Endocrine Abstracts (2008) 16 P464

Posttraumatic hypopituitarism is associated with an unfavorable body composition and lipid profile, and decreased quality of life 12 months after injury

Marianne Klose1, Torquil Watt1, Jannick Brennum2 & Ulla Feldt-Rasmussen1

1Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark; 2Department of Neurosurgery, KAS Glostrup, Copengagen, Denmark.

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 18–64); BMI: 25 kg/m2 (17–39); severity: mild (Glasgow Coma Scale score (GCS) 13–15) n=44, moderate (GCS 9–12) 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.

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