújo B, Rech CG, Ferreira NP, Oliveira MC (2019) Assessment of anthropometric and physical health indicators before and after pituitary surgery in patients with nonfunctioning pituitary adenomas, acromegaly, and Cushing disease. Indian J Endocrinol Metab. https://doi.org/10.4103/ijem.IJEM_301_19CrossRefPubMedPubMedCentral

16.

Lim CT, Korbonits M (2018) Update on the clinicopathology of pituitary adenomas. Endoc Pract. https://doi.org/10.4158/EP-2018-0034CrossRefMATH

17.

Melmed S (2020) Pituitary-tumor endocrinopathies. NEJM. https://doi.org/10.1056/nejmra1810772CrossRefPubMed

18.

Miya A, Nakamura A, Miyoshi H, Kameda H, Nomoto H, Nagai S, Atsumi T (2015) Glucose tolerance is improved following surgery for silent somatotroph adenoma. Int J Diabetes Clin ReS. https://doi.org/10.23937/2377-3634/1410047CrossRef

19.

Nilsson L, Binart N, Bohlooly-Y M, Bramnert M, Egecioglu E, Kindblom J, Billig H (2005) Prolactin and growth hormone regulate adiponectin secretion and receptor expression in adipose tissue. BBRC. https://doi.org/10.1016/j.bbrc.2005.04.026CrossRefPubMed

20.

Park S, Blumenthal J, Lee S, Georgiades A (2011) Association of cortisol and the metabolic syndrome in Korean men and women. J Korean Med Sci 26:914–918CrossRefPubMedPubMedCentral

21.

Pérez-López C, Palpán AJ, Saez-Alegre M, Zamarrón Á, Alfonso C, Álvarez-Escola C, Isla A (2021) Volumetric study of nonfunctioning pituitary adenomas: predictors of gross total resection. World Neurosurg. https://doi.org/10.1016/j.wneu.2020.12.020CrossRefPubMed

22.

Posawetz AS, Trummer C, Pandis M, Aberer F, Pieber TR, Obermayer-Pietsch B, Theiler-Schwetz V (2021) Adverse body composition and lipid parameters in patients with prolactinoma: a case-control study BMC. Endocr Disord. https://doi.org/10.1186/s12902-021-00733-6CrossRef

23.

Rabinowitz D, Zierler KL (1963) A metabolic regulating device based on the actions of human growth hormone and of insulin, singly and together, on the human forearm. Nature 199(4896):913–915ADSCrossRefPubMedMATH

24.

Schwetz V, Librizzi R, Trummer C, Theiler G, Stiegler C, Pieber TR, Pilz S (2017) Treatment of hyperprolactinemia reduces total cholesterol and LDL in patients with prolactinomas. Metab Brain Dis. https://doi.org/10.1007/s11011-016-9882-2CrossRefPubMed

25.

Vargas-Ortega G, González-Virla B, Balcázar-Hernández L, Nieto-Guzmán O, Garrido-Mendoza AP, Flores-Maya MA, Mendoza-Zubieta V (2018) Cardiovascular risk and metabolic syndrome characteristics in patients with nonfunctional pituitary macroadenoma. Int J Endocrinol. https://doi.org/10.1155/2018/2852710CrossRefPubMedPubMedCentral

26.

Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, Wright JT (2018) 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. https://doi.org/10.1161/HYP.0000000000000065/-/DC1CrossRefPubMed

27.

Zheng X, Li S, Zhang WH, Yang H (2015) Metabolic abnormalities in pituitary adenoma patients: a novel therapeutic target and prognostic factor. Diabetes Metab Syndr Obes: Targets Ther. https://doi.org/10.2147/DMSO.S86319CrossRef

Title: Improvement of metabolic syndrome and its components in patients who underwent transsphenoidal resection for pituitary adenoma
Authors: A. P. Cortés-Contreras
A. Salazar-Pigeon
J. A. González-Almazán
R. Flores-Rabasa
J. L. Navarro-Olvera
L. A. Méndez-García
J. D. Carrillo-Ruiz
Publication date: 01-12-2024
Publisher: Springer Vienna
Keywords: Pituitary Adenoma
Arterial Hypertension
Arterial Hypertension
Hyperglycemia
Obesity
Obesity
Published in: Acta Neurochirurgica / Issue 1/2024
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-024-05938-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Improvement of metabolic syndrome and its components in patients who underwent transsphenoidal resection for pituitary adenoma

Abstract

Background

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2024

Internal carotid artery-persistent primitive anterior choroidal artery aneurysms: report of two cases and literature review

Retraction Note: Magnesium lithospermate B alleviates the production of endothelin-1 through an NO-dependent mechanism and reduces experimental vasospasm in rats

Takanori Fukushima 1942 – 2024

How I do it: hearing preservation in large vestibular schwannomas using vestibular nerve fiber preservation technique

Extended reality in cranial and spinal neurosurgery – a bibliometric analysis

Biportal endoscopy-assisted lateral mass screw fixation using a third portal