Spanish Researchers Characterize Prevalence of Hypopituitarism in Their Population

   Spanish researchers have shown the prevalence of hypopituitarism in their general population to be 44.4 per 100,000 inhabitants, with most of cases due to a pituitary tumor or its treatment. They presented the results of their study at ENDO 2011: the 93rd Annual Meeting & Expo of the Endocrine Society in Boston.

   Hypopituitarism is associated with an increased prevalence of cardiovascular risk factors and premature death. Investigators from Hospital Clinico Universitario at Santiago de Compostela  performed a retrospective review of a large series of adult patients with hypopituitarism, analyzing its prevalence, association with cardiovascular risk factors, and mortality.

   There were 180 adult hypopituitary patients (58.1% female) from a population of 405,218 inhabitants (prevalence 44.4/100,000), who were followed for 10 years. The mean age at diagnosis was 45.2 +/-21.2 years (3-81). Following data analysis, the researchers found that the most frequent cause of hypopituitarism was a pituitary tumor and/or its treatment (80 cases, 44.6%), most of them non-functioning tumors (45 cases, 56.2%). Seventy-five percent were macroadenomas (mean size 27.9 +/-11.3mm, 4-51); 82 patients (45.6%) underwent surgery and 48 (26.7%) were irradiated. Pituitary deficiencies on follow-up were: FSH/LH (78.9%), TSH (71.1%), ACTH (59.4%), GH (55%), and ADH (18.9%).

   The degree of hypopituitarism (number of affected axes) was associated with radiotherapy (P<0.01) but not with the etiology of hypopituitarism or surgery. Sixteen percent of patients had diabetes, 34% hypertension, 38% hyperlipidemia, 16% cardiovascular disease, and 54% obesity. Seven patients died during follow-up (48.1% female). There was an association between mortality and radiotherapy (P<0.001), degree of hypopituitarism (P<0.01), glucocorticoid doses (P=0.02), diabetes (P<0.001), hypertension (P<0.001), hyperlipidemia (P=0.02), and previous cardiovascular disease (P=0.03).

   As noted, most of cases of hypopituitarism devolved from a pituitary tumor or its treatment. The Spanish investigators concluded that cranial radiotherapy, degree of hypopituitarism, high substitutive steroid doses, and some cardiovascular risk factors (e.g., diabetes, hypertension, and hyperlipidemia) are related to mortality.