title: Metabolic alterations in patients who develop traumatic brain injury (TBI)-induced hypopituitarism.
abstract: 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.
  
  
  METHODS
  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.
  
  
  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.
authors: Department of Translational Medicine, Università del Piemonte Orientale A Avogadro, Novara, Italy.
authors: F
authors: F
authors: Prodam
authors: V
authors: V
authors: Gasco
authors: M
authors: M
authors: Caputo
authors: M
authors: M
authors: Zavattaro
authors: L
authors: L
authors: Pagano
authors: P
authors: P
authors: Marzullo
authors: S
authors: S
authors: Belcastro
authors: A
authors: A
authors: Busti
authors: C
authors: C
authors: Perino
authors: S
authors: S
authors: Grottoli
authors: E
authors: E
authors: Ghigo
authors: G
authors: G
authors: Aimaretti
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism*; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D001930:Brain Injuries / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D013007:Growth Hormone-Releasing Hormone / Q000378:metabolism; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007018:Hypopituitarism / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D062606:Tertiary Care Centers
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D019382:Human Growth Hormone; D013007:Growth Hormone-Releasing Hormone