Pre- and post-clinical-radiological and surgical evaluation of patients with pituitary adenoma and metabolic syndrome.

in The International journal of neuroscience by R Flores-Rabasa, J A González-Almazán, A P Cortés-Contreras, L A Méndez-García, F Velasco, J L Navarro-Olvera, G Aguado-Carrillo, A Benítez-Gasca, J D Carrillo-Ruiz

TLDR

  • The study found that pituitary adenoma surgery can reduce the size of the tumor, lower levels of glucose, triglycerides, and c-HDL in the blood, and improve the classification of the tumor. This suggests that pituitary adenoma surgery can improve the health of people with metabolic syndrome and reduce the risk of related diseases.

Abstract

Pituitary adenomas are benign tumors located in the anterior hypophysis. Its appearance is associated with the development of parameters related to metabolic syndrome; therefore, surgical treatment could reduce associated morbimortality. Pre- and post-surgical MRI, using the Hardy-Wilson and Knosp classification, and clinical data according to the American Association of Clinical Endocrinology (AACE) criteria for metabolic syndrome: all the patients were followed-up until 208.57 days were reviewed on 217 consecutive patients with pituitary surgery. Seventy-four patients were included in this study. There was a significant reduction in tumor size in mm[average pre- and post-surgery respectively: 12,362 mm(±12,397); 3,910 mm(±7,160)], (< 0.0001). This was confirmed by the Hardy-Wilson and Knosp classification, where most patients went from grade IV C (33.7%) to grade 0 (12.1%), IA (20.2%), IIB (21.36%), and IIC (16.2%); as well as from grade 4 (24.3%) to grade 0 (45.9%), respectively. After surgery, there were statistically significant reductions in total serum levels of glucose [average pre- and post-surgery, respectively: 116 mg/dL (±26.9); 90 mg/dL (±10.2)], (< 0.001), triglycerides [average pre- and post-surgery, 240 mg/dL (±102); 171 mg/dL (±60.5)], (= 0.001); and HDL-c [average pre- and post-surgery, respectively: 39 mg/dL (±11.8); 44.6 mg/dL (±8.4)], (= 0.029). The other parameters remained unchanged. This is the first study to demonstrate the relationship between the presence of pituitary adenoma and significative changes in serum glucose, triglycerides and c-HDL related to metabolic syndrome.

Overview

  • The study focuses on the relationship between pituitary adenomas and significant changes in serum glucose, triglycerides, and c-HDL related to metabolic syndrome. The hypothesis being tested is whether surgical treatment of pituitary adenomas can reduce associated morbidity and mortality. The methodology used for the experiment includes pre- and post-surgical MRI using the Hardy-Wilson and Knosp classification, and clinical data according to the American Association of Clinical Endocrinology (AACE) criteria for metabolic syndrome. The primary objective of the study is to determine the impact of pituitary adenoma surgery on metabolic syndrome parameters and associated morbidity and mortality.

Comparative Analysis & Findings

  • The study found a significant reduction in tumor size, total serum levels of glucose, triglycerides, and c-HDL after pituitary adenoma surgery. The Hardy-Wilson and Knosp classification showed a significant reduction in the grade of tumors, with most patients going from grade IV C to grade 0. The study also found that the other parameters remained unchanged. These findings suggest that pituitary adenoma surgery can have a positive impact on metabolic syndrome parameters and associated morbidity and mortality.

Implications and Future Directions

  • The study's findings have significant implications for the field of research and clinical practice. The study provides evidence that pituitary adenoma surgery can have a positive impact on metabolic syndrome parameters and associated morbidity and mortality. Future research could explore the long-term effects of pituitary adenoma surgery on metabolic syndrome parameters and associated morbidity and mortality. The study also highlights the importance of using the Hardy-Wilson and Knosp classification for evaluating pituitary adenomas and their impact on metabolic syndrome parameters.
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