title: Hypopituitarism and mortality in pituitary adenoma.
abstract: OBJECTIVE
  Previous studies on hypopituitarism and mortality have concluded that insufficient pituitary function is associated with decreased survival. For several reasons the results are difficult to compare - particularly because definitions and treatment of hypopituitarism have varied and various underlying disorders have been included. The purpose was to assess the relationship between mortality and pituitary function.
  
  
  METHODS
  One hundred and sixty consecutive patients (99 men and 61 women) with functionless, suprasellar pituitary adenoma. All were operated on transsphenoidally during the period 1985-1996. Additional radiotherapy was given to 29 patients. Mortality was calculated 12.4 years (median, range 8.1-19.9) after operation. Postoperative hormonal deficits were treated in most, though GH substitution was given only to a minority of patients.
  
  
  RESULTS
  Postoperatively 30% of the patients had normal pituitary function (normal adrenocortical, thyroid and gonadal function), 26% were panhypopituitary and 36% had partial pituitary insufficiency. Forty-one patients had died (34.7 expected) yielding a standard mortality ratio (SMR) of 1.18 (95% confidence limits (CI) 0.87-1.60). SMR was significantly increased in women (1.97, CI 1.20-3.21) but not in men (0.83, CI 0.55-1.26). SMR in patients with normal pituitary function, panhypopituitarism and partial insufficiency were not different from that in the general population. SMR in hypopituitary women was substantially higher than in men with pituitary insufficiency. Treatment with growth hormone in GH-deficient patients did not influence survival.
  
  
  CONCLUSIONS
  Pituitary surgery for nonfunctioning adenoma and subsequent pituitary insufficiency had no effect on mortality in men, but was associated with significantly increased mortality in women. Suboptimal hormonal substitution in women may play a role.
authors.affiliation: Department of Endocrinology, Aarhus University Hospital, Aalborg, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Lindholm
authors.forename: E Husted
authors.initials: EH
authors.lastname: Nielsen
authors.forename: P
authors.initials: P
authors.lastname: Bjerre
authors.forename: J Sandahl
authors.initials: JS
authors.lastname: Christiansen
authors.forename: C
authors.initials: C
authors.lastname: Hagen
authors.forename: S
authors.initials: S
authors.lastname: Juul
authors.forename: J
authors.initials: J
authors.lastname: Jørgensen
authors.forename: A
authors.initials: A
authors.lastname: Kruse
authors.forename: P
authors.initials: P
authors.lastname: Laurberg
authors.forename: K
authors.initials: K
authors.lastname: Stochholm
mesh_terms: D000236:Adenoma / Q000150:complications / Q000401:mortality* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D013006:Growth Hormone / Q000172:deficiency; D006801:Humans; D007016:Hypophysectomy; D007018:Hypopituitarism / Q000209:etiology / Q000401:mortality* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications / Q000401:mortality* / Q000601:surgery; D012044:Regression Analysis; D012737:Sex Factors; D014057:Tomography, X-Ray Computed
chemical_list: D013006:Growth Hormone