Endocrine Abstracts

JOINT2554

Background: Whether Body mass index (BMI) impacts on surgical outcomes and complications in patients with non-functioning pituitary adenomas (NFPA) who undergo transsphenoidal surgery (TSS) has not been explored.

Objective: To assess the influence of BMI on quality of life (QoL) and surgical complications in patients with NFPA.

Methods: Before and 12 months after TSS, BMI, endocrine function, QoL (EQ-5D visual analogue scale (EQ-VAS)), peri- and postoperative complications were assessed in 122 consecutive patients with NFPA. A 5% body weight change was considered significant.

Results: The mean preoperative BMI was 27.9 ± 4.9, 42 (34%) patients had BMI <25, and 37 (30%) had BMI >30 kg/m². Preoperative hypogonadotropic hypogonadism (HH) was more common in patients with BMI >30 compared to those with BMI <25, 57% vs 33%; P = 0.044. High BMI was not associated with any perioperative complications. At 12 months after TSS the mean BMI was unchanged (27.9±5.3, P = 0.53), but 19 patients (16%) had lost weight and 17 (14%) had gained weight. A larger portion of patients with BMI >30 had growth hormone (GH) deficiency and HH compared to patients with BMI <25, 70% vs 45%; P = 0.036, and 57% vs 26%; P = 0.01, respectively. A larger portion of patients who gained weight had central hypothyroidism and adrenal insufficiency compared with those who had lost weight, 71% vs 26%; P = 0.018 and 53% vs 11%; P = 0.010, respectively. The median EQ-VAS score increased in patients with BMI <25 from 70.0 (Interquartile range (IQR) 53-80) to 80 (65-93); P = 0.008, and in patients who lost weight, from 70 (40-80) to 85 (65-94); P = 0.007. In patients with BMI >30, EQ-VAS did not improve (70 [40-85] to 80 [63-90]; P = 0.426), nor in patients who gained weight (75 [60-90] to 80 [58-90], P = 0.460).

Conclusions: High BMI is common in patients with NFPA and is associated with preoperative HH and postoperative HH and GH deficiency. Adrenal insufficiency and central hypothyroidism occur more frequently in patients who gain weight after TSS. High BMI and increased body weight are associated with less improvement of QoL.