Prevalence and incidence of hypopituitarism in an adult Caucasian population in northwestern Spain

Regal, Milagros Lisset León; Páramo, C.; Sierra, Josep M.; García-Mayor, Ricardo V.

doi:10.1046/j.1365-2265.2001.01406.x

Cited by 305 publications

(181 citation statements)

References 18 publications

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“…Hypopituitarism characterized by diminished pituitary gland function can result from multiple underlying causes with a prevalence of 45.5 cases per 100,000 internationally (Regal, Paramo, Sierra, & Garcia‐Mayor, 2001). Combined deficiencies of growth hormone, thyrotropin, and prolactin are typical in congenital hypopituitarism, a form of hypopituitarism in which mutation in PIT1 is a common genetic cause (Stieg et al, 2017; Takagi et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

VCAM‐1 upregulation accompanies muscle remodeling following resistance‐type exercise in Snell dwarf (Pit1^dw/dw) mice

et al. 2018

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Snell dwarf mice (Pit1dw/dw) exhibit deficiencies in growth hormone, prolactin, and thyroid stimulating hormone. Besides being an experimental model of hypopituitarism, these mice are long‐lived (>40% lifespan extension) and utilized as a model of slowed/delayed aging. Whether this longevity is accompanied by a compromised quality of life in terms of muscular performance has not yet been characterized. In this study, we investigated nontrained and trained muscles 1 month following a general validated resistance‐type exercise protocol in 3‐month‐old Snell dwarf mice and control littermates. Nontrained Snell dwarf gastrocnemius muscles exhibited a 1.3‐fold greater muscle mass to body weight ratio than control values although muscle quality, maximum isometric torque normalized to muscle mass, and fatigue recovery were compromised. For control mice, training increased isometric torque (17%) without altering muscle mass. For Snell dwarf mice, isometric torque was unaltered by training despite decreased muscle mass that rendered muscle mass to body weight ratio comparable to control values. Muscle quality and fatigue recovery improved twofold and threefold, respectively, for Snell dwarf mice. This accompanied a fourfold increase in levels of vascular cell adhesion molecule‐1 (VCAM‐1), a mediator of progenitor cell recruitment, and muscle remodeling in the form of increased number of central nuclei, additional muscle fibers per unit area, and altered fiber type distribution. These results reveal a trade‐off between muscle quality and longevity in the context of anterior pituitary hormone deficiency and that resistance‐type training can diminish this trade‐off by improving muscle quality concomitant with VCAM‐1 upregulation and muscle remodeling.

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Section: Discussionmentioning

confidence: 99%

VCAM‐1 upregulation accompanies muscle remodeling following resistance‐type exercise in Snell dwarf (Pit1^dw/dw) mice

et al. 2018

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“…In previous cohort studies performed in Spain, Japan, and the USA, it was found that SS was an uncommon disorder among women (18,19,20). Therefore, SS has become a neglected and unnoticed syndrome because of its rarity in developed countries.…”

Section: Discussionmentioning

confidence: 99%

Extensive investigation of 114 patients with Sheehan's syndrome: a continuing disorder

Diri

Tanrıverdi

Karaca

et al. 2014

European Journal of Endocrinology

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Objective: Sheehan's syndrome (SS) is a well-known cause of hypopituitarism resulting from postpartum pituitary necrosis. Because of its rarity in Western society, its diagnosis is often overlooked. We aimed to investigate the clinical, laboratory, and radiological aspects of SS in a large number of patients. Study design: A retrospective assessment of the medical records of 114 patients with SS was conducted. In addition, sella turcica volumes of 29 healthy women were compared with those of patients by magnetic resonance imaging examinations. Results: The mean period of diagnostic delay was 19.7 years in patients with SS. It was found that 52.6% of patients had nonspecific complaints, 30.7% had complaints related to adrenal insufficiency, and 9.6% had complaints related to hypogonadism when diagnosed. At the time of diagnosis, 55.3% of the patients had panhypopituitarism, while 44.7% had partial hypopituitarism. The number of deficient hormones was found to be increased over the years. None of the patients whose basal prolactin was below 4.0 ng/ml had adequate prolactin responses to TRH test, while all patients whose basal prolactin was above 7.8 ng/ml had adequate responses. Mean sella volume was found to be significantly lower in the SS group (340.5G214 mm 3 ) than that in the healthy group (602.5G192 mm 3 ). Conclusions: SS is a common cause of hypopituitarism in underdeveloped and developing countries. The main reasons for diagnostic delay seem to be the high frequency of patients with nonspecific complaints and neglect of SS. In addition, the TRH stimulation test was found to have a high sensitivity and specificity to recognize PRL deficiency. Furthermore, small sella size may have an important contributing role in the etiopathogenesis of SS.

