Endocr Pract. 2018 Sep;24(9):815-822. doi: 10.4158/EP-2018-0122. Epub 2018 Jul 5.
Nonfunctioning pituitary adenoma (NFPA) accounts for 30% of all pituitary adenomas, and its incidence has been increasing compared to previous years. Increased risk of cardiovascular effects shown in recent studies is noteworthy in patients with NFPA diagnosis, but the number of studies on the subject is limited. In this study, we aimed to assess possible cardiovascular effects and risk via arterial stiffness measurements in patients diagnosed with NFPA.
We performed arterial stiffness measurements for 30 patients diagnosed with NFPA and 30 healthy volunteers and compared the results to explore the relationship between arterial stiffness parameters, hormone levels, and adenoma size.
Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), central SBP, central DBP, augmentation index corrected for a heart rate of 75 beats per minute (AIx@75), and pulse wave velocity (PWV) values of the patients with NFPA diagnosis were significantly higher than the control group. PWV was found to have a significant and negative correlation with growth hormone and insulin-like growth factor 1 (IGF-1). A significant and positive correlation was found between adenoma median short-axis length and PWV. IGF-1 was found to have a significant and negative correlation with adenoma median long- and short-axis length. In multivariate linear regression analysis, we found that IGF-1 was an independent predictor of PWV.
Both arterial stiffness parameters such as AIx@75 and PWV and peripheral SBP, DBP, and MBP values were found to be high in NFPA patients with no cardiovascular risk factors. Our findings suggest increased cardiovascular effect and risk in patients with NFPA diagnosis, and therefore, we recommend that patients are monitored closely in this respect.
ACTH = adrenocorticotropic hormone; AIx@75 = augmentation index corrected for a heart rate of 75 beats per minute; BMI = body mass index; CVD = cardiovascular disease; DBP = diastolic blood pressure; FSH = follicle-stimulating hormone; GH = growth hormone; HT = hypertension; IGF-1 = insulin-like growth factor 1; LH = luteinizing hormone; MBP = mean blood pressure; MRI = magnetic resonance imaging; NFPA = nonfunctioning pituitary adenoma; PP = pulse pressure; PWA = pulse wave analysis; PWV = pulse wave velocity; SBP = systolic blood pressure; TSH = thyroid-stimulating hormone.
无功能垂体腺瘤（NFPA）占所有垂体腺瘤的 30%，其发病率较前几年有所增加。最近的研究表明 NFPA 患者存在心血管效应风险增加，值得关注，但关于该主题的研究数量有限。在本研究中，我们旨在通过动脉僵硬度测量评估 NFPA 患者的可能心血管效应和风险。
我们对 30 例 NFPA 患者和 30 例健康志愿者进行了动脉僵硬度测量，并比较了结果，以探讨动脉僵硬度参数、激素水平和腺瘤大小之间的关系。
NFPA 诊断患者的收缩压（SBP）、舒张压（DBP）、平均血压（MBP）、中心 SBP、中心 DBP、心率为 75 次/分钟校正的增强指数（AIx@75）和脉搏波速度（PWV）值均明显高于对照组。PWV 与生长激素和胰岛素样生长因子 1（IGF-1）呈显著负相关。腺瘤中轴短径与 PWV 呈显著正相关。IGF-1 与腺瘤中轴长径和短径呈显著负相关。多元线性回归分析发现，IGF-1 是 PWV 的独立预测因子。
在无心血管危险因素的 NFPA 患者中，动脉僵硬度参数（如 AIx@75 和 PWV）以及外周 SBP、DBP 和 MBP 值均升高。我们的研究结果表明 NFPA 患者存在心血管效应和风险增加，因此我们建议密切监测此类患者。
ACTH = 促肾上腺皮质激素；AIx@75 = 心率为 75 次/分钟校正的增强指数；BMI = 体重指数；CVD = 心血管疾病；DBP = 舒张压；FSH = 卵泡刺激素；GH = 生长激素；HT = 高血压；IGF-1 = 胰岛素样生长因子 1；LH = 黄体生成素；MBP = 平均血压；MRI = 磁共振成像；NFPA = 无功能垂体腺瘤；PP = 脉压；PWA = 脉搏波分析；PWV = 脉搏波速度；SBP = 收缩压；TSH = 促甲状腺激素。
