Front Horm Res. 2018;49:1-19. doi: 10.1159/000485997. Epub 2018 Apr 5.
Prevalence of metabolic syndrome (MetS) and mortality rates from cardiovascular causes are increased in patients with hypopituitarism. Features of obesity, visceral adiposity, dyslipidemia, insulin resistance, and hypertension are common in these patients. Unreplaced growth hormone (GH) deficiency and inadequate replacement of other hormone insufficiencies may be responsible for the adverse body composition and metabolic profile associated with hypopituitarism. Recently, fatty liver disease was added to this unfavorable metabolic phenotype. Long-term treatment with low-dose GH replacement is considered safe and advantageous for metabolic profile and normalization of cardiovascular mortality rates in hypopituitary patients. Positive influence of optimal balance in replacement of other pituitary hormone deficiencies with doses of hydrocortisone (<20 mg/day), weight-adjusted T4 doses, and transdermal estrogen in women is also very important. Active screening and treatment of all cardiometabolic risk factors and comorbidities may further improve outcomes in patients with hypopituitarism.
垂体功能减退症患者的代谢综合征（MetS）患病率和心血管原因死亡率均升高。肥胖、内脏肥胖、血脂异常、胰岛素抵抗和高血压等特征在这些患者中很常见。未替代的生长激素（GH）缺乏和其他激素不足的替代不足可能是与垂体功能减退症相关的不良身体成分和代谢特征的原因。最近，脂肪肝疾病也被添加到这种不利的代谢表型中。长期低剂量 GH 替代治疗被认为是安全的，并有利于代谢特征和降低垂体功能减退症患者的心血管死亡率。用氢化可的松（<20mg/天）、体重调整的 T4 剂量和经皮雌激素替代其他垂体激素不足的剂量达到最佳平衡也具有重要意义。积极筛查和治疗所有心血管代谢危险因素和合并症可能进一步改善垂体功能减退症患者的预后。
