Pituitary最新文献

{"title":"Correction to: The effect of centralized care on the management of postoperative fluctuations in plasma sodium concentration after pediatric suprasellar brain tumor surgery.","authors":"S C Hulsmann, D C Zaal, J P J van Gestel, M Sie, O H J Eelkman Rooda, K M van Baarsen, R E A Musson, B Bakker, E E S Nieuwenhuis, E W Hoving, R M Wösten-van Asperen, H M van Santen","doi":"10.1007/s11102-026-01723-4","DOIUrl":"10.1007/s11102-026-01723-4","url":null,"abstract":"","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 5","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Long-term cabergoline use does not predict degree of prolactinoma fibrosis nor significantly impact surgical outcomes.","authors":"Adam N Mamelak, Rachel Fox, Yaakov Rosenberg, Daniel Gomez, Yujie Cui, Anat Ben Shlomo, Artak Labadzhyan, Ning-Ai Liu, Vivien Bonert, Odelia Cooper","doi":"10.1007/s11102-026-01734-1","DOIUrl":"10.1007/s11102-026-01734-1","url":null,"abstract":"","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 5","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of endothelial dysfunction in women with prolactinoma.","authors":"Mehmet Cagri Unal, Osman Onur Daloglu, Ugur Karabiyik, Nihat Kalay, Kursad Unluhizarci, Zuleyha Karaca","doi":"10.1007/s11102-026-01754-x","DOIUrl":"10.1007/s11102-026-01754-x","url":null,"abstract":"<p><strong>Aim: </strong>Prolactinoma has been associated with impaired glucose metabolism and adverse cardiometabolic outcomes. This study aimed to evaluate the metabolic effects of hyperprolactinemia and its impact on endothelial function, as well as changes following treatment.</p><p><strong>Methods: </strong>Twenty patients with prolactinoma and 15 age- and BMI-similar healthy controls were included. All participants underwent an oral glucose tolerance test (OGTT) to assess glucose and insulin responses. Endothelial function was evaluated using carotid intima-media thickness (CIMT) and flow-mediated dilation (FMD) measured by Doppler ultrasonography, along with echocardiographic assessment. In patients, all measurements were repeated after six months of treatment, once prolactin levels normalized.</p><p><strong>Results: </strong>The mean age of patients was 26.9 ± 7.4 years with a BMI of 25.1 ± 5.6 kg/m². Patients had higher 120-minute glucose levels during OGTT compared to controls (105.1 ± 24.2 vs. 90.5 ± 15.9 mg/dL, p = 0.015). Following treatment, both 120-minute glucose levels and area under the curve glucose were significantly reduced (p = 0.045 and p = 0.005, respectively). Echocardiographic parameters, including systolic and diastolic function, as well as CIMT, were similar between groups and remained unchanged after treatment. In contrast, FMD was significantly lower in patients at baseline compared to controls (6.81 ± 5.22% vs. 16.8 ± 2.59%, p < 0.001) and improved after cabergoline therapy (13.18 ± 5.78%, p = 0.003), indicating endothelial dysfunction and its reversal with treatment.</p><p><strong>Conclusion: </strong>Patients with prolactinoma exhibit increased glucose intolerance and impaired endothelial function in the absence of overt global cardiac dysfunction. These alterations appear to be reversible following treatment.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 5","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in pituitary medicine: what should an endocrinologist know?","authors":"Damla N Costa, Rozalina G McCoy, Debraj Mukherjee, Roberto Salvatori","doi":"10.1007/s11102-026-01747-w","DOIUrl":"10.1007/s11102-026-01747-w","url":null,"abstract":"<p><p>Pituitary disorders often include complex radiology imaging, rare clinical presentations, and need for multidisciplinary decision-making and prolonged follow-up, all features that make them a natural target for artificial intelligence (AI). The resulting literature is expanding rapidly, but carries an unfamiliar vocabulary and set of methods, which can leave clinicians without a clear entry point. This short perspective offers such an entry point, succinctly outlining how AI learns from data, how a clinical AI application moves from question to deployment, providing examples, and addressing how to read the field critically.