Objective: To describe body-composition, lipid profile, and health-related quality of life (HRQL) in patients with traumatic brain injury (TBI) in relation to the development of posttraumatic hypopituitarism.
Design: Cross-sectional with a nested prospective sub-study.
Patients: The cross-sectional cohort included 104 hospitalized patients with TBI (26F/78M; age: median 41 years (range 1864); BMI: 25 kg/m2 (1739); severity: mild (Glasgow Coma Scale score (GCS) 1315) n=44, moderate (GCS 912) n=20, severe (GCS<9) n=40). A nested cohort of 46 patients was followed prospectively. The study was approved by the local Ethical Committee.
Measurements: Body mass index (BMI), waist circumference, lipid profile, total- and regional- fat mass was assessed 3 and 12 months (prospective) or only 12 months (cross-sectional) post-traumatically. HRQL questionnaires (NHP, EQ-5D and the GH deficiency specific instrument QoL-AGHDA) were completed pre-traumatically, 3 and 12 months (prospective) or only 12 months (cross-sectional) post-traumatically.
Results: Patients with posttraumatic hypopituitarism had higher age-, gender- and BMI- adjusted 12 months LDL-cholesterol, waist circumference, and total fat mass (P<0.05 in all cases), and a higher increase in total cholesterol (P=0.01) during follow-up compared with sufficient patients. These findings were unrelated to 12 months IGF-I and IGF-I SD-scores.
Hypopituitary patients also had worse age-, BMI- and TBI severity- adjusted overall EQ-5D VAS (P=0.03) and QoL-AGHDA (P=0.01) scores, and worse NHP dimension scores of sleep (P=0.03), energy (P=0.02), and social isolation (P=0.04), compared to patients with an intact pituitary function.
Conclusion: Posttraumatic hypopituitarism was an independent predictor of the classical phenotypic features of hypopituitarism including an unfavorable lipid and body-composition profile, as well as worsened HRQL.
03 - 07 May 2008
European Society of Endocrinology