title: Primary empty sella and GH deficiency: prevalence and clinical implications.
abstract: Primary empty sella (PES) is a particular anatomical condition characterized by the herniation of liquor within the sella turcica. The pathogenesis of this alteration, frequently observed in general population, is not yet completely understood. Recently reports demonstrated, in these patients, that hormonal pituitary dysfunctions, specially growth hormone (GH)/insulin- like growth factor (IGF-I) axis ones, could be relevant. The aim of this paper is to evaluate GH/IGF-I axis in a group of adult patients affected by PES and to verify its clinical relevance. We studied a population of 28 patients with a diagnosis of PES. In each patient we performed a basal study of thyroid, adrenal and gonadal - pituitary axis and a dynamic evaluation of GH/IGF-I after GH-releasing hormone (GHRH) plus arginine stimulation test. To evaluate the clinical significance of GH/IGF-I axis dysfunction we performed a metabolic and bone status evaluation in every patients. We found the presence of GH deficit in 11 patients (39.2%). The group that displayed a GH/IGF-I axis dysfunction showed an impairment in metabolic profile and bone densitometry. This study confirms the necessity to screen the pituitary function in patients affected by PES and above all GH/IGF-I axis. Moreover the presence of GH deficiency could be clinically significant.
authors.affiliation: Cattedra di Endocrinologia, Sapienza Università di Roma, Rome, Italy. ipofisi@ospedalesantandrea.it
authors.forename: Maurizio
authors.initials: M
authors.lastname: Poggi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Monti
authors.forename: Chiara
authors.initials: C
authors.lastname: Lauri
authors.forename: Chiara
authors.initials: C
authors.lastname: Pascucci
authors.forename: Valeria
authors.initials: V
authors.lastname: Bisogni
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Toscano
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D015519:Bone Density; D015897:Comorbidity; D003863:Depression / Q000209:etiology; D004652:Empty Sella Syndrome / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D005221:Fatigue / Q000209:etiology; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D019382:Human Growth Hormone / Q000097:blood / Q000172:deficiency*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007006:Hypogonadism / Q000209:etiology; D007037:Hypothyroidism / Q000453:epidemiology; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D007558:Italy / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000209:etiology*; D010903:Pituitary Gland, Anterior / Q000378:metabolism*; D010908:Pituitary Hormones, Anterior / Q000097:blood; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D013963:Thyroid Hormones / Q000097:blood
chemical_list: D001786:Blood Glucose; D012739:Gonadal Steroid Hormones; D008055:Lipids; D010908:Pituitary Hormones, Anterior; D013963:Thyroid Hormones; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D006854:Hydrocortisone