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 5","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revival of neurophysin-I as a complementary biomarker for circulating oxytocin.","authors":"Elizabeth A Lawson","doi":"10.1007/s11102-026-01745-y","DOIUrl":"10.1007/s11102-026-01745-y","url":null,"abstract":"<p><p>There is renewed interest in oxytocin (OXT) associated neurophysin-I (NP-I) as a surrogate biomarker of endogenous OXT secretion into circulation. OXT measurement in humans remains challenging because current assays vary in their specificity for free and protein-bound OXT, and OXT-related peptide species, including extended forms and peptide fragments, and results are influenced by sample handling and analytical methods. NP-I, a carrier protein that is co-synthesized and co-secreted with OXT, can be measured using a validated sandwich immunoassay without extraction. Studies support NP-I as a promising marker of OXT release to circulation, although it is not a replacement for direct OXT measurement. This Editorial reviews the biological relationship between OXT and NP-I, discusses the advantages and limitations of NP-I as a biomarker, and highlights future opportunities for integrating NP-I measurement with advances in OXT assay methodology to improve understanding of the human OXT system in health and disease.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 5","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term endocrine outcomes of transsphenoidal surgery for prolactinomas: a 20-year single-center cohort study.","authors":"Roméo Bujiriri Murhega, Stefan Matei Constantinescu, Christian Raftopoulos, Dominique Maiter, Edward Fomekong","doi":"10.1007/s11102-026-01749-8","DOIUrl":"10.1007/s11102-026-01749-8","url":null,"abstract":"<p><strong>Background: </strong>The role of transsphenoidal surgery in the management of prolactinomas remains debated in the era of dopamine agonist therapy. This descriptive study evaluated the long-term endocrine outcomes of transsphenoidal surgery in a highly selected single-center surgical cohort.</p><p><strong>Methods: </strong>We retrospectively reviewed all patients who underwent transsphenoidal surgery for prolactinomas at a tertiary referral center between September 1995 and July 2015. Biochemical remission was defined as normalization of serum prolactin levels 6 months after surgery. Persistent disease and recurrence were assessed during long-term follow-up. The analysis was descriptive and all subgroup comparisons were exploratory.</p><p><strong>Results: </strong>Fifty-five patients were included (47 women and 8 men; median age, 30 years), comprising 35 microprolactinomas (64%), 18 macroprolactinomas (33%), and 2 giant prolactinomas (3%). The median follow-up was 10.8 years. Biochemical remission at 6 months was achieved in 29 patients (53%), whereas persistent disease and recurrence were observed in 21 (38%) and 5 patients (9%), respectively. Remission rates were 60% for microprolactinomas and 44% for macroprolactinomas, whereas both giant prolactinomas had persistent disease. No male patient achieved biochemical remission, whereas remission was observed in 29 of 47 women (62%). This observation is exploratory: 6 of the 8 men harboured a macro- or giant prolactinoma and their median preoperative prolactin level was 848.7 ng/mL, against 136.4 ng/mL in women. Transient diabetes insipidus occurred in 9% of patients, whereas permanent complications were uncommon.</p><p><strong>Conclusions: </strong>In this highly selected surgical cohort, transsphenoidal surgery was followed by durable endocrine control in approximately half of the patients and by a low recurrence rate. These descriptive findings are compatible with a role for surgery as a second-line option, but do not allow inference about its comparative effectiveness.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 5","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of the TRH test for central hypothyroidism in patients with pituitary and parasellar tumors: a single-center retrospective cross-sectional study.","authors":"Battsetseg Buyandalai, Tetsuya Takamizawa, Kazuhiko Horiguchi, Sho Sekiguchi, Masashi Yoshikawa, Takuya Watanabe, Yutaka Watanuki, Emi Ishida, Satoshi Yoshino, Shunichi Matsumoto, Rei Yamaguchi, Masahiko Tosaka, Masanobu Yamada, Eijiro Yamada","doi":"10.1007/s11102-026-01751-0","DOIUrl":"10.1007/s11102-026-01751-0","url":null,"abstract":"<p><strong>Purpose: </strong>The utility and diagnostic interpretation of the thyrotropin-releasing hormone (TRH) test for diagnose central hypothyroidism (CeH) remain unclear.