Cattedra di Endocrinologia, Sapienza Università di Roma, Rome, Italy.
Ann Ist Super Sanita. 2012;48(1):91-6. doi: 10.4415/ANN_12_01_15.
Primary empty sella (PES) is a particular anatomical condition characterized by the herniation of liquor within the sella turcica. The pathogenesis of this alteration, frequently observed in general population, is not yet completely understood. Recently reports demonstrated, in these patients, that hormonal pituitary dysfunctions, specially growth hormone (GH)/insulin- like growth factor (IGF-I) axis ones, could be relevant. The aim of this paper is to evaluate GH/IGF-I axis in a group of adult patients affected by PES and to verify its clinical relevance. We studied a population of 28 patients with a diagnosis of PES. In each patient we performed a basal study of thyroid, adrenal and gonadal - pituitary axis and a dynamic evaluation of GH/IGF-I after GH-releasing hormone (GHRH) plus arginine stimulation test. To evaluate the clinical significance of GH/IGF-I axis dysfunction we performed a metabolic and bone status evaluation in every patients. We found the presence of GH deficit in 11 patients (39.2%). The group that displayed a GH/IGF-I axis dysfunction showed an impairment in metabolic profile and bone densitometry. This study confirms the necessity to screen the pituitary function in patients affected by PES and above all GH/IGF-I axis. Moreover the presence of GH deficiency could be clinically significant.
原发性空蝶鞍（PES）是一种特殊的解剖学状态，其特征是鞍内脑脊液疝出。这种改变在普通人群中经常观察到，但发病机制尚不完全清楚。最近的报告表明，在这些患者中，垂体激素功能障碍，特别是生长激素（GH）/胰岛素样生长因子（IGF-I）轴的功能障碍，可能与之相关。本文旨在评估一组患有 PES 的成年患者的 GH/IGF-I 轴，并验证其临床相关性。我们研究了一组 28 例诊断为 PES 的患者。在每位患者中，我们进行了甲状腺、肾上腺和性腺-垂体轴的基础研究，并在 GH 释放激素（GHRH）加精氨酸刺激试验后进行了 GH/IGF-I 的动态评估。为了评估 GH/IGF-I 轴功能障碍的临床意义，我们对每位患者进行了代谢和骨状态评估。我们发现 11 例（39.2%）存在 GH 缺乏。显示 GH/IGF-I 轴功能障碍的组表现出代谢特征和骨密度测定值受损。本研究证实了在患有 PES 的患者中筛查垂体功能的必要性，尤其是 GH/IGF-I 轴。此外，GH 缺乏的存在可能具有临床意义。
