Pituitary最新文献

{"title":"Persistent barriers to growth hormone replacement therapy for adults.","authors":"Andrew R Hoffman","doi":"10.1007/s11102-026-01707-4","DOIUrl":"10.1007/s11102-026-01707-4","url":null,"abstract":"","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 4","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259434","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":"Three-week actigraphy to assess sleep behaviour and circadian rest-activity patterns in suspected and confirmed Cushing's syndrome: an exploratory prospective cohort study.","authors":"Annika Steinkogler, Stephanie Zopp, Adriana Albani, Marily Theodoropoulou, Isabel Stüfchen, Júnia R O L Schweizer, Friederike Völter, Katrin Ritzel, Kathrin Moser, Katharina Schilbach, Martin Bidlingmaier, Martin Reincke, Elisabeth Nowak","doi":"10.1007/s11102-026-01686-6","DOIUrl":"10.1007/s11102-026-01686-6","url":null,"abstract":"<p><strong>Purpose: </strong>Sleep disturbances are common in endogenous Cushing's syndrome (CS), impair quality of life, and often persist despite remission. We evaluated the diagnostic value of actigraphy in suspected CS, characterised sleep and rest-activity patterns during remission, and examined associations between late-night salivary cortisol (LNSC) and objective sleep measures.</p><p><strong>Methods: </strong>Exploratory prospective single-centre cohort study at LMU Hospital Munich with two cohorts: (1) individuals evaluated for suspected CS and (2) patients in remission, stratified by recovered versus persistent adrenal insufficiency. Participants wore an ActTrust2 actigraph for 21 days, provided daily LNSC samples, and completed the Munich Chronotype Questionnaire.</p><p><strong>Results: </strong>Cohort 1 included 16 patients with confirmed CS and 13 with exclusion of CS. Actigraphy detected comparable sleep efficiency, fragmentation and circadian rest-activity rhythms in both groups, without distinct alterations attributable to active CS, except for a significantly earlier chronotype (p=0.022). Cohort 2 comprised 23 patients in remission (13 with persistent, 10 with recovered adrenal insufficiency) and showed similar sleep characteristics across subgroups. LNSC revealed high inter- and intraindividual variability without consistent associations with actigraphy-derived sleep parameters. Statistically significant effects were confined to patients with persistent adrenal insufficiency, in whom higher LNSC (likely reflecting non-physiological replacement therapy) was associated with earlier bedtime, longer time in bed, prolonged sleep-onset latency, and reduced sleep efficiency.</p><p><strong>Conclusion: </strong>Apart from chronotype, actigraphy showed limited discriminatory value between clinical groups. LNSC was highly variable and showed no consistent associations with sleep parameters, underscoring the need for improved biomarkers and monitoring strategies in CS.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 4","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259432","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":"Reassuring long-term data on efficacy and safety of pegvisomant monotherapy in a large series of patients with acromegaly.","authors":"Leandro Kasuki, Ansgar Heck","doi":"10.1007/s11102-026-01708-3","DOIUrl":"10.1007/s11102-026-01708-3","url":null,"abstract":"","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 4","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252906","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":"Management-specific outcome evaluation of pituitary apoplexy; conservative and surgical approach.","authors":"M C Guijt, M J T Verstegen, A H Zamanipoor Najafabadi, L E H Bakker, I C Notting, I C M Pelsma, W R van Furth, N R Biermasz, K M J A Claessen","doi":"10.1007/s11102-026-01695-5","DOIUrl":"10.1007/s11102-026-01695-5","url":null,"abstract":"<p><strong>Purpose: </strong>Pituitary apoplexy can be managed by early surgery or a conservative approach, if necessary, followed by later elective surgery. Choice of management is related to correct diagnosis, symptom severity at presentation and symptom development prior to contacting the pituitary center of excellence (PTCOE). Specific circumstances may dictate a specific choice, in others shared decision-making is key. This retrospective cohort study aimed to describe clinical decision-making and outcomes of pituitary apoplexy treatment.