Comprehensive evaluation and analysis of pituitary hormones in male patients with non-functional pituitary adenoma during the perioperative period.

OBJECTIVE

To analyze perioperative hormonal changes in male patients with non-functioning pituitary adenomas undergoing transsphenoidal surgery and establish a method for assessing adenopituitary function.

METHODS

We retrospectively analyzed preoperative clinical and imaging data, and perioperative anterior pituitary hormone levels of 123 male non-functioning pituitary adenomas patients who underwent surgery from 2012 to 2022. Hormone scores were calculated using an inverse tangent function normalized to normal hormone levels (0-1). Total pituitary hormone score summed six hormones (GH, ACTH, TSH, PRL, FSH, LH) reflecting overall pituitary secretion. ROC curves and AUC were calculated for assessment.

RESULTS

Most hormone levels (except GH, FSH) and total scores decreased postoperatively in large/giant adenoma groups, recovering by 3 months. Significant preoperative and postoperative differences were found in GH, TSH, LH, and total scores (P < 0.05). TSH, PRL, FSH, and total scores showed significant time-related changes, while GH, ACTH, and LH remained stable. Total scores differed significantly between patients with and without preoperative hypopituitarism (P < 0.001 for ACTH, FSH, LH, TSH). Prediction models had AUCs of 0.755 and 0.636 for patients without and with preoperative hypopituitarism, respectively.

CONCLUSIONS

Male non-functioning pituitary adenomas patients experienced immediate postoperative hormonal drops, followed by gradual recovery. The total hormone score efficiently assessed pituitary function, simplifying complex hormonal dynamics.