Clinical Features And Influencing Factors Of Metabolic Syndrome In Patients With Pituitary Adenomas

Objective: This thesis aims to clarify the condition,clinical features and influencing factors of metabolic syndrome in patients with pituitary adenomas,to improve clinicians’ understanding of pituitary adenomas combined with metabolic syndrome,and to provide a basis for clinical diagnosis and treatment of such patients.Methods: The clinical data of 210 patients with pituitary adenoma treated by surgery in the Department of Neurosurgery,the Second Hospital of Lanzhou University from May 2021 to March 2023 were retrospectively analyzed,including gender,age,clinical manifestations,height,weight,blood pressure,blood sugar,blood lipid,hormone level and other laboratory tests,MRI/CT and histopathological examinations.The clinical data were analyzed by SPSS 26.0 statistical software,and to further explore the clinical characteristics and influencing factors of patients with pituitary adenoma complicated with metabolic syndrome.Results:1.A total of 210 patients with pituitary adenoma were included in this study,including 114 males(54.29%)and 96 females(45.71%).Among them,the ratio of male to female was 1.19,the median age was 52.50(42.00,58.25)years.Among the 210 cases with pituitary adenoma,66 cases(31.43%)were with metabolic syndrome(MS),and144 cases(68.57%)were without MS;102(48.57%)were overweight and obese,89(42.38%)had hypertension,32(15.24%)had hyperglycemia;90(42.86%)had hypertriglyceridemia and 104(49.52%)had low High density lipoprotein cholesterol(HDL-C).Among the 66 cases of pituitary adenoma with MS,43(65.15%)cases had three MS components,17(25.76%)had four MS components and 6(9.09%)had five MS components.2.Compared with patients in the non-MS group,the proportions of patients in the MS group with endocrine symptoms,with FPA,preoperative hypopituitarism and with pituitary apoplexy were higher,and the levels of body mass index(BMI),blood pressure,fasting blood glucose(FPG),TG and uric acid(UA)were higher,while the levels of HDL-C and LH were lower,and the difference was statistically significant(P<0.05).3.The incidence of MS and its components including overweight and obesity,hyperglycemia and hypertriglyceridemia in patients with FPA was higher than that in patients with NFPA,and the incidence of overweight and obesity,hyperglycemia,MS and the number of its components were significantly different between the two groups(P<0.05).4.Furthermore,the included population was divided into three groups: functional somatotroph adenoma,functional lactotroph adenoma and NFPA.A total of 185 patients with pituitary adenoma were included,with 37 cases(20.00%),25 cases(13.51%)and 123 cases(66.49%)in the three groups respectively.There were significant differences in sex,age,course of disease,combined with MS,BMI,FPG and UA among the three groups(P<0.05).The number of female patients with somatotroph adenoma was significantly higher than that with NFPA(P=0.004).The age of patients with NFPA was significantly higher than that of somatotroph adenoma and lactotroph adenoma(P<0.001),but the course of disease was significantly shorter than that of them(P=0.001).In terms of metabolic parameters,compared with NFPA,the proportion of MS(P=0.016)and the level of BMI(P=0.022)in patients with somatotroph adenoma were higher.Compared with somatotroph adenoma,the level of FPG in lactotroph adenomas and NFPA was lower(P<0.001),but the level of UA was higher(P<0.05).5.The independent risk factors of pituitary adenoma with MS were UA increased(OR=1.007,95%CI 1.003～1.011,P=0.001),FPA(OR=3.254,95%CI 1.632～6.491,P=0.001),hypopituitarism before operation(OR=2.995,95%CI 1.430～6.272,P=0.004)and pituitary apoplexy(OR=2.627,95%CI 1.034～6.675,P=0.042).Conclusion: Before surgical treatment,31.43% of patients with pituitary adenoma complicated with MS,and most of them had different degrees of metabolic abnormalities.UA increased,FPA,preoperative hypopituitarism and pituitary apoplexy may be independent risk factors for patients with pituitary adenoma complicated with MS.