肥胖与脑垂体体积——采用三维磁共振成像的相关性研究。
Obesity and pituitary gland volume - a correlation study using three-dimensional magnetic resonance imaging.
机构信息
Department of Radiology, Charité - Universitätsmedizin Berlin, Germany.
Institute of Neuroradiology, Charité - Universitätsmedizin Berlin, Germany.
出版信息
Neuroradiol J. 2020 Oct;33(5):400-409. doi: 10.1177/1971400920937843. Epub 2020 Jul 15.
PURPOSE
Obesity has become a major health problem and is associated with endocrine disorders and a disturbed hypothalamic-pituitary axis. The purpose of this study was to correlate pituitary gland volume determined by routine magnetic resonance imaging with patient characteristics, in particular body mass index and obesity.
MATERIAL AND METHODS
A total of 144 'healthy' patients with normal findings in cerebral magnetic resonance imaging were retrospectively included. Pituitary gland volume was measured in postcontrast three-dimensional T1-weighted sequences. A polygonal three-dimensional region of interest covering the whole pituitary gland was assessed manually. Physical characteristics (gender, age, body height and body mass index) were correlated with pituitary gland volume. Multiple subgroup and regression analyses were performed.
RESULTS
Pituitary gland volumes were significantly larger in females than in males (<0.001) and young individuals (<35 years) versus middle-aged patients (35-47 years) (=0.042). Obese patients (body mass index ≥30) had significantly larger pituitary gland volumes than overweight (25<body mass index<30; =0.011) and normal-weight (body mass index <25; =0.005) patients. In males, pituitary gland volumes of body mass index subgroups showed significant differences (=0.038). Obese males had larger pituitary gland volumes than overweight patients (=0.066) and significantly larger volumes than normal-weight (=0.023) patients. Obese females also had larger pituitary gland volumes but without statistical significance (>0.05). Regression analysis showed that increased pituitary gland volume is associated with higher body mass index independent from gender, age and body height.
CONCLUSION
Pituitary gland volume is increased in obese individuals and a high body mass index can be seen as an independent predictor of increased pituitary gland volume. Therefore, gland enlargement might be an imaging indicator of dysfunction in the hypothalamus-pituitary axis. Besides gender and age, body mass index should be considered by radiologists when diagnosing abnormal changes in pituitary gland volume.
目的
肥胖已成为一个主要的健康问题，与内分泌紊乱和下丘脑-垂体轴紊乱有关。本研究的目的是将常规磁共振成像确定的垂体体积与患者特征相关联，特别是体重指数和肥胖。
材料和方法
回顾性纳入了 144 名脑磁共振成像正常的“健康”患者。在对比增强三维 T1 加权序列中测量垂体体积。手动评估覆盖整个垂体的多边形三维感兴趣区。将身体特征（性别、年龄、身高和体重指数）与垂体体积相关联。进行了多个亚组和回归分析。
结果
女性的垂体体积明显大于男性（<0.001），年轻个体（<35 岁）大于中年患者（35-47 岁）（=0.042）。肥胖患者（体重指数≥30）的垂体体积明显大于超重患者（25<体重指数<30；=0.011）和正常体重患者（体重指数<25；=0.005）。在男性中，体重指数亚组的垂体体积存在显著差异（=0.038）。肥胖男性的垂体体积大于超重患者（=0.066），明显大于正常体重患者（=0.023）。肥胖女性的垂体体积也更大，但无统计学意义（>0.05）。回归分析表明，垂体体积的增加与性别、年龄和身高无关，与体重指数的增加相关。
结论
肥胖个体的垂体体积增加，高体重指数可以被视为垂体体积增加的独立预测因子。因此，腺体增大可能是下丘脑-垂体轴功能障碍的影像学指标。除性别和年龄外，放射科医生在诊断垂体体积异常变化时还应考虑体重指数。
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