</p><p><strong>Methods: </strong>Outcome measures were factors relevant to treatment choice, visual acuity (VA), visual field defects (VFD), cranial nerve palsies, pituitary function, measured at three time points (baseline, 6 months after diagnosis, last follow-up).</p><p><strong>Results: </strong>We studied 98 patients with clinical apoplexy diagnosed between 2005 and 2021. After the first clinical evaluation, 45 patients underwent early surgery and 53 initial conservative management. Main indications for early surgery were lowered VA and/or severe VFD. Postoperatively, mean VA improved from 0.63 (SD = 0.36) to 1.03 (SD = 0.3). VFD improved in 72.2% of patients. During continued follow-up, 21 initially conservatively treated patients had later elective surgery. VFD improved in 85.7% of these patients. Mean follow-up was > 38 months for each group.</p><p><strong>Conclusion: </strong>The choice for surgery is mainly driven by ophthalmological symptoms, in which severity determines its timing. Although ophthalmological recovery rates are reasonable, (endocrine) outcomes of apoplexy are unfavorable, irrespective of trajectory. Prospective studies are needed to assess optimal (timing of) treatment, in particular in those patients without an obvious reason for early surgery, taking into account the heterogeneity and variable course of this condition.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 3","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056399","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":"Speckle-tracking echocardiography reveals the synergistic impact of GH/IGF-1 excess and metabolic dysregulation on cardiac dysfunction in acromegaly.","authors":"Meiping Chen, Pengyuan Zhang, Wei He, Jiewen Jin, Rong Huang, Zhihong Liao, Haipeng Xiao, Fengjuan Yao, Yanbing Li, Hai Li","doi":"10.1007/s11102-026-01684-8","DOIUrl":"10.1007/s11102-026-01684-8","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiac involvement in acromegaly is traditionally attributed to GH/IGF-1 excess, yet the subclinical impact of disease activity and metabolic comorbidities remains inadequately quantified. This study aims to characterize subclinical myocardial dysfunction in acromegaly using speckle-tracking echocardiography (STE) and explore its associations with disease activity, metabolic parameters, and treatment status.</p><p><strong>Methods: </strong>In this cross-sectional study, 74 patients with acromegaly (39 females) underwent detailed clinical, biochemical, and STE evaluation. STE-derived parameters of myocardial strain and work were analyzed including global longitudinal strain (GLS), left ventricular systolic dyssynchrony (LVSD), and global wasted work (GWW), and global work efficiency (GWE). Stratification by sex, treatment (naïve/active/remission), and metabolic profile was performed. Multivariable linear regressions identified predictors of cardiac structure/function.</p><p><strong>Results: </strong>Male patients exhibited higher IGF-1 level, BMI, and more pronounced cardiac alterations than females (all p < 0.05). IGF-1 z-score was strongly correlated with cardiac structural indices (IVS thickness, r = 0.564; LVPW thickness, r = 0.431) and dysfunction (LVSD, r = 0.359; GWE, r = - 0.361; all p < 0.01). These associations were significantly potentiated in high-BMI and high-triglyceride-glucose (TyG) index subgroups. Patients achieving biochemical remission showed superior cardiac structure and function compared to untreated/active groups (p < 0.05). Multivariable linear regressions analysis identified IGF-1 z-score as an independent predictor of both LVPW thickness (β = 0.210, p = 0.045) and LVSD index (β = 2.249, p = 0.048), with BMI and male sex as additional predictors of LVPW thickening.</p><p><strong>Conclusions: </strong>Subclinical cardiac dysfunction in acromegaly is driven by IGF-1, exacerbated by metabolic factors, and improved with remission. STE supports early risk stratification and integrated management.