Journal of Mazandaran University of Medical Sciences (Jun 2024)
The Relationship between Fatigue, Sleep Quality, and Physical Activity with Adenoma Size in Patients with Pituitary Adenoma
Abstract
Background and purpose: Previous reports on the symptoms and quality of life of patients with pituitary adenomas have paid little attention to physical activity. However, numerous studies have shown that physical activity can significantly influence prolactin secretion. Prolactin secretion levels, in turn, can affect various clinical outcomes, including tumor size, sleep quality, and fatigue levels in patients with pituitary adenomas. Given the intricate relationship between these factors, it is crucial to investigate how they interact to impact the overall health and quality of life of these patients. This study aims to bridge this gap by exploring the relationship between tumor size and fatigue levels, sleep quality, and physical activity in patients with pituitary adenomas. Understanding these relationships can provide insights into potential therapeutic strategies to improve patient outcomes. Materials and methods: A total of 116 patients diagnosed with pituitary adenomas from the Neurosurgery and Internal Medicine departments of Imam Khomeini Hospital in Sari were included in the study via census sampling. The inclusion criteria ensured that all participants had a confirmed diagnosis of pituitary adenoma. Demographic characteristics, tumor size (from patients' imaging records), prolactin levels (from patient records), physical activity levels (using the International Physical Activity Questionnaire), sleep quality (using the Pittsburgh Sleep Quality Index), and fatigue levels (using the Multidimensional Fatigue Inventory 20) were measured using checklists and validated questionnaires. Results: In the present study, 68 participants (58.6%) were female, and 48 (41.4%) were male. A total of 108 participants (93.1%) were aged 55 years or younger, and 8 participants (6.9%) were older than 55, with a mean age of 43.72±7.70 years. Of the participants, 71(61.2%) had prolactinomas, and 39(33.6%) had non-functional tumors. Tumor sizes ranged from 2.1 to 42.9 mm, with a mean size of 16.16±8.71 mm. The mean prolactin level was 561.52±413 ng/mL, with a minimum level of 8 ng/mL and a maximum of 1578 ng/mL. The results showed significant differences in the mean scores of sleep quality (5.81±1.91 vs. 6.73±2.14), fatigue (55.86±8.79 vs. 60.32±8.39), and physical activity (1203.95±258.65 vs. 1085.20±310.99) between patients with microadenomas and macroadenomas (P=0.048, P=0.008, P=0.038). Furthermore, correlation coefficients for age (r=0.415), fatigue (r=0.336), sleep quality (r=0.253), physical activity (r=-0.230), and prolactin (r=0.496) with tumor size were significant. The findings indicated that with increasing age, fatigue scores, sleep quality scores, and prolactin levels, tumor size also increases, while higher physical activity levels are associated with smaller tumor sizes. Additionally, as tumor size increases, prolactin levels, fatigue scores, and sleep quality scores increase, whereas physical activity scores decrease. Conclusion: The study concludes that with increasing age, fatigue and sleep quality scores worsen, but physical activity levels decrease. Moreover, as tumor size increases, prolactin levels, fatigue scores, and sleep quality scores increase, while physical activity scores decrease. An increase in prolactin levels is also associated with increased fatigue.
