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Growth hormone deficiency and hypopituitarism in adults after complicated mild traumatic brain injury

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Abstract

Purpose

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.

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Abbreviations

mTBI:

mild TBI

GHD:

GH deficiency

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Funding

This work was supported in part by grant IG 14066/2013 to AB from the Associazione Italiana per la Ricerca sul Cancro (AIRC). SG has received financial support for educational programs from Merck-Serono.

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Authors and Affiliations

  1. Department of Health Sciences, Endocrinology, University Magna Graecia of Catanzaro, Campus Universitario, Viale Europa, Località Germaneto, 88100, Catanzaro, Italy

    Stefania Giuliano, Serafina Talarico, Lucia Bruno, Francesco Beniamino Nicoletti, Claudio Ceccotti & Antonino Belfiore

  2. Neurosurgery Unit, Pugliese-Ciaccio Hospital, Catanzaro, Italy

    Francesco Beniamino Nicoletti & Claudio Ceccotti

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  1. Stefania Giuliano
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  2. Serafina Talarico
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  3. Lucia Bruno
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  4. Francesco Beniamino Nicoletti
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  5. Claudio Ceccotti
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  6. Antonino Belfiore
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Correspondence to Antonino Belfiore.

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Stefania Giuliano and Serafina Talarico have equally contributed to the work

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Giuliano, S., Talarico, S., Bruno, L. et al. Growth hormone deficiency and hypopituitarism in adults after complicated mild traumatic brain injury. Endocrine 58, 115–123 (2017). https://doi.org/10.1007/s12020-016-1183-3

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