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Is there any gender difference in epidemiology, clinical presentation and co-morbidities of non-functioning pituitary adenomas? A prospective survey of a National Referral Center and review of the literature

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Abstract

Purpose

Gender differences in patients diagnosed with non-functioning Pituitary Adenomas (NFPA) in a National Referral Center for Pituitary Tumors at the Federico II University of Naples, Italy.

Methods

Patients newly diagnosed with non-functioning sellar masses found on pituitary Magnetic Resonance Imaging from January 1st 2016 to December 31th 2018 underwent anthropometric measurements, basal evaluation of pituitary function, and metabolic assessment. Fatty live index (FLI) and visceral adiposity index (VAI) were calculated.

Results

Seventy-three patients (35 males, 51.1 ± 17.0 years; 38 females, 41.8 ± 18.1 years) presented with NFPA. Lesions > 1 cm (85.7% vs. 47.3%; χ2 = 10.26, p = 0.001) and hypopituitarism (77.1% vs. 7.9%; χ2 = 33.29, p = 0.001) were more frequent in males than females. The highest sizes of pituitary adenomas were significantly associated with male gender (OR = 1.05, p = 0.049; R2 = 0.060; IC 1.00–1.10). Headache (62.8% vs. 31.6%; χ2 = 5.96, p = 0.015) and visual field deficits (57.1% vs. 26.3%; χ2 = 5.93, p = 0.015) were significantly more frequent in males than in females. There was no sex difference in obesity prevalence, but the metabolic syndrome was more common among males than females (60.6% vs. 26.3%; χ2 = 7.14, p = 0.001). FLI was also higher in males (69.6 ± 27.3 vs. 49.2 ± 31.3; p < 0.001), while there were no differences in VAI.

Conclusions

Apart from the possible delay in the diagnosis induced by the gender differences in symptom presentation, the higher prevalence of macroadenomas amongst NFPA in males compared with females let to hypothesize a key role of the sex hormone profile as predictive factors of their biological behavior and metabolic profile. Further studies are, however, mandatory to better support the influence of gender differences on onset, progression, and metabolic consequences of NFPA.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy

    C. Di Somma, E. Scarano, G. de Alteriis, L. Barrea, E. Riccio, R. Arianna, S. Savastano & A. Colao

  2. Department of Clinical Medicine and Surgery, Endocrinology Unit, Centro Italiano per la cura e il Benessere del paziente con obesità (C.I.B.O), University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy

    L. Barrea, S. Savastano & A. Colao

  3. Cattedra Unesco “Educazione alla salute e allo sviluppo sostenibile”, University Federico II, Naples, Italy

    A. Colao

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  1. C. Di Somma
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  2. E. Scarano
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  3. G. de Alteriis
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  4. L. Barrea
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Contributions

Conceptualization, CdS, SS and AM; data curation, ES and GdA; formal analysis, CdS, SS, and AC; funding acquisition, CdS, SS, and AC; investigation, ES, GdA, LB, ER, RA; methodology, CdS, SS and AM; writing—original draft, LB and SS; writing—review & editing, CdS, SS, and AC.

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Correspondence to C. Di Somma.

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The study design was made in accordance with the Helsinki II Declaration for Study on human experimentation and approved by the local ethic committee (n. 63/97).

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All patients signed their informed consent. Consent for publication: The study design was made in accordance with the Helsinki II Declaration for Study on human experimentation and approved by the local ethic committee (n. 63/97),

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Di Somma, C., Scarano, E., de Alteriis, G. et al. Is there any gender difference in epidemiology, clinical presentation and co-morbidities of non-functioning pituitary adenomas? A prospective survey of a National Referral Center and review of the literature. J Endocrinol Invest 44, 957–968 (2021). https://doi.org/10.1007/s40618-020-01379-2

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  • DOI: https://doi.org/10.1007/s40618-020-01379-2

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Article history

  1. Latest

    Is there any gender difference in epidemiology, clinical presentation and co-morbidities of non-functioning pituitary adenomas? A prospective survey of a National Referral Center and review of the literature
    • C. Di Somma
    • E. Scarano
    • G. de Alteriis
    • L. Barrea
    • E. Riccio
    • R. Arianna
    • S. Savastano
    • A. Colao
    Published:
    01 May 2021
    Received:
    23 June 2020
    Accepted:
    30 July 2020

    DOI: https://doi.org/10.1007/s40618-020-01379-2

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