Associated factor analysis of early repolarization syndrome in patients with growth hormone-secreting pituitary adenomas

Abstract

Objective To study the incidence rate and risk factors of early repolarization syndrome (ERS) in patients with growth hormone-secreting pituitary adenomas. Methods A total of 103 patients with pituitary growth hormone (GH) adenomas (GH adenoma group) and 99 patients with pituitary nonfunctional adenomas (nonfunctional adenoma group) admitted to Department of Neurosurgery, Pituitary Tumor Center, the First Affiliated Hospital, Sun Yat-sen University, from August 2014 to August 2016 were prospectively enrolled. Comparison was conducted about the difference of left ventricular mass index (LVMI), prevalence of valvular disease, incidence of myocardial ischemia and incidence of ERS between the two groups. The risk factors of ERS in patients with growth hormone-secreting pituitary adenomas were investigated by Logistic regression analysis. Results Compared with pituitary nonfunctional adenomas, the growth hormone (GH), insulin-like growth factor-1 (IGF-1), LVMI and ERS were significantly increased in pituitary growth hormone adenomas (all P<0.05), and the incidences of ERS were 35.0% (36/103) and 13.1% (13/99) in pituitary growth hormone adenomas and pituitary nonfunctional adenomas, respectively. The results of Logistic regression analysis showed that LVMI was an independent risk factor for ERS (OR=1.012, 95%CI: 1.003-1.021, P=0.012). The results of the bivariate correlation analysis showed that the duration of disease (r=0.287, P<0.01), serum GH (r=0.310, P<0.01), IGF-1 (r=0.282, P<0.01) and diabetes mellitus (r=0.247, P<0.01) were associated with LVMI. The results of multivariate linear regression analysis demonstrated that the duration of disease and IGF-1 were positive risk factors of LVMI (all P<0.05). Conclusions Compared with that in pituitary nonfunctional adenomas, the incidence of ERS is significantly higher in pituitary growth hormone adenomas. Serum GH, IGF-1 and blood glucose demonstrate continuous increase which lead to myocardial hypertrophy and elevated LVMI and may be one of the reasons for increased incidence of ERS. Key words: Growth hormone-secreting pituitary adenoma; Insulin-like growth factors; Left ventricular mass index; Early repolarization syndrome