Tanriverdi F, Dokmetas H S, Kebapcı N, Kilicli F, Atmaca H, Yarman S, Ertorer M E, Erturk E, Bayram F, Tugrul A, Culha C, Cakir M, Mert M, Aydin H, Taskale M, Ersoz N, Canturk Z, Anaforoglu I, Ozkaya M, Oruk G, Hekimsoy Z, Kelestimur F, Erbas T
Department of Endocrinology, Erciyes University Medical School, 38039, Kayseri, Turkey,
Endocrine. 2014 Sep;47(1):198-205. doi: 10.1007/s12020-013-0127-4. Epub 2013 Dec 24.
Hypopituitarism in adult life is commonly acquired and the main causes are known as pituitary tumors and/or their treatments. Since there are new insights into the etiology of hypopituitarism and presence of differences in various populations, more studies regarding causes of hypopituitarism are needed to be done in different ethnic groups with sufficient number of patients. Therefore, we performed a multi-center database study in Turkish population investigating the etiology of hypopituitarism in 773 patients in tertiary care institutions. The study was designed and coordinated by the Pituitary Study Group of SEMT (The Society of Endocrinology and Metabolism of Turkey). Nineteen tertiary reference centers (14 university hospitals and 5 training hospitals) from the different regions of Turkey participated in the study. It is a cross-sectional database study, and the data were recorded for 18 months. We mainly classified the causes of hypopituitarism as pituitary tumors (due to direct effects of the pituitary tumors and/or their treatments), extra-pituitary tumors and non-tumoral causes. Mean age of 773 patients (49.8 % male, 50.2 % female) was 43.9 ± 16.1 years (range 16-84 years). The most common etiology of pituitary dysfunction was due to non-tumoral causes (49.2 %) among all patients. However, when we analyze the causes according to gender, the most common etiology in males was pituitary tumors, but the most common etiology in females was non-tumoral causes. According to the subgroup analysis of the causes of hypopituitarism in all patients, the most common four causes of hypopituitarism which have frequencies over 10 % were as follows: non-secretory pituitary adenomas, Sheehan's syndrome, lactotroph adenomas and idiopathic. With regard to the type of hormonal deficiencies; FSH/LH deficiency was the most common hormonal deficit (84.9 % of the patients). In 33.8 % of the patients, 4 anterior pituitary hormone deficiencies (FSH/LH, ACTH, TSH, and GH) were present. Among all patients, the most frequent cause of hypopituitarism was non-secretory pituitary adenomas. However, in female patients, present study clearly demonstrates that Sheehan's syndrome is still one of the most important causes of hypopituitarism in Turkish population. Further, population-based prospective studies need to be done to understand the prevalence and incidence of the causes of hypopituitarism in different countries.
成人垂体功能减退症通常是后天获得的，主要病因是垂体肿瘤和/或其治疗。鉴于对垂体功能减退症病因有了新的认识，且不同人群存在差异，因此需要在不同种族、有足够数量患者的群体中开展更多关于垂体功能减退症病因的研究。为此，我们在土耳其人群中进行了一项多中心数据库研究，调查了三级医疗机构中773例患者垂体功能减退症的病因。该研究由土耳其内分泌与代谢学会（SEMT）垂体研究组设计并协调。来自土耳其不同地区的19个三级参考中心（14所大学医院和5所培训医院）参与了该研究。这是一项横断面数据库研究，数据记录时长为18个月。我们主要将垂体功能减退症的病因分为垂体肿瘤（由于垂体肿瘤的直接影响和/或其治疗）、垂体外肿瘤和非肿瘤性病因。773例患者（49.8%为男性，50.2%为女性）的平均年龄为43.9±16.1岁（范围16 - 84岁）。在所有患者中，垂体功能障碍最常见的病因是非肿瘤性病因（49.2%）。然而，当我们按性别分析病因时，男性最常见的病因是垂体肿瘤，而女性最常见的病因是非肿瘤性病因。根据对所有患者垂体功能减退症病因的亚组分析，发生率超过10%的最常见的四种垂体功能减退症病因如下：无分泌功能的垂体腺瘤、希恩综合征、催乳素瘤和特发性病因。关于激素缺乏的类型，促卵泡激素/促黄体生成素缺乏是最常见的激素缺乏（84.9%的患者）。33.8%的患者存在4种垂体前叶激素缺乏（促卵泡激素/促黄体生成素、促肾上腺皮质激素、促甲状腺激素和生长激素）。在所有患者中，垂体功能减退症最常见的病因是无分泌功能的垂体腺瘤。然而，在女性患者中，本研究清楚地表明希恩综合征仍是土耳其人群垂体功能减退症最重要的病因之一。此外，需要开展基于人群的前瞻性研究，以了解不同国家垂体功能减退症病因的患病率和发病率。
