{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:19:29Z","timestamp":1787314769224,"version":"build-2736575974"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T00:00:00Z","timestamp":1691452800000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009228","name":"Region \u00d6rebro County","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009228","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009240","name":"Swedish Association of Local Authorities and Regions","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009240","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Data on pre- and postoperative pituitary function in nonfunctioning pituitary adenomas (NFPA) are not consistent. We aimed to investigate pituitary function before and up to 5 years after transsphenoidal surgery with emphasis on the hypothalamic-pituitary-adrenal axis (HPA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and methods<\/jats:title>\n                    <jats:p>Data from the Swedish Pituitary Register was used to analyze anterior pituitary function in 838 patients with NFPA diagnosed between 1991 and 2014. Patients who were reoperated or had received radiotherapy were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Preoperative ACTH, TSH, LH\/FSH, and GH deficiencies were reported in 31% (236\/755), 39% (300\/769), 51% (378\/742), and 28% (170\/604) of the patients, respectively. Preoperative median tumor volume was 5.0 (2.4-9.0) cm3. Among patients with preoperative, 1 year and 5 years postoperative data on the HPA axis (n = 428), 125 (29%) were ACTH-deficient preoperatively. One year postoperatively, 26% (32\/125) of them had recovered ACTH function while 23% (70\/303) patients had developed new ACTH deficiency. Thus, 1 year postoperatively, 163 (38%) patients were ACTH-deficient (P &amp;lt; .001 vs. preoperatively). No further increase was seen 5 years postoperatively (36%, P = .096). At 1 year postoperatively, recoveries in the TSH and LH\/FSH axes were reported in 14% (33\/241) and 15% (46\/310), respectively, and new deficiencies in 22% (88\/403) and 29% (83\/288), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adrenocorticotrophic hormone deficiency increased significantly at 1 year postoperatively. Even though not significant, some patients recovered from or developed new deficiency between 1 and 5 years postoperatively. This pattern was seen in all axes. Our study emphasizes that continuous individual evaluations are needed during longer follow-up of patients operated for NFPA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejendo\/lvad104","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T16:25:07Z","timestamp":1691425507000},"page":"217-224","source":"Crossref","is-referenced-by-count":12,"title":["Pituitary function before and after surgery for nonfunctioning pituitary adenomas\u2014data from the Swedish Pituitary Register"],"prefix":"10.1093","volume":"189","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7056-0001","authenticated-orcid":false,"given":"Nasrin","family":"Al-Shamkhi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, \u00d6rebro University Hospital and School of Medical Sciences, Faculty of Medicine and Health, \u00d6rebro University , \u00d6rebro , Sweden"},{"name":"Department of Endocrinology and Diabetology, Uppsala University Hospital , Uppsala , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2488-0375","authenticated-orcid":false,"given":"Katarina","family":"Berinder","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Karolinska University Hospital and Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Borg","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sk\u00e5ne University Hospital, Lund University , Lund , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4844-8336","authenticated-orcid":false,"given":"Pia","family":"Burman","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sk\u00e5ne University Hospital, Lund University , Malm\u00f6 , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6471-9503","authenticated-orcid":false,"given":"Per","family":"Dahlqvist","sequence":"additional","affiliation":[{"name":"Department of Public Health and Clinical Medicine, Ume\u00e5 University , Ume\u00e5 , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3980-1927","authenticated-orcid":false,"given":"Charlotte","family":"H\u00f6ybye","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Karolinska University Hospital and Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9734-0786","authenticated-orcid":false,"given":"Daniel S","family":"Olsson","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sahlgrenska University Hospital , Gothenburg , Sweden"},{"name":"Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden"},{"name":"Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0204-9492","authenticated-orcid":false,"given":"Oskar","family":"Ragnarsson","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sahlgrenska University Hospital , Gothenburg , Sweden"},{"name":"Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden"},{"name":"Wallenberg Center for Molecular and Translational Medicine, University of Gothenburg , G\u00f6teborg , 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