UNASSIGNED: Retrospective case-control longitudinal study at a tertiary referral center.
UNASSIGNED: From 287 men, we selected 25 PSPA-nt men undergoing prolactin normalization (<20.0 ng/mL) during the follow-up. Graded symptoms of TD were investigated by structured interviews. Biochemical changes and TD symptoms were compared to those of a matched cohort of 61 men with pituitary neoplasms and normal testosterone levels (PA-nt).
UNASSIGNED: Baseline testosterone levels were similar between PSPA-nt and PA-nt subjects. The prevalence of specific and suggestive symptoms of TD was higher in PSPA-nt (20% and 68%) than in PAnt (3.3 and 29.5%; P = .02 and P = .0015, respectively). At the follow-up, total and bioavailable testosterone levels increased in PSPA-nt but not in PA-nt patients (Δ change: 1.28 ± 2.1 vs0.03 ± 1.5 ng/mL, + 0.33 ± 0.55 vs-0.26 ± 0.60 ng/mL; P = .0028 and P = .0088, respectively). LH and FSH levels also increased in PSPA-nt men (P < .05). Specific and suggestive, but not nonspecific symptoms of TD, improved only in PSPA-nt men (P < .05 for both). Baseline testosterone and LH were the strongest predictors of testosterone improvement in PSPA-nt patients.
UNASSIGNED: Despite having normal testosterone levels at baseline, patients with PSPA-nt experience a relief of TD symptoms and an improvement of their pituitary-gonadal axis function following prolactin normalization, especially when baseline TT and LH levels are in the low-normal range.
■第三级转诊中心的回顾性病例对照纵向研究。
■来自287名男性,我们选择了25名PSPA-nt男性在随访期间经历催乳素正常化(<20.0ng/mL)。通过结构化访谈调查了TD的分级症状。将生化变化和TD症状与61例垂体肿瘤和正常睾丸激素水平(PA-nt)男性的配对队列进行了比较。
PSPA-nt和PA-nt受试者的基线睾酮水平相似。PSPA-nt中TD的特异性和暗示性症状的患病率(20%和68%)高于PAnt(3.3%和29.5%;分别为P=.02和P=.0015)。在后续行动中,PSPA-nt患者的总睾酮水平和生物可利用睾酮水平增加,但PA-nt患者没有增加(Δ变化:1.28±2.1vs0.03±1.5ng/mL,+0.33±0.55vs-0.26±0.60ng/mL;分别为P=.0028和P=.0088)。PSPA-nt男性的LH和FSH水平也升高(P<0.05)。具体和暗示,但不是TD的非特异性症状,仅在PSPA-nt男性中有所改善(两者P<0.05)。基线睾酮和LH是PSPA-nt患者睾酮改善的最强预测因子。
■尽管基线时睾酮水平正常,PSPA-nt患者在催乳素正常化后,TD症状得到缓解,垂体-性腺轴功能得到改善,特别是当基线TT和LH水平处于低正常范围时。