Diabetes mellitus and Size of Profil Area on X-ray Film of Sella turcica

Abstract

Real size of profil area of sella turcica (cm2) was measured on 46 diabetic patients, 16 women and 30 men, through planimetry of its figure on x-ray film obtained by “round sight rotatography” and mathematical conversion. 22 patients (48 per cent) gave smaller value than 0.80, and 19 patients did so larger one than 0.91 (41 per cent), while the size of most of healthy persons had been reported to be implied in the range of 0.81-0.9.The distribution of age of onset among those having smaller sella showed two peaks, one being found before 30 and the other after 41, and that among those having larger one showed only one peak which were found after 40 among women or 50 among men respectively. Observations were, therefore, made by dividing the patients into 3 groups according to onset age on one hand and size of sella on the other: Those having large sella of over 0.81 (group I) and those having small sella of under 0.80 and onset in advanced age of after 31 years (group II) or in younger age of before 30 years (group III). Refer to the latter two groups, however, 7 out of 8 cases of group III and 4 out of 14 cases of group II were found with value smaller than 0.65. Therefore, average size of sella of each group compared in this order of the magnitude: 1>II>III.Those belonging to group III were found chiefly among those whose fasting blood sugar were found higher than 180mg/dl and urine quantity over 3,000 cc. per day. Among those of group II more were found with low blood sugar and without polyuria than among those of group I. Refer to the group II, more were found with obesity and relatively low blood sugar among women than among men, and more were asthenic in type and found with high blood sugar among men than amog women.Retinitis or retinal hemorrhage was found more frequently in those of group I, and tuberculosis, catalacta or nephritic singns was so in those of groups I and II. Vascular hypertension was, however, more frequently seen in those being obesed and having small sella or in those being asthenic in type and having large sella than in the other.7 cases were seemed to be relatively resistent to insulin as the drop in blood sugar after injection of 5 units was, on each of them, below 30mg/dl, and 6 cases out of these were those belonging to group I.That sella turcica of diabetic patients was, as above mentioned, often too small or too large suggested the presence of some endocrine dysfunctions on them under which conditions diabetes mellitus might be facilitated to develope or modified on its course or nature.Etiological or therapeutical considerations were made to emphasize an importance of measuring real size of sella tucica on diabetics.