Postoperative growth hormone dynamics in clinically nonfunctioning pituitary adenoma

Area of Science:

• Endocrinology
• Neurosurgery
• Oncology

Background:

• Growth hormone deficiency (GHD) is an endocrine disorder often caused by non-functioning pituitary adenoma (NFPA).
• Transsphenoidal surgery is a common treatment for NFPA, but postoperative GHD dynamics require further investigation.
• Understanding GH recovery post-surgery is crucial for managing endocrine health in NFPA patients.

Purpose of the Study:

• To investigate the time-dependent changes in GH secretion after transsphenoidal surgery for NFPA.
• To identify factors influencing GH recovery in patients with severe GHD (sGHD) post-surgery.
• To establish optimal assessment methods for postoperative GHD.

Main Methods:

• Analysis of 119 patients with NFPA who underwent transsphenoidal surgery.
• Postoperative GH secretion evaluation using GH-releasing peptide-2 (GHRP2) infusion.
• Univariate and multivariate analyses to identify predictors of sGHD recovery.

Main Results:

• Immediately after surgery, 79.0% of patients had sGHD, but 28.7% recovered within 1-2 years.
• Younger age, single primary surgery, isolated GH deficiency, and cystic adenoma predicted recovery.
• Multivariate analysis identified younger age and no hormone replacement therapy as significant predictors of recovery.

Conclusions:

• Postoperative sGHD should be assessed via GHRP2 infusion, irrespective of IGF1 standard deviation score (SD-S) levels.
• Recovery from sGHD is common within 1-2 years post-surgery, especially in younger patients or those with isolated GHD.
• Reassessment for GHD using GHRP2 testing at 1-2 years post-surgery is recommended for these patients.