Incidence, mortality, and cardiovascular diseases in pituitary adenoma in Korea: a nationwide population-based study

Oh, Jae Sang; Kim, Hyun Jung; Hann, Hoo Jae; Kang, Tae Uk; Kim, Dong‐Sook; Kang, Min Ji; Lee, Ji Young; Shim, Jai Joon; Lee, Man Ryul; Ahn, Hyeong Sik

doi:10.1007/s11102-020-01084-6

Cited by 19 publications

(32 citation statements)

References 39 publications

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“…On the other hand, in patients with CD, significant improvement was observed in the mortality rate of patients in the treated group. CD is known to have a high CVD-associated mortality rate because of impaired glucose metabolism and persistent hypertension caused by neurohormonal effects [2,[23][24][25][26]. Few studies have demonstrated the long-term mortality in CD, with conflicting results.…”

Section: Discussionmentioning

confidence: 99%

“…In Korea, two studies have been reported which investigated the epidemiology of PAs using the HIRA database. Park et al [ 4 ] reported that the incidence of hyperprolactinemia was 15 cases per million, with the prevalence increasing from 38.5 to 68.6 cases per million between 2009 and 2013, while Oh et al [ 25 ] reported only the incidence, which was 16 cases per million. The disagreement between studies using the same database with respect to the incidence is possibly due to differences in the operational definition of the disease in terms of different combination of diagnostic and BEP codes in each study [ 4 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Park et al [ 4 ] reported that the incidence of hyperprolactinemia was 15 cases per million, with the prevalence increasing from 38.5 to 68.6 cases per million between 2009 and 2013, while Oh et al [ 25 ] reported only the incidence, which was 16 cases per million. The disagreement between studies using the same database with respect to the incidence is possibly due to differences in the operational definition of the disease in terms of different combination of diagnostic and BEP codes in each study [ 4 , 25 ]. In addition, previous results in Korea demonstrated that the highest incidence rate was observed in patients in their 30s, and a sharp decline of the incidence rate was observed among older individuals [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of females were a 10-fold higher than that of males, but this sex disparity tended to become equalized in patients aged >50 years [ 1 , 4 , 6 ]. One hypothesis for this phenomenon is that the clinical symptoms and signs related to amenorrhea-galactorrhea syndrome are more definite in women than in men [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…A prolactinoma is known to be one of the most frequent subtypes of PA, which accounts for 40% to 50% of PAs. CD is rare, accounting for 4% to 6% of PAs and has a high cardiovascular mortality rate [2,[23][24][25][26]. Despite their importance in public health care, epidemiologic data on morbidity and mortality of these two diseases is not enough, even with incoherent results.…”

Section: Introductionmentioning

confidence: 99%

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Descriptive Epidemiology and Survival Analysis of Prolactinomas and Cushing’s Disease in Korea

et al. 2021

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Background:Only a few studies have established the epidemiology of prolactinoma and Cushing's disease in Korea. Furthermore, the incidence of these disease are increasing than before associated with the development of technologies. This study was designed to evaluate the epidemiology of prolactinoma and Cushing's disease and their survival analysis according to treatment. Methods: The nationwide, population-based study evaluated incidence and prevalence of prolactinoma and Cushing's disease using de-identified claims data in The Korean Health Insurance Review and Assessment Service database between 2013 and 2017. The survival analysis investigated regarding treatment over a period of 6 years. A log-rank test and Cox proportional hazard regression analysis were used. Results: The 6,056 patients with newly diagnosed prolactinoma and 584 patients with Cushing's disease were recorded between 2013 and 2017. The annual incidence of prolactinoma was 23.5 cases per million, and its prevalence was 82.5 cases per million, and 2.3 cases per million/year and 9.8 cases per million for Cushing's disease. The survival benefit was insignificant in prolactinoma according to treatment, but treatment of Cushing's disease ameliorated the survival rate significantly. Conclusion: Overall, the incidence of prolactinoma and Cushing's disease was similar with those found previously, but the prevalence of two diseases were inconsistent when compared with the early studies. The present study also proposed necessity of treatment in Cushing's disease for improving the survival rate.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Descriptive Epidemiology and Survival Analysis of Prolactinomas and Cushing’s Disease in Korea

et al. 2021

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Comparative mortality in pituitary adenomas subtypes: a tertiary referral center study

Toma,

Niculescu,

Găloiu

et al. 2024

Endocrine

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Purpose Mortality in pituitary adenomas (PAs) has been extensively compared to general population. However, direct comparisons between PA subtypes are scarce. We aimed to compare mortality in various subtypes of PA (acromegaly, Cushing’s disease (CD), macroprolactinomas and non-functioning pituitary macroadenomas (MacroNFPA)), within a single referral center. Methods We retrospectively analyzed mortality and survival time in all 962 PAs admitted in our department between 2011 and 2023: acromegaly (n = 306), CD (n = 69), macroprolactinoma (n = 168) and MacroNFPA (n = 419). Results Median follow-up was 10.2 (5.2, 15.2) years. The overall survival probability was 90.9% and 78.1% after 10 and 20 years respectively with age at diagnosis as the only significant predictor. There were no significant differences in survival probability between various PA subtypes in the whole cohort. In patients over 45 years of age at diagnosis there was a significant difference in survival probability between the four groups (p = 0.01) in the first 15 years of follow-up. In head-to-head comparisons CD had a significantly higher mortality risk than patients with acromegaly (HR 3.38 [CI 95% 1.07 to 10.60]) even after adjusting for age and sex. Conclusion Patients diagnosed with CD after 45 years of age have a significantly lower survival probability than other PA subtypes in the first 15 years of follow-up. All other PA subtypes had a similar survival probability after adjusting for age and sex. Due to advances in medical treatment of hormone secreting tumors, mortality in patients with PAs might increasingly depend more on tumor mass than on hormonal hypersecretion.

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The potential link between acromegaly and risk of acute ischemic stroke in patients with pituitary adenoma: a new perspective

Alnaaim,

Al-kuraishy,

Zailaie

et al. 2023

Acta Neurol Belg

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Acromegaly is an endocrine disorder due to the excess production of growth hormone (GH) from the anterior pituitary gland after closed epiphyseal growth plates. Acromegaly is mainly caused by benign GH-secreting pituitary adenoma. Acute ischemic stroke (AIS) is one of the most common cardiovascular complications. It ranks second after ischemic heart disease (IHD) as a cause of disability and death in high-income countries globally. Thus, this review aimed to elucidate the possible link between acromegaly and the development of AIS. The local effects of acromegaly in the development of AIS are related to the development of pituitary adenoma and associated surgical and radiotherapies. Pituitary adenoma triggers the development of AIS through different mechanisms, particularly aneurysmal formation, associated thrombosis, and alteration of cerebral microcirculation. Cardiovascular complications and mortality were higher in patients with pituitary adenoma. The systemic effect of acromegaly-induced cardio–metabolic disorders may increase the risk for the development of AIS. Additionally, acromegaly contributes to the development of endothelial dysfunction (ED), inflammatory and oxidative stress, and induction of thrombosis that increases the risk for the development of AIS. Moreover, activated signaling pathways, including activator of transcription 3 (STAT3), nuclear factor kappa B (NF-κB), nod-like receptor pyrin 3 (NLRP3) inflammasome, and mitogen-activated protein kinase (MAPK) in acromegaly may induce systemic inflammation with the development of cardiovascular complications mainly AIS. Taken together, acromegaly triggers the development of AIS through local and systemic effects by inducing the formation of a cerebral vessel aneurysm, the release of pro-inflammatory cytokines, the development of oxidative stress, ED, and thrombosis correspondingly.

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Incidence, mortality, and cardiovascular diseases in pituitary adenoma in Korea: a nationwide population-based study

Cited by 19 publications

References 39 publications

Descriptive Epidemiology and Survival Analysis of Prolactinomas and Cushing’s Disease in Korea

Descriptive Epidemiology and Survival Analysis of Prolactinomas and Cushing’s Disease in Korea

Comparative mortality in pituitary adenomas subtypes: a tertiary referral center study

The potential link between acromegaly and risk of acute ischemic stroke in patients with pituitary adenoma: a new perspective

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