Correlation between the pituitary size and function in patients with asthenia

Area of Science:

• Endocrinology
• Radiology
• Internal Medicine

Background:

• Asthenia is a common symptom with various underlying causes.
• Pituitary morphology can influence endocrine function.
• Empty sella syndrome (ES) involves herniation of the subarachnoid space into the sella turcica.

Purpose of the Study:

• To investigate the correlation between pituitary gland size and function in patients experiencing asthenia.
• To assess the impact of empty sella (complete and partial) on endocrine parameters.

Main Methods:

• Mid-sagittal Magnetic Resonance Imaging (MRI) was used to evaluate pituitary morphology.
• Endocrinological assessments were performed on 38 patients with asthenia.
• Statistical analyses, including multiple regression, were employed to determine correlations.

Main Results:

• Patients with complete empty sella (ES) and partial empty sella (PES) exhibited lower BMI, blood pressure, serum sodium, ACTH, cortisol, TSH, and T(4) compared to controls.
• Serum cortisol levels showed a significant independent correlation with pituitary gland size (beta = 0.586, p = 0.0069).
• No significant correlations were found between pituitary size and other tested variables (age, BMI, blood pressure, serum Na, ACTH, TSH, T(4)) after multivariate analysis.

Conclusions:

• A strong relationship exists between reduced pituitary gland size and the degree of adrenocortical dysfunction in asthenic patients.
• The pituitary-adrenal axis appears particularly vulnerable in empty sella syndrome.
• Thorough evaluation of the hypophysial adrenal axis is recommended for individuals with reduced pituitary size, including the elderly.