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“…The main concern of the primary care provider, then, is to know the prevalence of undiagnosed hypothalamic/pituitary disease causing hypothyroidism. Population-based data on this subject is limited, but Regal et al 27 reported a prevalence of hypothyroidism due to hypopituitarism of just 19-29/100,000 (perhaps 1 case per 4355 patients) in an adult Caucasian population in northwestern Spain. This prevalence is likely an underestimate based on flaws in case identification inherent in population-based studies.…”

Section: Hypothalamic And/or Pituitary Diseasementioning

confidence: 99%

Biochemical Testing of the Thyroid: TSH is the Best and, Oftentimes, Only Test Needed – A Review for Primary Care

Sheehan

2016

Clin Med Res

148

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Disorders of thyroid function are common, and screening, diagnosis, and management are often performed by primary care providers. While management of significant biochemical abnormalities is reasonably straight forward, laboratory tests only slightly outside, or even within, the normal range are becoming more difficult to appropriately manage. A large part of this increasing difficulty in appropriate management is caused by patients requesting, and even demanding, certain tests or treatments that may not be indicated. Symptoms of thyroid dysfunction are non-specific and extremely prevalent in the general population. This, along with a growing body of information available to patients via the lay press and internet suggesting that traditional thyroid function testing is not reliable, has fostered some degree of patient mistrust. Increasingly, when a physician informs a patient that their thyroid is not the cause of their symptoms, the patient is dissatisfied and even angry. This review aims to clarify the interpretation of normal and mild abnormalities of thyroid function tests by describing pituitarythyroid physiology and through an in depth review of, arguably, the three most important biochemical tests of thyroid function: TSH, free T4, and anti-TPO antibodies. It is important for primary care providers to have an understanding of the shortcomings and proper interpretation of these tests to be better able to discuss thyroid function with their patients.

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Prevalence and incidence of hypopituitarism in an adult Caucasian population in northwestern Spain

Cited by 305 publications

References 18 publications

VCAM‐1 upregulation accompanies muscle remodeling following resistance‐type exercise in Snell dwarf (Pit1^dw/dw) mice

VCAM‐1 upregulation accompanies muscle remodeling following resistance‐type exercise in Snell dwarf (Pit1^dw/dw) mice

Extensive investigation of 114 patients with Sheehan's syndrome: a continuing disorder

Biochemical Testing of the Thyroid: TSH is the Best and, Oftentimes, Only Test Needed – A Review for Primary Care

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Prevalence and incidence of hypopituitarism in an adult Caucasian population in northwestern Spain

Cited by 305 publications

References 18 publications

VCAM‐1 upregulation accompanies muscle remodeling following resistance‐type exercise in Snell dwarf (Pit1dw/dw) mice

VCAM‐1 upregulation accompanies muscle remodeling following resistance‐type exercise in Snell dwarf (Pit1dw/dw) mice

Extensive investigation of 114 patients with Sheehan's syndrome: a continuing disorder

Biochemical Testing of the Thyroid: TSH is the Best and, Oftentimes, Only Test Needed – A Review for Primary Care

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VCAM‐1 upregulation accompanies muscle remodeling following resistance‐type exercise in Snell dwarf (Pit1^dw/dw) mice

VCAM‐1 upregulation accompanies muscle remodeling following resistance‐type exercise in Snell dwarf (Pit1^dw/dw) mice