Traumatic brain injury (TBI) and lipid profile abnormalities: study 12 months after the brain injury
Carolina Di Somma1, Francesca Rota1, Silvia Rovere2, Maria Rosaria Ambrosio3, Alessandra Fusco4, Ginevra Corneli2, Antonio Bianchi4, Laura De Marinis4, Ettore Ciro degli Uberti3, Gaetano Lombardi1, Ezio Ghigo2, Annamaria Colao1 & Gianluca Aimaretti4
Aim of this study was to evaluate lipid profile and the severity of GHD, in a large group of TBI patients with or without GH deficiency. We assayed lipid profile (Total-, HDL- Cholesterol, Triglycerides) in 62 TBI subjects 12 months after TBI (41 M, 21 F, 1381 yrs, BMI: 24.6±0.6 kg/m2), and in 62 sex-, age- and BMI-matched controls. Based on the GH peak after GHRH+ARG test, patients were stratified as: 1) severe GHD (GH peak ≤ 9 μg/l; n=13; 20.9%); 2) partial GHD (GH peak in between 9.116.5 μg/l; n=6; 9.7%); 3) non-GHD (GH peak >16.5 μg/l; n=43; 69.3%). IGF-I levels were lower (P<0.001) in patients with severe GHD (88.7±11.1 μg/L) than in those with partial GHD, non-GHD and in controls (148.1±33.9, 219.2±10.7, and 251.8±10.8 μg/L, respectively). HDL-cholesterol were lower (P<0.01) in patients with severe GHD (44.1±2.7 mg/dL) than in those non-GHD and in controls (54.4±1.3 and 59.3±1.1, respectively), while, no significant differences was found in partial GHD. In patients with severe GHD, total- and HDL-cholesterol ratio (4.9±0.4, P<0.01) were higher than in those with partial GHD (4.4±0.2,), non-GHD (3.9±0.2), and controls (2.9±0.1). In addition, partial GHD patients had total- and HDL-cholesterol ratio (4.4±0.2, P<0.01) higher than those non-GHD (3.9±0.2), and controls (2.9±0.1). Triglycerides levels were not different among severe GHD, partial GHD and non GHD TBI patients and controls. In all subjects, a significant correlation was found between the GH peak and age (r=−0.41; P<0.01), BMI (r=−0.33; P<0.05), IGF-I (r=0.36; P<0.01), total cholesterol (r=−0.37; P<0.05), HDL cholesterol (r=0.36; P<0.05), total- and HDL- cholesterol ratio (r=−0.47; P<0.01). IGF-I was correlated with age (r=−0.54, P<0.001), total cholesterol (r=−0.46; P<0.01), HDL cholesterol (r=0.39; P<0.05), total- and HDL- cholesterol ratio (r=−0.51; P<0.01). In conclusion, impairment of lipid profile was evident in TBI patients with severe GHD.