Endocrine Abstracts (2013) 32 P628 | DOI: 10.1530/endoabs.32.P628

Sheehan's syndrome females have a high incidence of cardiovascular morbidity and an increased prevalence of cardiovascular risk factors

Ines Slim1, Nadra Bhouri1, Houneida Zaghouane3, Molka Chadli1, Monia Zaouali2, Koussay Ach1, Amel Maaroufi1, Maha Kacem1, Chakib Kraiem3 & Larbi Chaieb1

1Department of Diabetes and Endocrinology, Farhat Hahed Univsity Hospital, Sousse, Tunisia; 2Department of Physiology, Ibn Jazzar Faculty of Medicine, University of Sousse, Sousse, Tunisia; 3Department of Radiology, Farhat Hached University Hospital, Sousse, Tunisia.

Introduction: While severe GH deficiency (GHD) is a well-established feature of Sheehan’s syndrome (SS), the effects of GH deficiency in these patients has not been extensively investigated. In the present studyh we evaluated the cardiovascular risk in patients with SS.

Methods: Twenty female with SS and well-treated with cortisone and thyroid hormones was included. Metabolic syndrome according to IDF-2005 criteria and insulin resistance estimated by HOMA-IR were investigated. GHD was searched based on Glucagon test. Common carotid intima-media thickness (IMT) was measured by B mode ultrasound. Cardiovascular risk was assessed by SCORE.

Results: The GHD was found in 95% of patients. Hypertension represents the most frequent history of cardiovascular disease. The mean BMI was at 28.10±6 kg/m2, 35% of patients were obese. The mean waist circumference was at 99.5±15 cm. Fasting glucose more than 5.5 mmol/l was present in 45% of subjects. A total cholesterol >5.2 mmol/l was observed in 65% of cases, an LDL-C >4.1 mmol/l in 35% of cases, an HDL-C <1 mmol/l in 15% and a triglyceride level >1.7 mmol/l in 60% of cases. Metabolic syndrome was present in 55% of cases. Forty percent of patients had insulin resistance. The IMT was not increased in all cases; the presence of atheromatous plaques was noted in one case. The IMT was positively correlated with diastolic blood pressure and LDL-C. Cardiovascular risk was moderate in 40% of cases and very high in 15% of cases. Patients with high cardiovascular risk had higher systolic blood pressure and fasting glucose.

Conclusion: These findings highlight the importance of closely cardiovascular and metabolic monitoring of patients with SS unsubstituted in GH and raise the question of the benefit of GH replacement in these patients.