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 3","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056408","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":"The hook effect in macroprolactinomas: tumor size thresholds, prolactin patterns, and clinical consequences - a systematic review.","authors":"Prashant Yadav, Amir H Hamrahian, Roberto Salvatori","doi":"10.1007/s11102-026-01705-6","DOIUrl":"10.1007/s11102-026-01705-6","url":null,"abstract":"<p><strong>Purpose: </strong>The immunoassay \"hook effect\" may cause spuriously low prolactin (PRL) measurements in patients with macroprolactinomas, leading to misdiagnosis and inappropriate management. This systematic review aimed to determine the tumor size threshold and distribution at which the hook effect has been documented, characterize the pre-dilution PRL pattern, quantify the magnitude of PRL underestimation, and assess the clinical consequences of unrecognized hook effect.</p><p><strong>Methods: </strong>PubMed, Embase, Scopus, Google Scholar, and Web of Science were searched for articles published between January 2000 and August 2025. Studies reporting individual patient data with confirmed hook effect (pre- and post-dilution PRL, tumor size, and confirmation by serial dilution) were included. Quality was assessed using the JBI Critical Appraisal Checklist for Case Reports. Data were synthesized using individual patient data (IPD) quantitative methods. The review was registered on PROSPERO (CRD420261375863) and reported per PRISMA 2020 guidelines.</p><p><strong>Results: </strong>Twenty-three patients from 14 studies across 9 countries were included, with a median maximum tumor diameter of 48.0 mm (IQR 35.5-55.0; range 22-100 mm); the smallest confirmed hook-effect tumor diameter measured 22 mm, reported in two independent cases, and 9 of 23 cases (39.1%) occurred in tumors below the conventional giant adenoma threshold (≥ 40 mm). Median pre-dilution PRL was 100.0 ng/mL (IQR 62.0-164.5), while median post-dilution PRL was 6,460.0 ng/mL (IQR 3,608.5-16,657.5), yielding a median fold increase of 64.7× (IQR 46.8-141.5). Pre-dilution PRL ranged from 26 to 200 ng/mL in 82.6% of cases (95% CI: 62.9-93.0%), values often misattributed to stalk effect. Unrecognized hook effect led to unnecessary surgery in 55.6% of cases with documented clinical outcomes. The hook effect was documented across multiple immunoassay platforms.</p><p><strong>Conclusions: </strong>Pre-dilution PRL values often overlap with the range attributed to stalk effect, and serial dilution testing should be considered for pituitary macroadenoma with PRL disproportionately low relative to tumor size, regardless of whether the tumor meets the giant adenoma threshold to prevent misdiagnosis, unnecessary surgical intervention and delayed initiation of dopamine agonist therapy.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 3","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056372","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":"Osteometabolic complications in patients with secreting pituitary adenomas: Is there an impact of gender?","authors":"Luigi di Filippo, Matteo Acanfora, Simona Bolamperti, Umberto Terenzi, Maristella Bonomo, Andrea Giustina","doi":"10.1007/s11102-026-01667-9","DOIUrl":"10.1007/s11102-026-01667-9","url":null,"abstract":"<p><p>Pituitary adenomas are common intracranial neoplasms and represent a clinically relevant but frequently underrecognized cause of secondary osteoporosis and fragility fractures. Hormonal excess, coexisting pituitary deficiencies, and the iatrogenic burden of multimodal treatments act synergistically to impair bone remodeling, microarchitecture, and mechanical strength. Consequently, skeletal fragility may manifest at a relatively young age and is often inadequately predicted by dual-energy X-ray absorptiometry (DXA)-derived areal bone mineral density (aBMD) alone.This narrative review summarizes current evidence on skeletal involvement in functioning pituitary adenomas, including acromegaly, Cushing's disease (CD), prolactinomas, and thyrotropin [TSH]-secreting adenomas (TSHomas), with a specific focus on sex-related differences relevant to clinical practice. Although several pituitary adenomas are more prevalent in women, male patients frequently present with delayed diagnoses, harboring larger and more aggressive tumors. Consequently, men may be affected by a longer cumulative exposure to hormone excess and a higher prevalence and severity of panhypopituitarism, often exacerbated by the mass effect and multiline therapies. Across clinical cohorts, these interacting factors are consistently associated with an increased burden of fragility fractures, particularly in male patients.In