{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:17:41Z","timestamp":1792210661475,"version":"4.4.0"},"reference-count":37,"publisher":"The Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Pituitary adenomas (PAs) are one of the three major lesions in Multiple Endocrine Neoplasia type 1 (MEN1), with a prevalence of 32% to 58%, yet their specific risk factors remain unidentified. This study aimed to identify predictors influencing PA occurrence in MEN1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This nationwide, multicenter, retrospective cohort study involved 240 MEN1 patients, 55.8% female. The main variables were age-related penetrance, PA subtype and size, and MEN1 germline pathogenic variants (PVs). The primary outcome was PA development. Cox regression was applied first to the full cohort and then to a prospectively screened subgroup (n = 199) free of symptom-driven bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PAs were detected in 112 (46.6%) patients at a mean age of 36.1 \u00b1 13.9 years; most (63.3%) were diagnosed through screening. Prolactinomas (49.1%) and microadenomas (62.5%) predominated. In the full cohort, the following independent factors were related to PA development: age (per additional year; HR 0.916, 95% CI 0.893-0.993; P &amp;lt; .001), prior primary hyperparathyroidism (HR: 3.090, 95% CI: 1.943-4.914, P &amp;lt; .001), non-missense MEN1 PVs (HR: 1.976, 95% CI: 1.125-3.468, P = .018), and female sex (HR: 1.706, 95% CI: 1.082-2.689, P = .022). The same factors remained significant in the screened subgroup.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Risk of PA in MEN1 clusters at younger ages and declines thereafter. Prior primary hyperparathyroidism, non-missense MEN1 PVs, and female sex further mark higher-risk profiles. These findings may help personalize PA follow-up\u2014prioritizing closer imaging in early adulthood and allowing longer intervals when baseline imaging is normal and additional risk markers are absent\u2014pending validation in larger multicenter studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaf497","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T11:58:58Z","timestamp":1757073538000},"page":"e811-e820","source":"Crossref","is-referenced-by-count":3,"title":["Risk Factors for Pituitary Adenoma Development in Multiple Endocrine Neoplasia Type 1: A Nationwide Study of 240 Cases"],"prefix":"10.1210","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5859-257X","authenticated-orcid":false,"given":"Nuria","family":"Vald\u00e9s","sequence":"first","affiliation":[{"name":"Endocrinology & Nutrition Department, Hospital Universitario Cruces , 48903 Barakaldo, Bizkaia ,","place":["Spain"]},{"name":"Biobizkaia Health Research Institute, Hospital Universitario Cruces, University of the Basque Country (UPV\/EHU), CIBERDEM, CIBERER, Endo-ERN , 48903 Barakaldo, Bizkaia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana R","family":"Romero-Lluch","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Hospital Universitario Virgen del Roc\u00edo , 41013 Sevilla ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estrella","family":"Diego","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Hospital Universitario Cruces , 48903 Barakaldo ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Calatayud","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Hospital Universitario Doce de Octubre , 28041 Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4622-9508","authenticated-orcid":false,"given":"Cristina","family":"Lamas","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Complejo Hospitalario Universitario de Albacete , 02006 Albacete ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Araujo-Castro","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Hospital Universitario Ram\u00f3n y Cajal , 28034 Madrid ,","place":["Spain"]},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica Ram\u00f3n y Cajal (IRYCIS) , 28034 Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3800-531X","authenticated-orcid":false,"given":"Rosa","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Endocrinology & Diabetes Research Group, Hospital Universitario Cruces, Endo-ERN , 48903 Barakaldo, Bizkaia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep","family":"Oriola","sequence":"additional","affiliation":[{"name":"Biochemistry and Molecular Genetics Department. 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Hospital Cl\u00ednic, University of Barcelona , 08036 Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"\u00c1lvarez-Escol\u00e1","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Hospital Universitario La Paz , 28046 Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ngel D\u00edaz","family":"P\u00e9rez","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Hospital Universitario San Carlos , 28040 Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Alc\u00e1zar","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Hospital Universitario Severo Ochoa , 28914 Madrid 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