Abstract
Endocrine dysfunction is known to occur after traumatic brain injury. The purpose of this study was to examine the incidence of various endocrine dysfunctions after a stroke. The Taiwan National Health Insurance Research Database (NHIRD) was searched from 2001 to 2011 for patients with a diagnosis of stroke. Stroke patients were matched by diagnosis date, age, and sex to patients without a stroke. Cox proportional hazards regression analyses were performed to compare the incidence of goiter, acquired hypothyroidism, thyroiditis, pituitary dysfunction, and disorders of the adrenal glands between stroke and non-stroke patients. There were 131,951 patients in the stroke group, and 131,951 in the matched non- stroke group (mean age 66.1 ± 14.9 years). Stroke patients had significantly higher risk of acquired hypothyroidism (crude hazard ratio [cHR] = 1.65, 95% confidence interval [CI]: 1.44, 1.90; adjusted hazard ratio [aHR] = 1.65, 95% CI: 1.42, 1.91), pituitary dysfunction (cHR = 2.32, 95% CI: 1.79, 2.99; aHR = 1.92, 95% CI: 1.46, 2.52), and disorders of the adrenal glands (cHR = 1.79, 95% CI: 1.52, 2.12; aHR =1.62, 95% CI: 1.36, 1.92) than non-stroke patients. Pituitary dysfunction and disorders of the adrenal glands were found in both hemorrhagic stroke and ischemic stroke patients, while hypothyroidism was seen in ischemic stroke patients only. No significant association was found for goiter and thyroiditis. In conclusions, stroke survivors have an approximately 2-fold increased risk of developing acquired hypothyroidism, pituitary dysfunction, or disorders of the adrenal glands. These risks should be taken into account in the management of patients who have ischemic or hemorrhagic strokes.
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The analyzed data sets generated during the study are available from the corresponding author on reasonable request.
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Acknowledgements
The study is based in part on data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health, Taiwan, and managed by the National Health Research Institutes. The interpretation and reporting of these data are the sole responsibility of the authors.
Funding
This work was supported by the National Natural Science Foundation of China (No.81760223,81,560,206), Natural Science Foundation of Yunnan Province (No. FB2016121), Yunnan Health Training Project of High Level Talents (No. H-201601), and Technology and Science Innovation Team Foundation of Kunming Medical University (No. CXTD201707).
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FW: Conception and design; Drafting of the manuscript.
MYL: Acquisition of data; clinical studies.
LZ: Acquisition of data.
LY: Analysis and interpretation of data; statistical analysis.
GL: Critical revision of the manuscript; Supervision.
HJC: guarantor of integrity of the entire study.
GW: Critical revision of the manuscript; literature research.
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The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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This study was conducted in accordance with ethics committee guidelines of Kunming Medical University and with the approval of the institutional review board. The study was also approved by the Institutional Review Board (IRB) of Min-Sheng General Hospital.
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Wang, F., Luo, My., Zhou, L. et al. Endocrine Dysfunction Following Stroke. J Neuroimmune Pharmacol 16, 425–436 (2021). https://doi.org/10.1007/s11481-020-09935-6
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DOI: https://doi.org/10.1007/s11481-020-09935-6