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High prevalence of morphometric vertebral fractures opportunistically detected on thoracic radiograms in patients with non-functioning pituitary adenoma.
Frara, Stefano; Uygur, Meliha Melin; Bolamperti, Filippo; di Filippo, Luigi; Doga, Mauro; Ferrari, Francesca; Losa, Marco; Mortini, Pietro; Giustina, Andrea.
Afiliación
  • Frara S; Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, Via Olgettina, 58, 20132, Milan, Italy.
  • Uygur MM; Endocrinology Unit, IRCCS Ospedale San Raffaele, Milan, Italy.
  • Bolamperti F; Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, Via Olgettina, 58, 20132, Milan, Italy.
  • di Filippo L; Department of Endocrinology and Metabolism Disease, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
  • Doga M; Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, Via Olgettina, 58, 20132, Milan, Italy.
  • Ferrari F; Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, Via Olgettina, 58, 20132, Milan, Italy.
  • Losa M; Endocrinology Unit, IRCCS Ospedale San Raffaele, Milan, Italy.
  • Mortini P; Endocrinology Unit, IRCCS Ospedale San Raffaele, Milan, Italy.
  • Giustina A; Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, Via Olgettina, 58, 20132, Milan, Italy.
Pituitary ; 27(4): 370-380, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38802688
ABSTRACT

PURPOSE:

Vertebral fractures (VFs), the hallmark of skeletal fragility, have been reported as an emerging complication in patients with pituitary diseases associated with hormonal excess and/or deficiency, independently from bone mineral density. Non-functioning pituitary adenoma (NFPA) is amongst the most frequent pituitary adenomas; however, skeletal health in this context has never been investigated. We aimed at assessing the prevalence and the determinants of morphometric VFs in patients with NFPA.

METHODS:

We enrolled 156 patients (79 M/77F, mean age 55.75 ± 12.94 years) at admission in Neurosurgery Unit before trans-sphenoidal surgery and compared them with an age and sex-matched control group of subjects with neither history/risk factors for secondary osteoporosis nor pituitary disorders. We performed a vertebral morphometric evaluation of the thoracic spine on pre-operative X-ray images (MTRx) and collected biochemical, demographic, and clinical data from the entire cohort.

RESULTS:

The prevalence of thoracic VFs in patients with NFPA was significantly higher than the control group (26.3% vs. 10.3%; p < 0.001). In the NFPA group, 20 patients (48.8% of the fractured patients) showed multiple VFs, 14 (34.1% of them) showed moderate/severe VFs. Patients with VFs were significantly older and had lower serum free triiodothyronine (fT3) levels than non-fractured ones (p = 0.002 and p = 0.004; respectively). The prevalence of secondary male hypogonadism was higher among men with VFs as compared to those with no VFs (72% vs. 48.1%; p = 0.047). Consistently, total testosterone levels in males were significantly lower in fractured patients than in non-fractured ones (p = 0.02). The prevalence of gonadotroph adenomas was significantly higher among patients with VFs (p = 0.02). In multiple logistic regression analysis, older age and lower serum fT3 levels were independent factors predicting the risk for VFs.

CONCLUSIONS:

For the first time, we reported a high prevalence of thoracic radiological VFs in patients with NFPAs. Our data should prompt clinicians to proceed with a clinical bone fragility evaluation already during the diagnostic work-up, particularly in those with concomitant hypogonadism, or in those with older age and/or with lower fT3.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Hipofisarias / Fracturas de la Columna Vertebral Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Pituitary Asunto de la revista: ENDOCRINOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Hipofisarias / Fracturas de la Columna Vertebral Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Pituitary Asunto de la revista: ENDOCRINOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos