Kałuża Bernadetta, Furmanek Mariusz, Domański Jan, Żuk-Łapan Aleksandra, Babula Emilia, Poprawa Iga, Landowska Małgorzata, Jarząbek Karolina, Popczyńska Justyna, Filipowicz Paulina, Wielgolewska Małgorzata, Walecki Jerzy, Franek Edward
Department of Internal Medicine, Endocrinology and Diabetology, National Medical Institute of the Ministry of the Interior and Administration in Warsaw, 02-507 Warsaw, Poland.
Student Scientific Group of the Medical University of Warsaw at the Department of Internal Medicine, Endocrinology and Diabetology, National Medical Institute of the Ministry of the Interior and Administration in Warsaw, 02-507 Warsaw, Poland.
Biomedicines. 2025 Mar 21;13(4):762. doi: 10.3390/biomedicines13040762.
The aim of the study was to prospectively assess the impact of certain parameters of pituitary morphology assessed with the use of magnetic resonance imaging on the occurrence of hormonal disorders in patients with primary partial empty sella (PES) or primary empty sella (ES). Forty-three patients were divided into two groups: group 1-patients with PES ( = 20); group 2-patients with ES ( = 23). Patients with ES were characterized by larger both the transverse (14.8 ± 2.9 mm vs. 17.2 ± 2.9 mm, = 0.016) and anteroposterior (AP) diameters of the pituitary (11.4 ± 1.4 mm vs. 13.2 ± 1.9 mm, = 0.003), a smaller craniocaudal (CC) diameter (3.9 ± 0.62 mm vs. 2.2 ± 0.6 mm, = 0.001), and a lower pituitary volume (332.8 ± 107.6 mm vs. 243.5 ± 70.9 mm, = 0.001). Moreover, an AP infundibular displacement was more common in patients with ES (7 [35%] vs. 16 [69.6%]., = 0.023). Despite the fact that secondary adrenocortical insufficiency was shown to be significantly more common and ACTH levels to be significantly lower (27.5 ± 13.2 pg/mL vs. 21.8 ± 17.6 pg/mL, = 0.039) in patients with ES (0 [0%] vs. 3 [13.4%], = 0.046), univariate logistic regression did not reveal any significant associations of pituitary diameters, pituitary volume, or pituitary stalk displacement with endocrine disorders, such as secondary adrenocortical insufficiency or hyperprolactinemia, which was confirmed with multivariate logistic regression adjusted for age, sex, BMI, and arterial hypertension. Radiologically assessed CC, AP, and transverse pituitary diameters, pituitary volume, or pituitary stalk displacement in patients with PES or ES have no bearing on the rates of hormonal disorders. Nonetheless, certain hormonal disorders may be more common in patients with ES, which suggests a need for hormone-level assessments in this population.
本研究的目的是前瞻性评估使用磁共振成像评估的垂体形态学某些参数对原发性部分空蝶鞍(PES)或原发性空蝶鞍(ES)患者激素紊乱发生情况的影响。43例患者分为两组:第1组为PES患者(n = 20);第2组为ES患者(n = 23)。ES患者的垂体横径(14.8±2.9mm对17.2±2.9mm,P = 0.016)和前后径(AP)均较大(11.4±1.4mm对13.2±1.9mm,P = 0.003),颅尾径(CC)较小(3.9±0.62mm对2.2±0.6mm,P = 0.001),垂体体积较低(332.8±107.6mm对243.5±70.9mm,P = 0.001)。此外,AP漏斗移位在ES患者中更常见(7例[35%]对16例[69.6%],P = 0.023)。尽管ES患者继发性肾上腺皮质功能不全明显更常见且促肾上腺皮质激素(ACTH)水平明显更低(27.5±13.2pg/mL对21.8±17.6pg/mL,P = 0.039)(0例[0%]对3例[13.4%],P = 0.046),但单因素逻辑回归未发现垂体直径、垂体体积或垂体柄移位与内分泌紊乱(如继发性肾上腺皮质功能不全或高催乳素血症)之间存在任何显著关联,这在针对年龄、性别、体重指数和动脉高血压进行调整的多因素逻辑回归中得到了证实。放射学评估的PES或ES患者的CC、AP和垂体横径、垂体体积或垂体柄移位与激素紊乱发生率无关。尽管如此,某些激素紊乱在ES患者中可能更常见,这表明该人群需要进行激素水平评估。