title: Sheehan's syndrome and its impact on bone mineral density.
abstract: 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.
authors.affiliation: Department of Endocrinology, Dicle University School of Medicine, 21280 Diyarbakir, Turkey. dgokalp@dicle.edu.tr
authors.forename: Deniz
authors.initials: D
authors.lastname: Gokalp
authors.forename: Alpaslan
authors.initials: A
authors.lastname: Tuzcu
authors.forename: Mithat
authors.initials: M
authors.lastname: Bahceci
authors.forename: Senay
authors.initials: S
authors.lastname: Arikan
authors.forename: Cihan Akgul
authors.initials: CA
authors.lastname: Ozmen
authors.forename: Timucin
authors.initials: T
authors.lastname: Cil
mesh_terms: 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