1. Metabolic alterations in patients who develop traumatic brain injury (TBI)-induced hypopituitarism
- Author
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Silvia Grottoli, Arianna Busti, Paolo Marzullo, Marco Zavattaro, Sara Belcastro, Loredana Pagano, Gianluca Aimaretti, Marina Caputo, Flavia Prodam, Valentina Gasco, C. Perino, and Ezio Ghigo
- Subjects
Adult ,Blood Glucose ,Male ,medicine.medical_specialty ,Traumatic brain injury ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Poison control ,Hypopituitarism ,Growth Hormone-Releasing Hormone ,Body Mass Index ,Tertiary Care Centers ,Endocrinology ,Insulin resistance ,Internal medicine ,Humans ,Insulin ,Medicine ,Retrospective Studies ,medicine.diagnostic_test ,Human Growth Hormone ,business.industry ,Hypertriglyceridemia ,Glucose Tolerance Test ,Middle Aged ,Prognosis ,medicine.disease ,Cross-Sectional Studies ,Brain Injuries ,Female ,business ,Lipid profile ,Biomarkers ,Dyslipidemia ,Follow-Up Studies - Abstract
Hypopituitarism is associated with metabolic alterations but in TBI-induced hypopituitarism data are scanty. The aim of our study was to evaluate the prevalence of naïve hypertension, dyslipidemia, and altered glucose metabolism in TBI-induced hypopituitarism patients.Cross-sectional retrospective study in a tertiary care endocrinology center. 54 adult patients encountering a moderate or severe TBI were evaluated in the chronic phase (at least 12 months after injury) after-trauma. Presence of hypopituitarism, BMI, hypertension, fasting blood glucose and insulin levels, oral glucose tolerance test (if available) and a lipid profile were evaluated.The 27.8% of patients showed various degrees of hypopituitarism. In particular, 9.3% had total, 7.4% multiple and 11.1% isolated hypopituitarism. GHD was present in 22.2% of patients. BMI was similar between the two groups. Hypopituitaric patients presented a higher prevalence of dyslipidemia (p0.01) and altered glucose metabolism (p0.005) with respect to non hypopituitaric patients. In particular, triglycerides (p0.05) and HOMA-IR (p0.02) were higher in hypopituitaric TBI patients.We showed that long-lasting TBI patients who develop hypopituitarism frequently present metabolic alterations, in particular altered glucose levels, insulin resistance and hypertriglyceridemia. In view of the risk of premature cardiovascular death in hypopituitaric patients, major attention has to been paid in those who encountered a TBI, because they suffer from the same comorbidities and may present other deterioration factors due to complex pharmacological treatments and restriction in participation in life activities and healthy lifestyle.
- Published
- 2013
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