Brain injury biomarkers and intraoperative hypotension: associations with pituitary hormone deficiency following transsphenoidal endoscopic surgery for non-functioning pituitary adenomas
Authors' conclusion
Elevated postoperative plasma GFAP, NfL, and tau might indicate increased risk of long-term postoperative pituitary hormone deficiency. Relative IOH may also contribute to these deficiencies.
Study context
- Population
- Patients undergoing endoscopic transsphenoidal surgery for non-functioning pituitary adenomas
- Participants
- 100 patients
- Exposure
- New pituitary hormone deficiency vs none: brain injury biomarkers and intraoperative hypotension (IOH)
- Outcome
- New APH-D and new AVP-D
- Follow-up
- 12 months postsurgery
Main finding
As reported in the abstract
Postoperative plasma GFAP, NfL and tau and new deficiency · postoperative days 1 and 5
- Elevated postoperative glial fibrillary acidic protein (GFAP), NfL and tau associated with new anterior pituitary hormone deficiency (APH-D)
- GFAP also linked to new arginine vasopressin deficiency (AVP-D)
- Mixed-effects models
Observational data: associations, not effects.
Further findings
Duration of relative IOH (>20% below preoperative MAP), new APH-D vs no new APH-D
- Longer relative IOH with new APH-D: median [IQR] 155 min [54-216] vs. 82 min [20-154]
- P = 0.03
- Mann-Whitney U test
Relative or absolute IOH and new AVP-D
- No difference in relative or absolute IOH with new AVP-D
Original publication
Brain injury biomarkers and intraoperative hypotension: associations with pituitary hormone deficiency following transsphenoidal endoscopic surgery for non-functioning pituitary adenomas. Pituitary. Published 8 December 2025. doi:10.
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