Cardiovascular risk profile in Growth Hormone treated adults with a craniopharyngioma compared to a non-functioning pituitary adenoma: a national cohort study

2021 ◽  
Author(s):  
Tim Verweij ◽  
Tessa N.A. Slagboom ◽  
Nadège C. van Varsseveld ◽  
Aart-Jan Van der Lely ◽  
Madeleine L Drent ◽  
...  

Context: Cardiovascular risk profile might differ between growth hormone treated patients with a craniopharyngioma and a non-functioning pituitary adenoma (NFPA), since patients with craniopharyngioma more frequently suffer from hypothalamic metabolic disruption. Objective: The aim of this study is to investigate cardiovascular risk profile in adult patients with a craniopharyngioma compared to NFPA before and after treatment with growth hormone replacement therapy due to severe GH deficiency. Design: A sub-analysis of the Dutch National Registry of Growth Hormone Treatment in Adults was performed, in which we compared 291 patients with craniopharyngioma to 778 patients with NFPA. Cardiovascular risk profile and morbidity was evaluated at baseline and during long-term follow-up within and between both groups. Results: At baseline, patients with craniopharyngioma demonstrated higher BMI than patients with NFPA and men with craniopharyngioma showed greater waist circumference and lower HDL compared to men with a NFPA. During follow-up, BMI, as well as diastolic blood pressure among patients using antihypertensive drugs, deteriorated in the craniopharyngioma group compared to the NFPA group. Lipid profile improved similarly in both groups over time. No differences were found between groups in the occurrence of diabetes mellitus, cerebrovascular accidents, cardiovascular disease, or in overall mortality. Conclusion: This study suggests that overall cardiovascular risk profile is worse in craniopharyngioma patients with growth hormone deficiency compared to patients with NFPA. During growth hormone replacement therapy, patients with craniopharyngioma demonstrated an increase in BMI over time, where BMI remained stable in patients with NFPA. Also, diastolic blood pressure did not improve with antihypertensive drugs in craniopharyngioma as seen in patients with NFPA.

Metabolism ◽  
2008 ◽  
Vol 57 (1) ◽  
pp. 121-129 ◽  
Author(s):  
Maria Claudia Peixoto Cenci ◽  
Flávia Lúcia Conceição ◽  
Débora Vieira Soares ◽  
Luciana Diniz Carneiro Spina ◽  
Rosane Resende de Lima Oliveira Brasil ◽  
...  

Author(s):  
Breanna L. Sheldon ◽  
Michael W. O’Brien ◽  
Matthew A. Adamo

Abstract Objectives Small pituitary cysts are commonly discovered on pediatric brain magnetic resonance imagings (MRIs), particularly in patients with growth hormone deficiency (GHD). We examined the need for operative management in children with these masses as well as the effect of growth hormone replacement (GHR) on these lesions. Methods This was a retrospective review of pituitary protocol MRIs conducted in children 0–19 at a single center between April 2010–November 2020. Sex, indication for initial MRI, volume, and whether surgery was performed was determined. Records were reviewed to determine whether GHD was present and treatment with GHR documented. For patients with subsequent MRIs, volume on most recent scan was calculated. Results Of the 101 children with cysts, 25 had laboratory-confirmed GHD and 76 did not. GHD patients had a higher mean age compared to no growth hormone deficiency (NGHD) cohort (11.2 and 8.4 years, respectively; p=0.02) and a larger proportion of males (p<0.001). The mean cyst volume on initial MRI was not significantly smaller in patients with GHD (0.063 ± 0.012 cm3) vs. those without GHD (0.171 ± 0.039 cm3, p=0.11). Of the 21 GHD patients who received GHR and had follow-up MRIs, 10 had no change in pituitary cyst size, two had cysts that shrank, and seven disappeared. The remaining two cysts enlarged an average of 0.061 ± 0.033 cm3. Zero GHR recipients required surgical intervention. Conclusions Small sellar cysts discovered incidentally on imaging in children are unlikely to require surgical intervention. GHR does not appear to significantly enlarge these pediatric pituitary lesions and is safe for use.


2016 ◽  
Vol 60 (6) ◽  
pp. 596-600 ◽  
Author(s):  
Natasha G. Ludwig ◽  
Rafael F. Radaeli ◽  
Mariana M. X. Silva ◽  
Camila M. Romero ◽  
Alexandre J. F. Carrilho ◽  
...  

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