Research Reports - Metabolic alterations in patients who develop traumatic brain injury (TBI)-induced hypopituitarism

Growth Horm IGF Res. 2013 Aug;23(4):109-13

Prodam F, Gasco V, Caputo M, Zavattaro M, Pagano L, Marzullo P, Belcastro S, Busti A, Perino C, Grottoli S, Ghigo E, Aimaretti G

OBJECTIVE: 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.
DESIGN: 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 12months 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.
RESULTS: 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 (p<0.01)
and altered glucose metabolism (p<0.005) with respect to non hypopituitaric
patients. In particular, triglycerides (p<0.05) and HOMA-IR (p<0.02) were higher
in hypopituitaric TBI patients.
CONCLUSIONS: 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.

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