Incidence, mortality, and cardiovascular diseases in pituitary adenoma in Korea: a nationwide population-based study
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Incidence, mortality, and cardiovascular diseases in pituitary adenoma in Korea: a nationwide population‑based study Jae Sang Oh1 · Hyun Jung Kim2 · Hoo Jae Hann3 · Tae Uk Kang4 · Dong Sook Kim5 · Min Ji Kang4 · Ji Young Lee1 · Jai Joon Shim1 · Man Ryul Lee6 · Hyeong Sik Ahn2 Accepted: 14 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Few nationally representative studies have evaluated the epidemiology of PA (pituitary adenoma). This South Korean study evaluated the incidence of different PA subtypes, cardiovascular disease (CVD), and related mortality. Methods This population-based study evaluated 31,898 patients with PA during 2005–2015. The incidence of PA, mortality, and CVD occurrence in PA cases were evaluated during a median follow-up of 5.3 years (range: 0–10 years). Cox regression analysis was used to evaluate the associations between CVD and mortality. Results The annual incidences (per 100,000 population) were 3.5 for non-functioning pituitary adenoma (NFPA), 1.6 for prolactinoma (PRL), 0.5 for growth hormone-secreting pituitary adenoma (GH), and 0.2 for adrenocorticotropic or thyroid-stimulating hormone-secreting pituitary adenoma (ACTH + TSH). The standardized mortality ratios were 1.9 for ACTH + TSH, 1.7 for NFPA with hypopituitarism, 1.4 for NFPA without hypopituitarism, 1.3 for GH, and 1.1 for PRL. During 2005–2015, the overall incidence of CVD among PA patients was 6.6% (2106 cases), and the standardized incidence ratios were 4.1 for hemorrhagic stroke, 3.0 for ischemic stroke, and 1.7 for acute myocardial infarction. The standardized incidence ratios for stroke were significantly higher in the ACTH + TSH and NFPA groups, which also had higher risks of CVD-related mortality, relative to the PRL and GH groups. Conclusion South Korea had a relatively high incidence of NFPA. The incidence of stroke was highest for ACTH + TSH and NFPA, which was directly related to mortality during long-term follow-up. Patients with these types of PA should receive stroke prevention measures to reduce their risk of mortality. Keywords Pituitary neoplasm · Incidence · Mortality · Stroke · Cardiovascular
Introduction Jae Sang Oh and Hyun Jung Kim have contributed equally to this manuscript. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11102-020-01084-6) contains supplementary material, which is available to authorized users. * Hyeong Sik Ahn [email protected] 1
Department of Neurosurgery, College of Medicine, Soonchunhyang University, Asan, Republic of Korea
2
Department of Preventive Medicine, College of Medicine, Korea University, 126‑1, 5‑ga, Anam‑dong, Sungbuk‑gu, Seoul 136‑705, Republic of Korea
3
Medical Research Institute, Ewha Womans University, Seoul, Republic of Korea
Pituitary adenomas (PA) account for approximately 10–15% of intracranial tumors and almost 25% of benign primary brain tumors [1]. The annual incidence of PA reportedly ranges from 2.7 cases to 9.8 cases per 100,000
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