title: Correlation between the pituitary size and function in patients with asthenia.
abstract: To explore the relationship between pituitary morphology and function, we performed mid-sagittal MRI and endocrinological evaluation in 38 patients with asthenia. Six patients were diagnosed as having complete empty sella (ES) and 16 patients partial empty sella (PES). BMI, blood pressure, serum Na, ACTH, cortisol, TSH and T(4) were lower in ES group and PES group than in the group with normal pituitary size. Age in the patients with ES was oldest. Multiple regression analysis revealed that serum cortisol level was independently correlated with the size of the pituitary (beta = 0.586, p = 0.0069). Other variables, including age, BMI, blood pressure, serum Na, ACTH, TSH and T(4), were not correlated with the pituitary size when multivariate analysis was employed. In conclusion, there is a close relationship between the reduction of size of pituitary gland and the degree of adrenocortical dysfunction in asthenic patients. It is suggested that the pituitary-adrenal axis is especially vulnerable in empty sella syndrome, and therefore, meticulous evaluation of the hypophysial adrenal axis is recommended in subjects with reduced pituitary size even in elderly population.
authors.affiliation: Department of Medicine, Kashiwa City Hospital, Kashiwa, Chiba.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamada
authors.forename: Ken
authors.initials: K
authors.lastname: Nojiri
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Sasazawa
authors.forename: Tomomichi
authors.initials: T
authors.lastname: Tsukui
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Miyahara
authors.forename: Kazumi
authors.initials: K
authors.lastname: Nakayama
authors.forename: Mitsuhisa
authors.initials: M
authors.lastname: Komatsu
authors.forename: Toru
authors.initials: T
authors.lastname: Aizawa
authors.forename: Ichiro
authors.initials: I
authors.lastname: Komiya
mesh_terms: D000309:Adrenal Insufficiency / Q000209:etiology*; D000368:Aged; D001247:Asthenia / Q000209:etiology*; D004652:Empty Sella Syndrome / Q000150:complications* / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010901:Pituitary Function Tests; D010902:Pituitary Gland / Q000473:pathology*