Matthesen Astrid Thaarup, Rosendal Christian, Christensen Emma H, Beckmann Helga, Klit Frederik Østergaard, Nikontovic Amar, Bizik Gustav, Vestergaard Peter, Dal Jakob
Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark.
Pituitary. 2025 Mar 13;28(2):42. doi: 10.1007/s11102-025-01509-0.
We aimed to evaluate the risk of psychiatric disorders through a retrospective cohort study comparing acromegaly and non-functioning pituitary adenomas (NFPAs) and a meta-analysis of existing literature.
The cohort study included data from patient records analyzed using Chi-, T-tests and binary regression. The meta-analysis included studies retrieved from PubMed, Embase and PsycINFO that reported risk of psychopathology in acromegaly compared to NFPA or healthy controls, using a random effects model.
The study population comprised 105 acromegaly and 211 NFPA patients, with similar sex distributions. Patients with acromegaly presented with smaller pituitary adenomas (17.9 (SD: 9.9) mm vs. 22.9 (SD: 10.6) mm, p < 0.001), more frequent pituitary surgery (89.1 vs. 60.2%, p < 0.001) and hormone replacement therapy (25.7 vs. 16.1%, p = 0.042). Acromegaly patients had higher risk of depression (RR: 1.9, CI95% [1.2-3.2], p = 0.009), and increased need of admissions to the psychiatric ward (5.7 vs. 0.5%, p = 0.006). The relative risk of anxiety was 1.4 (CI95% [0.5-4.4], p = 0.53). Daily opioid use was higher in acromegaly patients with psychiatric morbidity which was associated with a diagnosis of arthropathy (p = 0.009). From the meta-analysis (8 studies, 1387 patients) an increased risk of depression (RR:1.8, CI95% [1.3-2.5]) and anxiety (RR:1.9, CI95% [1.1-3.2]) was observed in acromegaly compared to NFPAs.
This study reveals a higher risk of psychiatric disorders in acromegaly, particularly depression and anxiety. Consequently, a need for increased psychiatric awareness in acromegaly is warranted.
我们旨在通过一项回顾性队列研究（比较肢端肥大症和无功能垂体腺瘤（NFPA））以及对现有文献的荟萃分析，评估精神障碍的风险。
队列研究纳入了使用卡方检验、t检验和二元回归分析的患者记录数据。荟萃分析纳入了从PubMed、Embase和PsycINFO检索到的研究，这些研究报告了肢端肥大症与NFPA或健康对照相比的精神病理学风险，采用随机效应模型。
研究人群包括105例肢端肥大症患者和211例NFPA患者，性别分布相似。肢端肥大症患者的垂体腺瘤较小（17.9（标准差：9.9）mm对22.9（标准差：10.6）mm，p<0.001），垂体手术更频繁（89.1%对60.2%，p<0.001），激素替代治疗更频繁（25.7%对16.1%，p = 0.042）。肢端肥大症患者患抑郁症的风险更高（相对风险：1.9，95%置信区间[1.2 - 3.2]，p = 0.009），入住精神科病房的需求增加（5.7%对0.5%，p = 0.006）。焦虑的相对风险为1.4（95%置信区间[0.5 - 4.4]，p = 0.53）。有精神疾病的肢端肥大症患者每日使用阿片类药物的量更高，这与关节病的诊断相关（p = 0.009）。从荟萃分析（8项研究，1387例患者）中观察到，与NFPA相比，肢端肥大症患者患抑郁症（相对风险：1.8，95%置信区间[1.3 - 2.5]）和焦虑症（相对风险：1.9，95%置信区间[1.1 - 3.2]）的风险增加。
本研究揭示了肢端肥大症患者患精神障碍的风险更高，尤其是抑郁症和焦虑症。因此，有必要提高对肢端肥大症患者精神问题的认识。
