Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

Pituitary function after transsphenoidal surgery including measurement of basal morning cortisol as predictor of adrenal insufficiency

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Thyroid function in COVID-19 and the association with cytokine levels and mortality

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Cholecystokinin and the hormone concept

    Research output: Contribution to journalReviewResearchpeer-review

  3. Determining minimal important change for the thyroid-related quality of life questionnaire ThyPRO

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Free testosterone and cardiometabolic parameters in men: comparison of algorithms

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Plasma levels of glucagon but not GLP-1 are elevated in response to inflammation in humans

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Brain tumours in children and adolescents may affect the circadian rhythm and quality of life

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Management of a DAVF in a Patient with Loeys-Dietz Syndrome Type II: Case Report and Overview of the Literature

    Research output: Contribution to journalLetterResearchpeer-review

  3. Increase of Ki-67 index and influence on mortality in patients with neuroendocrine neoplasms

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Acute and persistent symptoms in non-hospitalized PCR-confirmed COVID-19 patients

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

Introduction: Patients with pituitary adenomas undergoing transsphenoidal surgery require pre- and post-surgery examination of pituitary hormones. There is currently no consensus on how to evaluate the adrenal axis post-surgery. The aims of this study were to investigate factors that may predict postoperative adrenal insufficiency (AI) and to investigate the overall effect of transsphenoidal surgery on pituitary function.

Methods: One hundred and forty-three consecutive patients who had undergone transsphenoidal surgery for pituitary adenomas were included. Data on tumour size, pituitary function pre-surgery, plasma basal cortisol measured within 48 h post-surgery and pituitary function 6 months post-surgery were collected. Patients with AI prior to surgery, perioperative glucocorticoid treatment, Cushing's disease and no re-evaluation after 1 month were excluded (n = 93) in the basal cortisol analysis.

Results: Low plasma basal cortisol post-surgery, tumour size and previous pituitary surgery were predictors of AI (all P < 0.05). A basal cortisol cut-off concentration of 300 nmol/L predicted AI 6 months post-surgery with sensitivity and negative predictive value of 100%, specificity of 81% and positive predictive value of 25%. New gonadal, thyroid and adrenal axis insufficiencies accounted for 2, 10 and 10%, respectively. The corresponding recovery rates were 17, 7 and 24%, respectively.

Conclusion: Transsphenoidal surgery had an overall beneficial effect on pituitary endocrine function. Low basal plasma cortisol measured within 48 h after surgery, tumour size and previous surgery were identified as risk factors for AI. Measurement of basal cortisol post-surgery may help to identify patients at risk of developing AI.

Original languageEnglish
JournalEndocrine Connections
Volume10
Issue number7
Pages (from-to)750-757
Number of pages8
ISSN2049-3614
DOIs
Publication statusPublished - 14 Jul 2021

    Research areas

  • adrenal insufficiency, basal cortisol, central hypothyroidism, hypogonadotropic hypogonadism, pituitary endocrine function, pituitary surgery, transsphenoidal surgery, Basal cortisol, Hypogonadotropic hypogonadism, Transsphenoidal surgery, Pituitary surgery, Adrenal insufficiency, Central hypothyroidism, Pituitary endocrine function

ID: 66418974