title: Growth hormone deficiency and hypopituitarism in adults after complicated mild traumatic brain injury.
abstract: OBJECTIVE
  Traumatic brain injury is considered the main cause of hypopituitarism in adults, and GH deficiency appears to be the most frequent pituitary deficit. Most of the available studies have included all degrees of severity of trauma. We aimed to assess pituitary function and GH deficiency in adult patients at different time lengths after complicated mild TBI according to Glasgow Coma Scale. We also aimed to evaluate whether mild TBI patients with GH deficiency had developed alterations in the glycolipid profile.
  
  
  METHODS
  Forty-eight patients (34 men and 14 women) with complicated mild TBI were included in the study. Twenty-three patients were evaluated at 1 year (Group A) and 25 patients at 5 years or longer after the injury (Group B). All patients underwent basal hormonal evaluation for pituitary function. GH deficiency was investigated by the combined test (GH releasing hormone + arginine). The glycolipid profile was also evaluated.
  
  
  RESULTS
  GH deficiency occurred in 8/23 patients (34.7 %) of Group A and in 12/25 patients (48 %) of Group B. In addition, two patients, one in each group, showed evidence of central hypothyroidism. Patients with GH deficiency, especially in Group A, presented a higher frequency of visceral adiposity and adverse metabolic profile as compared to no-GH deficiency patients.
  
  
  CONCLUSIONS
  Patients examined at 1 year or several years from complicated mild TBI had a similarly high occurrence of isolated GH deficiency, which was associated with visceral adiposity and metabolic alterations. Our findings suggest that patients undergone complicated mild TBI should be evaluated for GH deficiency even after several years from trauma.
authors.affiliation: Department of Health Sciences, Endocrinology, University Magna Graecia of Catanzaro, Campus Universitario, Viale Europa, Località Germaneto, 88100, Catanzaro, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Giuliano
authors.affiliation: Department of Health Sciences, Endocrinology, University Magna Graecia of Catanzaro, Campus Universitario, Viale Europa, Località Germaneto, 88100, Catanzaro, Italy.
authors.forename: Serafina
authors.initials: S
authors.lastname: Talarico
authors.affiliation: Department of Health Sciences, Endocrinology, University Magna Graecia of Catanzaro, Campus Universitario, Viale Europa, Località Germaneto, 88100, Catanzaro, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Bruno
authors.affiliation: Department of Health Sciences, Endocrinology, University Magna Graecia of Catanzaro, Campus Universitario, Viale Europa, Località Germaneto, 88100, Catanzaro, Italy.|Neurosurgery Unit, Pugliese-Ciaccio Hospital, Catanzaro, Italy.
authors.forename: Francesco Beniamino
authors.initials: FB
authors.lastname: Nicoletti
authors.affiliation: Department of Health Sciences, Endocrinology, University Magna Graecia of Catanzaro, Campus Universitario, Viale Europa, Località Germaneto, 88100, Catanzaro, Italy.|Neurosurgery Unit, Pugliese-Ciaccio Hospital, Catanzaro, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ceccotti
authors.affiliation: Department of Health Sciences, Endocrinology, University Magna Graecia of Catanzaro, Campus Universitario, Viale Europa, Località Germaneto, 88100, Catanzaro, Italy. belfiore@unicz.it.
authors.forename: Antonino
authors.identifier: http://orcid.org/0000-0002-6181-4193
authors.initials: A
authors.lastname: Belfiore
mesh_terms: D050154:Adiposity; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D000070642:Brain Injuries, Traumatic / Q000150:complications* / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D005260:Female; D015600:Glasgow Coma Scale; D006728:Hormones / Q000097:blood; D019382:Human Growth Hormone / Q000097:blood / Q000172:deficiency*; D006801:Humans; D007018:Hypopituitarism / Q000209:etiology*; D007037:Hypothyroidism / Q000209:etiology; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006728:Hormones; D008055:Lipids; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D000324:Adrenocorticotropic Hormone
keywords: Cardiovascular risk; Complicated mild traumatic brain injury; GHD; Growth hormone deficiency in adults; Hypopituitarism