Harbeck Birgit, Danneberg Sven, Rahvar Amir-Hossein, Monig Heiner, Haas Christian S
University of Luebeck, Department of Medicine I, Ratzeburger Allee 160, 23538 Luebeck, Germany.
Endocr Metab Immune Disord Drug Targets. 2016;16(4):249-253. doi: 10.2174/1871530316666161130160809.
Patients with hypothalamic-pituitary disorders (HPD) may be of increased risk to develop overweight and obesity, thereby fostering cardiovascular events. However, it remains unclear if patients with pituitary dysfunctions per se have an increased risk of becoming obese.
The objective of this study was to evaluate prevalence and to identify possible predictors of overweight and obesity in patients with pituitary dysfunctions.
A total of 121 out-patients having various causes for HPD were assessed for height and body weight; body mass index (BMI) was calculated and correlated with clinical features. Patients were divided into various subgroups depending on underlying conditions and therapeutic modalities.
Most of the HPD patients were overweight or obese with males being significantly more affected. Of interest, patients with macroadenomas suffered significantly more often from overweight and obesity than individuals with microadenomas (73.4% vs. 43.5%, p= 0.006). Increased BMI (≥25 kg/m2) tended to be more common in patients with prolactinomas (70.0%), hormone deficiencies (76.1%) and hormone replacement therapies (76.6%) than in a healthy population.
In conclusion, we showed that patients with HPD: (i) frequently suffer from overweight and obesity; (ii) prevalence of overweight and obesity however is comparable to that in the general population; (iii) only patients with macroadenomas seem to have a significantly higher risk; (iv) hormone deficiencies and hormonal replacement therapy may foster weight gain and (v) radiation and surgical tumour therapy per se do not seem to be additional risk factors for weight gain.
下丘脑 - 垂体疾病（HPD）患者发生超重和肥胖的风险可能增加，从而增加心血管事件的发生几率。然而，垂体功能障碍患者本身是否具有更高的肥胖风险仍不清楚。
本研究的目的是评估垂体功能障碍患者超重和肥胖的患病率，并确定可能的预测因素。
对121例因各种原因导致HPD的门诊患者进行身高和体重评估；计算体重指数（BMI）并与临床特征进行关联。根据潜在疾病和治疗方式将患者分为不同亚组。
大多数HPD患者超重或肥胖，男性受影响更为显著。有趣的是，大腺瘤患者超重和肥胖的发生率明显高于微腺瘤患者（73.4% 对 43.5%，p = 0.006）。与健康人群相比，泌乳素瘤患者（70.0%）、激素缺乏患者（76.1%）和接受激素替代治疗的患者（76.6%）中BMI升高（≥25 kg/m²）更为常见。
总之，我们发现HPD患者：（i）经常患有超重和肥胖；（ii）超重和肥胖的患病率与普通人群相当；（iii）只有大腺瘤患者似乎具有显著更高的风险；（iv）激素缺乏和激素替代治疗可能促进体重增加；（v）放射治疗和手术肿瘤治疗本身似乎不是体重增加的额外风险因素。
