Sheehan's syndrome and its impact on bone mineral density.
BACKGROUND
Although there have been few studies investigating osteoporosis in isolated hormone deficiencies or other causes of hypopituitarism, the relationship between Sheehan's syndrome (SS) and osteoporosis has not been investigated. In the present study, we aimed to evaluate bone mineral density (BMD) in patients with SS in comparison with healthy women.


METHODS
Sixty-one patients with SS and 62 matched healthy controls were included. Biochemical, hormonal assessments and BMD evaluations were carried out in patients and controls, and a subgroup analysis according to menopausal status was done (premenopausal < 50 years; postmenopausal > 50 years).


RESULTS
The mean levels of serum anterior pituitary hormones were significantly lower in pre- and postmenopausal patients with SS compared with respective control groups (p < 0.0001). For both pre- and postmenopausal subjects, compared with respective controls, serum calcium and ALP levels, femur-T score, femur-Z score, spine (L1-L5)-T score, spine (L1-L5)-Z score and BMD values were lower, and phosphorus and parathyroid hormone (PTH) levels were higher in patients with SS.


CONCLUSIONS
Patients with SS had low BMD. The possible mechanism responsible for osteoporosis may be hypogonadism, growth hormone deficiency and disorders of parathyroid hormone and calcium metabolism. But the contribution of each anterior pituitary hormone deficiency on bone loss should be clarified in further prospective studies.
Gokalp
Deniz
D
Department of Endocrinology, Dicle University School of Medicine, 21280 Diyarbakir, Turkey. dgokalp@dicle.edu.tr
Tuzcu
Alpaslan
A
Bahceci
Mithat
M
Arikan
Senay
S
Ozmen
Cihan Akgul
CA
Cil
Timucin
T
D000328:Adult; D000368:Aged; D015519:Bone Density; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000503:physiopathology*; D008875:Middle Aged; D017698:Postmenopause; D017697:Premenopause