</p><p><strong>Method: </strong>To understand the significance of TRH testing for the diagnosis of CeH we reviewed the medical charts of 105 patients who underwent TRH test (200 µg) and analyzed TSH values and responses in three groups. Group 1, the control group, included 25 participants without pituitary and parasellar tumors (PPTs), and with normal pituitary function. Group 2, the CeH group, included 13 patients with PPTs and low free thyroxine (fT4) levels. Group 3 included 67 patients with PPTs but normal fT4 levels.</p><p><strong>Results: </strong>Basal TSH levels did not significantly differ between Group 1 and Group 2. After TRH test, a peak TSH value and fold-TSH response were significantly lower in Group 2. Group 2 showed a higher rate of delayed and prolonged TSH responses and lower fold-free triiodothyronine (fT3) responses. We determined the cut-off values of fold-TSH, prolonged response, and fold-fT3 responses for diagnosing CeH patients with high sensitivity and specificity. Using two or more of these cut-off values further reduced the false-positive rate to 4%. Group 3 had a higher rate of positive results than Group 1, suggesting that there are patients with hidden CeH.</p><p><strong>Conclusion: </strong>In this study, we revealed that CeH can be diagnosed with a TRH test with a probability of more than 90%, and the test may be useful for diagnosing the CeH in patients with normal fT4 levels.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 5","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soluble alpha-klotho as an adjunct biomarker of disease activity in acromegaly: Added value beyond GH and IGF-1.","authors":"Vivek Jha, Sanja Medenica, Naresh Sachdeva, Vaishali Kaur, Pinaki Dutta","doi":"10.1007/s11102-026-01748-9","DOIUrl":"10.1007/s11102-026-01748-9","url":null,"abstract":"<p><strong>Purpose: </strong>Assessment of disease activity in acromegaly is mainly based on growth hormone and insulin-like growth factor 1. However, discordance between these markers is common and may make follow-up difficult. This study evaluated soluble alpha-Klotho as an adjunct biomarker of biochemical disease activity in acromegaly.</p><p><strong>Methods: </strong>This case-control study included 80 patients with acromegaly and 80 controls. Patients were categorized as controlled, discordant, uncontrolled, or active disease. Serum soluble alpha-Klotho was measured by sandwich enzyme-linked immunosorbent assay and analyzed across groups, disease-status categories, and clinical-biochemical variables. Receiver operating characteristic analysis and nested models assessed its diagnostic and incremental value.</p><p><strong>Results: </strong>Alpha-Klotho concentrations were higher in acromegaly than controls [1551.9 (835.0-3158.3) vs. 759.7 (625.0-898.5) pg/mL; P < 0.001] and increased across disease-status categories: controlled treated acromegaly [722.0 (668.4-837.8)], discordant treated acromegaly [1426.9 (1119.0-1499.9)], uncontrolled treated acromegaly [2980.0 (2585.0-3650.0)], and newly diagnosed active acromegaly [3820.0 (2460.0-4620.0) pg/mL; overall P < 0.001]. Alpha-Klotho correlated with growth hormone and insulin-like growth factor 1 and identified active/uncontrolled disease with an area under the curve of 0.983. Its addition to growth hormone, insulin-like growth factor 1, age, sex, and body mass index improved discrimination from 0.947 to 0.986. Alpha-Klotho ≥ 1579.8 pg/mL was independently associated with active/uncontrolled disease.</p><p><strong>Conclusion: </strong>Soluble alpha-Klotho may serve as an adjunct marker of current biochemical activity in acromegaly, particularly for identifying uncontrolled treated or newly diagnosed active disease. It may aid selected cases with difficult biochemical interpretation, but should be used alongside GH, IGF-1, clinical assessment, and pituitary imaging, not as a replacement test.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 5","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond biochemical control: factors associated with quality of life in patients with acromegaly.","authors":"Ayşe Merve Ok Kurt, Özge Telci Çaklılı, Fatih Bektaş, Gamze Bilik Oyman, Ümmü Mutlu, Hülya Hacişahinoğulları, Gülşah Yenidünya Yalın, Nurdan Gül, Ayşe Kubat Üzüm, Ferihan Aral, Sema Yarman, Özlem Soyluk Selçukbiricik","doi":"10.1007/s11102-026-01746-x","DOIUrl":"10.1007/s11102-026-01746-x","url":null,"abstract":"<p><strong>Purpose: </strong>Quality of life (QoL) impairment may persist in acromegaly despite biochemical control. We evaluated disease-specific and generic QoL, psychological symptom burden, and associated factors.