Anterior pituitary hormone deficiency in subjects with total and partial primary empty sella: do all cases need endocrinological evaluation?
OBJECTIVE
To compare anterior pituitary functions between subjects with total and partial primary empty sella (PES) and to assess whether all cases with PES need endocrinological evaluation.


METHODS
Eighty-one subjects with PES (34 total and 47 partial) were included in the study. Basal anterior pituitary and its target hormones were assessed and those with low insulin like growth factor-1 and/or low basal cortisol levels underwent insulin tolerance test (ITT).


RESULTS
67.4% of the subjects with total and 14.9% of those with partial PES had different degrees of hypopituitarism. However, the frequency of hypopituitarism was significantly higher in cases with total PES. The odds ratio (OR) and 95% confidence interval (CI) of secondary hypothyroidism, secondary adrenal, growth hormone and gonadotropin deficiency in subjects with total compared to those with partial PES were as follows: OR = 20.0, 95% CI 4.16 - 95.9, OR = 2.4, 95% CI 1.34 - 5.7, OR = 15.3, 95% CI 4.48 - 52.6 and OR = 10.6, 95% CI 3.37 - 33.5, respectively.


CONCLUSIONS
A substantial number of subjects with PES, particularly those with total PES, have pituitary hormone deficiency, so regardless of the type of PES, all subjects must be promptly and carefully evaluated for anterior pituitary hormone deficiency.
Sisli Etfal Training and Research Hospital, Department of Endocrinology and Metabolism, Istanbul, Turkey.
Sayid Shafi
SS
Zuhur
Idris
I
Kuzu
Feyza Yener
FY
Ozturk
Ender
E
Uysal
Yuksel
Y
Altuntas
D003430:Cross-Sectional Studies; D004652:Empty Sella Syndrome / Q000097:blood / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000097:blood / Q000503:physiopathology*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010903:Pituitary Gland, Anterior / Q000378:metabolism / Q000503:physiopathology*; D010908:Pituitary Hormones, Anterior / Q000097:blood / Q000172:deficiency*
D010908:Pituitary Hormones, Anterior; D007334:Insulin-Like Growth Factor I