Risk for pituitary adenoma increased for adults with obesity history
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Adults with a high BMI have an increased risk for pituitary adenoma, with the risk even greater for those with a high BMI during early adulthood, according to findings published in the Journal of Clinical Endocrinology & Metabolism.
“Among a large prospective cohort of American men and women, having a higher BMI was associated with higher incidence of pituitary adenoma,” David Cote, an MD/PhD student in cancer epidemiology at Harvard Medical School and the Harvard T.H. Chan School of Public Health, told Healio. “These findings extended as far back as early adulthood and did not seem to be the result of differential health care utilization between those with higher and lower BMI. We also demonstrated similar associations between higher waist circumference and taller adult height and higher incidence of pituitary adenoma later in life.”
Cote and colleagues conducted a population-based study of participants in the Nurses’ Health Study (NHS), Nurses’ Health Study II (NHSII) and the Health Professionals Follow-Up Study (HPFS). Researchers calculated early adulthood BMI through self-reported weight at age 18 years in the NHS and NHSII and age 21 years in HPFS. Pituitary adenoma was identified if participants wrote in the diagnosis on any follow-up questionnaire. Follow-up began upon the return of the baseline questionnaire and continued through the date of pituitary adenoma diagnosis, death from another cause, date of the last returned questionnaire, or the end of the study.
The study included 118,991 participants in NHS, 115,031 from NHSII, and 50,924 from HPFS. Across a total of 7,350,156 years of follow-up, there were 387 cases of self-reported pituitary adenoma. Compared with participants with a BMI of less than 25 kg/m2, adults with a BMI of 30 kg/m2 or higher had an increased risk for pituitary adenoma (adjusted HR = 1.74; 95% CI, 1.33-2.28). Each additional 5 kg/m2 of BMI was associated with a 26% higher risk for pituitary adenoma.
Participants with a maximum BMI of 30 kg/m2 had an increased risk compared with those with a maximum BMI of 25 kg/m2 or less (aHR = 1.76; 95% CI, 1.34-2.3). The risk for pituitary adenoma was greater for those who had an early adulthood BMI of 30 kg/m2 or higher compared with those with a BMI of 25 kg/m2 or less (aHR = 2.65; 95% CI, 1.56-4.49).
“We essentially demonstrated that the association between BMI and pituitary adenoma incidence extends to as far back as early adulthood, around age 18 to 21 years,” Cote said. “This was surprising, both because it made it much less likely that reverse causation was biasing our results, but also because it suggests that exposures as far back as early adulthood can be associated with disease occurring much later in life.”
Compared with those in the lowest waist circumference quintile, adults in the highest waist circumference quintile had an increased risk for pituitary adenoma (HR = 2.3; 95% CI, 1.33-3.98). Each additional inch of waist circumference was associated with 6% higher risk. There was also an increased risk for pituitary adenoma for taller participants, with each additional inch of height associated with 5% higher risk (aHR = 1.05; 95% CI, 1.01-1.09).
Findings were consistent between women and men in the study, although men had a much smaller pituitary adenoma case count (n = 62) compared with women (n = 325). Adjustments for race did not change the findings, nor did an adjustment for recent health care utilization.
Cote said the findings are just the start for researchers hoping to identify more risk factors for pituitary adenomas.
“Very little is currently known about risk factors for pituitary adenomas, so exploration of other factors that have been associated with tumors of other sites, including alcohol use, medication use, and other dietary and behavioral factors may be revealing,” Cote said. “Our group aims to explore some of these factors in future studies, with the goal of identifying possible causes and also to improve our ability to predict occurrence of these lesions.”
For more information:
David Cote, can be reached at djcote15@gmail.com.
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