title: Higher incidence of morbidity in women than men with non-functioning pituitary adenoma: a Swedish nationwide study.
abstract: OBJECTIVE
  Increased mortality rates are found in women and young adults with non-functioning pituitary adenomas (NFPAs). This nationwide study aimed to investigate the burden of comorbidities in patients with NFPA and to examine whether gender influences the outcome.
  
  
  METHODS
  NFPA patients were identified and followed-up from National Registries in Sweden. It was a nationwide, population-based study.
  
  
  METHODS
  Standardised incidence ratios (SIRs) for comorbidities with 95% confidence intervals (CI). Comorbidities were analysed in all patients, both patients with and without hypopituitarism.
  
  
  RESULTS
  Included in the analysis were 2795 patients (1502 men, 1293 women), diagnosed with NFPA between 1987 and 2011. Hypopituitarism was reported in 1500 patients (54%). Mean patient-years at risk per patient was 7 (range 0-25). Both men (SIR 2.2, 95% CI: 1.8-2.5; P<0.001) and women (2.9, 2.4-3.6; P<0.001) had a higher incidence of type 2 diabetes mellitus (T2DM) than the general population, with women having a higher incidence compared with men (P=0.02). The incidence of myocardial infarction was increased in women (1.7, 1.3-2.1; P<0.001), but not in men. Both men (1.3, 1.1-1.6; P=0.006) and women (2.3; 1.9-2.8; P<0.001) had an increased incidence of cerebral infarction, with women having a higher incidence than men (P<0.001). The incidence of sepsis was increased for both genders. The incidence of fractures was increased in women (1.8, 1.5-1.8; P<0.001), but not for men.
  
  
  CONCLUSIONS
  This nationwide study shows excessive morbidity due to T2DM, cerebral infarction and sepsis in all NFPA patients. Women had higher incidence of T2DM, myocardial infarction, cerebral infarction and fracture in comparison to both the general population and to men.
authors.affiliation: Department of EndocrinologyInstitute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden daniel.olsson@gu.se.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Olsson
authors.affiliation: Department of Occupational and Environmental MedicineÖrebro University Hospital, Örebro, Sweden.
authors.forename: Ing-Liss
authors.initials: IL
authors.lastname: Bryngelsson
authors.affiliation: Department of EndocrinologyInstitute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Oskar
authors.initials: O
authors.lastname: Ragnarsson
mesh_terms: D000236:Adenoma / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000453:epidemiology*; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology*; D010911:Pituitary Neoplasms / Q000453:epidemiology*; D012042:Registries; D012737:Sex Factors; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult