Metabolic syndrome as a common comorbidity in adults with hypothalamic dysfunction

Abstract

ObjectiveHypothalamic dysfunction (HD) results in various endocrine disorders and is associated with an increased risk of metabolic comorbidities. This study aimed to analyze the clinical characteristics and metabolic abnormalities of adults with HD of various causes.MethodsThis study retrospectively reviewed adults with HD treated at our center between August 1989 and October 2020. Metabolic characteristics of patients were compared to those of age-, sex-matched lean, and body mass index (BMI)-matched controls.ResultsTemperature dysregulation (61.0%) was the most common hypothalamic physiological dysfunction. At least one anterior pituitary hormone deficiency was observed in 50 patients (84.7%), with hypogonadotropic hypogonadism being the most frequently observed. Metabolic syndrome was confirmed in 31 patients (52.5%) and was significantly more prevalent in those with panhypopituitarism or overweight/obesity. Metabolic syndrome (MetS) was significantly more common in patients with HD than in both lean and BMI-matched controls (P < 0.001 and P = 0.030, respectively). Considering the components of MetS, elevated fasting glucose levels were significantly more common in patients with HD than in BMI-matched controls (P = 0.029). Overweight/obesity and panhypopituitarism were significant risk factors for MetS in the multivariate analysis on patients with HD. Moreover, in the multivariate analysis on patients and BMI-matched control, HD was a significant risk factor of MetS (P=0.035, OR 2.919) after adjusted for age, sex and BMI.ConclusionsTemperature dysregulation and hypogonadotropic hypogonadism are the most common physiological and endocrine dysfunctions, respectively. MetS and unfavorable metabolic profiles were prevalent in adults with HD. HD was a significant risk factor of MetS after adjusted for BMI.

O desenvolvimento da Síndrome Metabólica em pacientes com Hipogonadismo de início tardio

“…A presença de um IMC ≥ 30kg/m², que é o ponto de corte para a definição de obesidade, foi determinante para a presença de baixos níveis séricos de testosterona. Também foi relatado por Xu et al (2022) que homens com hipogonadismo hipogonadotrófico apresentaram maiores sequelas metabólicas quando comparados com indivíduos saudáveis, tais como dislipidemia, redução do colesterol HDL e obesidade, o que reforça a bidirecionalidade entre os valores aquém de testosterona e as patologias endócrino-metabólicas.…”

Features of changes in the content of hormones of the hypothalamic-pituitary tract depending on the independent or combined variant of B16/F10 melanoma growth in mice of both sexes

“…It should be noted that the aggravation of the dysfunction of the hypothalamic-pituitary tract in a malignant process, especially in case of MPMT, can also have a detrimental effect on the body due to the development of concomitant metabolic disorders. It is known that damage to the hypothalamic-pituitary axis is associated with metabolic diseases, including abdominal obesity, elevated cholesterol/triglyceride levels, and insulin resistance that additionally lead to a higher risk of a cardiovascular disease and poor longterm prognosis [7].…”

“…The hypothalamus is one of the oldest brain structure, which controls complex physiological responses to maintain internal homeostasis, containing several types of neurons, which secrete different hormones: thyrotropin-releasing hormone (TRH), gonadotropin-releasing hormone (GnRH), corticotropin-releasing hormone (CRH), and somatostatin (STH-R) [7]. The hypothalamus functions together with the pituitary gland through the hypothalamic-pituitary axis, and releasing hormones are released from the hypothalamus into the bloodstream and enter the anterior pituitary gland [8].…”