pituitary disorders, fracture risk is commonly underestimated because DXA-derived aBMD does not adequately capture alterations in bone quality and structural integrity. Comprehensive skeletal evaluation, including systematic vertebral morphometry, trabecular bone score (TBS), and selected advanced imaging techniques, improves detection of occult fractures and refines fracture risk stratification. Moreover, the persistently low awareness, diagnosis, and treatment rates of osteoporosis in men represent a substantial and potentially modifiable gap in care, particularly in secondary forms related to endocrine diseases.This review highlights the need for a proactive, sex-aware clinical approach that integrates endocrine management with appropriate skeletal assessment and bone-directed therapy, with the aim of reducing fracture burden and improving long-term outcomes in patients with pituitary diseases.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 3","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056383","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":"Prolactinoma-associated headache: Clinical and radiological correlates and long-term outcomes.","authors":"Lukas Andereggen, Christoph Schankin, Philipp Schuetz, Andrea Stieger, Markus M Luedi, Atila Cihan, Michel Roethlisberger, Luigi Mariani, Jürgen Beck, Emanuel Christ","doi":"10.1007/s11102-026-01699-1","DOIUrl":"10.1007/s11102-026-01699-1","url":null,"abstract":"<p><strong>Purpose: </strong>While headache is frequently encountered in patients with prolactinomas, data on its determinants and long-term outcome following upfront medical versus upfront surgical treatment are limited. We aimed to identify clinical and radiological determinants of prolactinoma-associated headache (PAH) and to evaluate long-term headache outcomes according to the primary treatment strategy.</p><p><strong>Methods: </strong>We retrospectively analyzed 145 prolactinoma patients treated at a tertiary center. Headache at presentation, endocrine parameters, tumor size, and cavernous sinus involvement were assessed. Independent determinants of PAH at diagnosis were identified using multivariable logistic regression. Long-term headache status and prolactin outcomes were evaluated according to upfront dopamine agonist (DA) therapy or transsphenoidal surgery (TSS).</p><p><strong>Results: </strong>At diagnosis, 42 of 145 patients (28.9%) presented with PAH. Compared with patients without PAH, those with PAH were older, more often male, and more likely to harbor macroadenomas and tumors with cavernous sinus involvement. In multivariable analysis, cavernous sinus involvement was the only independent factor associated with PAH (adjusted OR, 7.8; 95% CI, 1.2-48.7; p = 0.03), whereas baseline prolactin levels were not independently associated. After a median follow-up of 80 months, headache prevalence declined from 28.9% to 2.8% (p < 0.001). Durable headache improvement was observed after both DA therapy and transsphenoidal surgery, with no significant difference between treatment modalities.</p><p><strong>Conclusion: </strong>PAH is most strongly linked to tumor invasiveness rather than to prolactin levels alone. Durable headache relief is achieved with both upfront surgical and medical therapy, suggesting that effective tumor control, rather than the specific initial treatment approach, is the key determinant of headache improvement. These findings support careful patient counseling and underscore the importance of an individualized multidisciplinary approach in prolactinoma patients presenting with headache.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 3","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006321","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":"Assessment of intratumoral collagen in pituitary neuroendocrine tumors (pituitary adenomas/PitNets) via digital pathology and its correlation with intraoperative consistency.","authors":"Acitores Cancela A, Ayuso-Cerezo H, Rodríguez Berrocal V, Carretero-Barrio I, Ruz-Caracuel I, Pian H, Díez Juan J, Iglesias P","doi":"10.1007/s11102-026-01703-8","DOIUrl":"10.1007/s11102-026-01703-8","url":null,"abstract":"<p><strong>Introduction: </strong>The success of endoscopic transsphenoidal resection of pituitary neuroendocrine tumors (pituitary adenomas/PitNets) depends largely on tumor consistency, as fibrous tumors pose greater surgical difficulty and are associated with higher morbidity. However, histological correlates of intraoperative consistency remain inconsistently defined. This study evaluated the relationship between intraoperative tumor consistency and collagen content using digital image analysis.