Long-term cardiometabolic outcome in patients with pituitary adenoma diagnosed in chilhood and adolescence

• Published in: Pituitary Vol. 24; no. 4; pp. 483 - 491
• Main Authors: Giovinazzo, Salvatore, Puglisi, Soraya, Cotta, Oana R., Alibrandi, Angela, Aversa, Tommaso, Cannavò, Laura, Ferraù, Francesco, Cannavò, Salvatore
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.08.2021; Springer Nature B.V
• Subjects: Adenoma; Adolescents; Adrenocorticotropic hormone; Body weight; Brain cancer; Brain tumors; Child development; Children; Complications; Diagnosis; Endocrinology; Growth hormone; Human Physiology; Medicine; Medicine & Public Health; Metabolism; Obesity; Overweight; Patients; Pituitary; Pituitary gland; Pituitary hormones; Prolactin; Remission; Tumors; Body mass index; Cardiometabolic; Hypopituitarism; Pediatric pituitary tumor; Pituitary adenoma
• ISSN: 1386-341X; 1573-7403
• DOI: 10.1007/s11102-020-01123-2

Purpose Pituitary adenomas (PAs) rarely occur in childhood and adolescence. Management of PAs in this critical age can be particularly challenging considering the auxological sequelae and potential long-term cardiometabolic consequences. We aimed to describe the clinical characteristics of patients with PA aged < 18years at diagnosis and during long-term follow-up, focusing on the prevalence of cardio-metabolic comorbidities and the impact of different therapeutic strategies. Methods Clinical data at diagnosis and at last follow-up visit (mean 10.3 ± 9.2 years) of 101 patients aged < 18 years with PA, referred to our University Hospital from 1990 to 2017, were retrospectively evaluated. Results At diagnosis, 11.9% of patients presented with pituitary hormone deficiencies, whose number was positively correlated with pituitary tumor diameter ( p  < 0.001). At diagnosis, 26.7% of patients were overweight and 15.8% were obese. In patients with hypercortisolism or GH excess the prevalence of obesity was more than 2-fold greater than in general population. No correlation was found between pituitary tumor size and BMI. At baseline, the greater the number of pituitary hormone deficits, the higher BMI ( p  = 0.039). In prolactinoma patients still on medical therapy at last visit, BMI was higher than at baseline. Conclusion We found an increased prevalence of overweight/obesity only in pediatric and adolescent patients with GH- or ACTH-secreting PA. Regarding cardio-metabolic comorbidities other than obesity/overweight, we have not found anything worth of mention. The remission of hypercortisolism positively impacted on BMI, while medical therapy in patients with prolactinoma seemed unable to avoid weight gain, suggesting a careful metabolic management of these patients.