title: Detection of Growth Hormone Deficiency in Adults with Chronic Traumatic Brain Injury.
abstract: This study examined the prevalence of growth hormone deficiency (GHD) in patients with traumatic brain injury (TBI) during the post-acute phase of recovery and whether GHD was associated with increased disability, decreased independence, and depression. A secondary objective was to determine the accuracy of insulin-like growth factor-1 (IGF-1) levels in predicting GHD in patients with TBI. Anterior pituitary function was assessed in 235 adult patients with TBI through evaluation of fasting morning hormone levels. GH levels were assessed through provocative testing, specifically the glucagon stimulation test. GHD was diagnosed in a significant number of patients, with 45% falling into the severe GHD (≤3 μg/L) category. IGF-1 levels were not predictive of GHD. Patients with GHD were more disabled and less independent compared with those patients who were not GHD. Those patients with more severe GHD also showed decreased levels of cortisol and testosterone. Symptoms of depression were also more prevalent in this group. In addition, patients with severe GHD had delayed admission to post-acute rehabilitation. This study confirms the high prevalence of GHD in patients with TBI and the necessity to monitor clinical symptoms and perform provocative testing to definitively diagnose GHD.
authors.affiliation: 1 Centre for Neuro Skills, David Geffen School of Medicine at UCLA , Bakersfield, California.|3 Centre for Neuro Skills - Clinical Education and Research Foundation, David Geffen School of Medicine at UCLA , Bakersfield, California.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Kreber
authors.affiliation: 1 Centre for Neuro Skills, David Geffen School of Medicine at UCLA , Bakersfield, California.|2 Department of Neurosurgery, David Geffen School of Medicine at UCLA , Bakersfield, California.|3 Centre for Neuro Skills - Clinical Education and Research Foundation, David Geffen School of Medicine at UCLA , Bakersfield, California.
authors.forename: Grace S
authors.initials: GS
authors.lastname: Griesbach
authors.affiliation: 1 Centre for Neuro Skills, David Geffen School of Medicine at UCLA , Bakersfield, California.|3 Centre for Neuro Skills - Clinical Education and Research Foundation, David Geffen School of Medicine at UCLA , Bakersfield, California.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Ashley
mesh_terms: D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000150:complications*; D002908:Chronic Disease; D005260:Female; D019382:Human Growth Hormone / Q000097:blood* / Q000172:deficiency; D006801:Humans; D007018:Hypopituitarism / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D020127:Recovery of Function
chemical_list: D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I
keywords: adult brain injury; clinical management of CNS injury; growth hormone deficiency; human studies; hypopituitarism