</p><p><strong>Methods: </strong>Biopsy samples from patients undergoing surgery for pituitary adenomas/PitNets were included. Tumor consistency was assessed intraoperatively by the same neurosurgeon and classified as soft, firm, or fibrous. Histological sections were stained with Masson's trichrome, and digital image analysis was performed using QuPath software. A trained pixel classifier artificial neural network differentiated collagen, tumor tissue, and background. Collagen content, as a surrogate marker of fibrosis, was quantified as a percentage of total tumor area. All analyses were conducted blinded to intraoperative assessments.</p><p><strong>Results: </strong>A total of 69 tumors were analyzed: 30 soft (43.5%), 22 firm (31.9%), and 17 fibrous (24.6%). Median collagen content increased progressively across groups (6.3%, 8.3%, and 22.0%, respectively). Fibrous tumors demonstrated significantly higher collagen content compared with soft and firm tumors (p < 0.05), while no significant difference was observed between soft and firm tumors. Collagen content was not associated with tumor subtype or patient age, and its deposition was heterogeneous between paired tissue blocks (CV = 59.83%).</p><p><strong>Conclusion: </strong>Digital collagen quantification provides an objective histological correlate of intraoperative tumor consistency, validating the distinction between soft and fibrous tumors, and establishing a reference standard for future studies aimed at developing preoperative predictive models.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 3","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006389","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":"Prevalence and patterns of biochemical discordance in patients with surgically treated acromegaly.","authors":"Anna Pennlund, Thomas Olsson Bontell, Thomas Skoglund, Helena Carén, Gudmundur Johannsson, Daniel S Olsson, Daniela Esposito","doi":"10.1007/s11102-026-01694-6","DOIUrl":"10.1007/s11102-026-01694-6","url":null,"abstract":"<p><strong>Objective: </strong>Discordance between growth hormone (GH) and insulin-like growth factor-1 (IGF-1), where one hormone is within the age- and sex-adjusted reference and the other is not, can be observed in patients with acromegaly. The discrepancy complicates the interpretation of disease activity, thereby presenting a significant challenge in the clinical management of acromegaly. This study aimed to assess postoperative discordance prevalence and clinical correlates to clarify the implication of discordance.</p><p><strong>Methods: </strong>This retrospective study describes a cohort of patients that has undergone pituitary surgery at Sahlgrenska University Hospital between 1994 and 2019 due to acromegaly. Medical records were reviewed and the group with postoperative discordant hormones was compared with the group with concordant hormones.</p><p><strong>Results: </strong>In a cohort of 82 patients surgically treated for acromegaly and thereafter examined with an oral glucose tolerance test (OGTT), 16 (19.5%) exhibited biochemical discordance. Fourteen of 16 patients showed elevated IGF-1 but normal GH. The IGF-1 levels at diagnosis were significantly higher in patients with discordance compared with the controlled concordant group. However, no differences were observed between the discordant and the concordant group regarding the baseline variables at diagnosis: age, gender, invasive tumour, micro/macro-adenoma or BMI, nor hypertensive treatment at time of surgery and postoperative radiotherapy or reoperation.</p><p><strong>Conclusion: </strong>The prevalence of biochemical discordance in our cohort was 19.5%. The predominant pattern was elevated IGF-1 levels with a normal nadir GH. The discordant group had higher IGF-1 at diagnosis, suggesting that greater preoperative disease activity may predispose to postoperative biochemical discordance.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"29 3","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006323","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}