</p><p><strong>Methods: </strong>In this cross-sectional study, 90 patients completed the Acromegaly Quality of Life Questionnaire (AcroQoL), EQ-5D-3 L, EQ-VAS, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Demographic, clinical, biochemical, and treatment-related data were retrieved from records. Correlation analyses and hierarchical multivariable linear regression were used to assess factors associated with total AcroQoL.</p><p><strong>Results: </strong>The cohort included 46 female and 44 male patients; 86 were in biochemical remission. Median total AcroQoL, BDI, BAI, EQ-5D index, and EQ-VAS scores were 76.7, 10.5, 9.0, 0.7, and 80.0, respectively. Female patients had lower total AcroQoL scores and higher anxiety and depression scores than male patients. Higher educational status was associated with better AcroQoL and lower BDI scores. In Model 1, female sex was associated with lower total AcroQoL; however, this association became non-significant after moderate-to-severe depressive symptoms were added in Model 2. Depressive symptom status showed the largest independent association with lower total AcroQoL among model variables (B = - 17.56, 95% CI - 25.23 to - 9.89, p < 0.001), while higher educational status remained independently associated with better QoL. R^² increased from 0.206 to 0.365.</p><p><strong>Conclusion: </strong>In this predominantly biochemically controlled cohort, disease-specific QoL was more closely associated with depressive symptom burden and educational status than with the clinical variables examined. These findings support routine assessment of psychological symptoms and patient-reported outcomes during long-term care.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 5","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural history of conservatively managed nonfunctioning pituitary macroadenomas in the elderly: A study from the Swedish Pituitary Registry.","authors":"Camilla Jerning, Charlotte Höybye, Sophie Bensing, Britt Edén Engström, Nasrin Al-Shamkhi, Bertil Ekman, Lorenza Bonelli, Henrik Borg, Pia Burman, Per Dahlqvist, Victor Hantelius, Oskar Ragnarsson, Anna Svensson, Jeanette Wahlberg, Anna-Karin Åkerman, Katarina Berinder, Maria Petersson","doi":"10.1007/s11102-026-01752-z","DOIUrl":"https://doi.org/10.1007/s11102-026-01752-z","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate adenoma progression, pituitary function, visual impairment, and need for later surgery in elderly patients with conservatively managed nonfunctioning pituitary macroadenomas (macro-NFPAs).</p><p><strong>Methods: </strong>Patients ≥ 65 years in the Swedish Pituitary Registry diagnosed 1991-2023 with macro-NFPA and a decision for conservative management were included (n = 673, 38% females). Data at diagnosis and at 1- and 5-year follow-up, defined as assessments closest to 1 year (0.5-<2.5) and 5 years (2.5-<7.5), were retrieved. Surgery was recorded up to 7.5 years. Variables included adenoma size, pituitary function, visual impairment, and surgery. Patients were stratified into age groups 65-72, 73-80, and ≥ 81 years.</p><p><strong>Results: </strong>At diagnosis, mean age was 76 years, females were older (p < 0.001). Mean adenoma diameter and volume were 20 mm and 3067 mm³. Visual field defects and reduced visual acuity were seen in 20% and 12%, with no sex differences. Males had more hormone deficiencies (45% vs. 33%, p < 0.01). Hormone deficiencies and visual impairments increased with age (p < 0.001). The oldest subgroup had the largest adenomas (p < 0.01), with females having larger tumours (p < 0.05) and males more deficiencies (p < 0.05). Adenoma size, hormone deficiencies, and visual impairments remained stable over time within each age group. 6.7% underwent surgery during follow-up. In regression analyses, later surgery was associated with visual field defects at diagnosis (p < 0.05) but not with adenoma size.</p><p><strong>Conclusion: </strong>Pituitary surgery was uncommon in conservatively managed elderly patients with macro-NFPAs. Baseline visual field defects, but not tumour size, were associated with subsequent surgery, supporting regular individualised follow-up in these patients.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 5","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}