Sex-Specific Cardiovascular Risks and Mortality in Patients with Panhypopituitarism: A Nationwide Cohort Study

Background Panhypopituitarism is a condition of combined deficiency of multiple pituitary hormones, which requires lifelong hormone replacement therapy. Hormone deficiency or inadequate hormone replacement may contribute to cardiovascular disease. Here, we aimed to investigate the burden of cardiova...

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Main Authors: Seung Shin Park, Hyunmook Jeong, Chang Ho Ahn, Min Jeong Park, Yong Hwy Kim, Kwangsoo Kim, Jung Hee Kim
Format: Article
Language:English
Published: Korean Endocrine Society 2025-06-01
Series:Endocrinology and Metabolism
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Online Access:http://www.e-enm.org/upload/pdf/enm-2024-2176.pdf
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author Seung Shin Park
Hyunmook Jeong
Chang Ho Ahn
Min Jeong Park
Yong Hwy Kim
Kwangsoo Kim
Jung Hee Kim
author_facet Seung Shin Park
Hyunmook Jeong
Chang Ho Ahn
Min Jeong Park
Yong Hwy Kim
Kwangsoo Kim
Jung Hee Kim
author_sort Seung Shin Park
collection DOAJ
description Background Panhypopituitarism is a condition of combined deficiency of multiple pituitary hormones, which requires lifelong hormone replacement therapy. Hormone deficiency or inadequate hormone replacement may contribute to cardiovascular disease. Here, we aimed to investigate the burden of cardiovascular, cerebrovascular diseases and mortality in patients with panhypopituitarism. Methods A total of 5,714 patients with panhypopituitarism were enrolled in the Korean National Health Insurance Service database from 2003 to 2020. Panhypopituitarism was defined according to the International Classification of Diseases, 10th Revision (ICD- 10) codes for hypopituitarism, pituitary adenoma, or craniopharyngioma and the continuous prescription of thyroid hormone and glucocorticoids. The risks of all-cause mortality, coronary artery disease (CAD), heart failure (HF), ischemic stroke, and intracranial hemorrhage were compared between patients with panhypopituitarism and age-, sex-, and index year-matched controls. Results The mean age of patients with panhypopituitarism and matched controls was 55.1 years, and men accounted for 51.5%. Patients with panhypopituitarism showed significantly higher all-cause mortality compared to matched controls after adjustment for covariates (hazard ratio [HR], 2.18; 95% confidence interval [CI], 1.95 to 2.43 in men and HR, 3.09; 95% CI, 2.78 to 3.44 in women). Additionally, there were higher risks of CAD, HF, ischemic stroke, and intracranial hemorrhage in both sexes, except for CAD in men. Conclusion Patients with panhypopituitarism have elevated risks of cardiovascular and cerebrovascular diseases as well as increased mortality. These risks are particularly prominent for all-cause mortality in women. Therefore, proactive monitoring for cardiovascular and cerebrovascular complications is required in patients with panhypopituitarism.
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spelling doaj-art-e7d946e46f8d4f2cb1bed3a1a8d02e3a2025-08-20T03:28:34ZengKorean Endocrine SocietyEndocrinology and Metabolism2093-596X2093-59782025-06-0140346948310.3803/EnM.2024.21762579Sex-Specific Cardiovascular Risks and Mortality in Patients with Panhypopituitarism: A Nationwide Cohort StudySeung Shin Park0Hyunmook Jeong1Chang Ho Ahn2Min Jeong Park3Yong Hwy Kim4Kwangsoo Kim5Jung Hee Kim6 Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea Department of Transdisciplinary Medicine, Institute of Convergence Medicine with Innovative Technology, Seoul National University Hospital, Seoul, Korea Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea Pituitary Center, Seoul National University Hospital, Seoul, Korea Department of Transdisciplinary Medicine, Institute of Convergence Medicine with Innovative Technology, Seoul National University Hospital, Seoul, Korea Department of Internal Medicine, Seoul National University College of Medicine, Seoul, KoreaBackground Panhypopituitarism is a condition of combined deficiency of multiple pituitary hormones, which requires lifelong hormone replacement therapy. Hormone deficiency or inadequate hormone replacement may contribute to cardiovascular disease. Here, we aimed to investigate the burden of cardiovascular, cerebrovascular diseases and mortality in patients with panhypopituitarism. Methods A total of 5,714 patients with panhypopituitarism were enrolled in the Korean National Health Insurance Service database from 2003 to 2020. Panhypopituitarism was defined according to the International Classification of Diseases, 10th Revision (ICD- 10) codes for hypopituitarism, pituitary adenoma, or craniopharyngioma and the continuous prescription of thyroid hormone and glucocorticoids. The risks of all-cause mortality, coronary artery disease (CAD), heart failure (HF), ischemic stroke, and intracranial hemorrhage were compared between patients with panhypopituitarism and age-, sex-, and index year-matched controls. Results The mean age of patients with panhypopituitarism and matched controls was 55.1 years, and men accounted for 51.5%. Patients with panhypopituitarism showed significantly higher all-cause mortality compared to matched controls after adjustment for covariates (hazard ratio [HR], 2.18; 95% confidence interval [CI], 1.95 to 2.43 in men and HR, 3.09; 95% CI, 2.78 to 3.44 in women). Additionally, there were higher risks of CAD, HF, ischemic stroke, and intracranial hemorrhage in both sexes, except for CAD in men. Conclusion Patients with panhypopituitarism have elevated risks of cardiovascular and cerebrovascular diseases as well as increased mortality. These risks are particularly prominent for all-cause mortality in women. Therefore, proactive monitoring for cardiovascular and cerebrovascular complications is required in patients with panhypopituitarism.http://www.e-enm.org/upload/pdf/enm-2024-2176.pdfpituitary diseasescardiovascular diseasesmortalitystroke
spellingShingle Seung Shin Park
Hyunmook Jeong
Chang Ho Ahn
Min Jeong Park
Yong Hwy Kim
Kwangsoo Kim
Jung Hee Kim
Sex-Specific Cardiovascular Risks and Mortality in Patients with Panhypopituitarism: A Nationwide Cohort Study
Endocrinology and Metabolism
pituitary diseases
cardiovascular diseases
mortality
stroke
title Sex-Specific Cardiovascular Risks and Mortality in Patients with Panhypopituitarism: A Nationwide Cohort Study
title_full Sex-Specific Cardiovascular Risks and Mortality in Patients with Panhypopituitarism: A Nationwide Cohort Study
title_fullStr Sex-Specific Cardiovascular Risks and Mortality in Patients with Panhypopituitarism: A Nationwide Cohort Study
title_full_unstemmed Sex-Specific Cardiovascular Risks and Mortality in Patients with Panhypopituitarism: A Nationwide Cohort Study
title_short Sex-Specific Cardiovascular Risks and Mortality in Patients with Panhypopituitarism: A Nationwide Cohort Study
title_sort sex specific cardiovascular risks and mortality in patients with panhypopituitarism a nationwide cohort study
topic pituitary diseases
cardiovascular diseases
mortality
stroke
url http://www.e-enm.org/upload/pdf/enm-2024-2176.pdf
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