Park Ki Deok, Kim Deog Young, Lee Ju Kang, Nam Hee-Seung, Park Yoon-Ghil
Department of Rehabilitation Medicine, Gachon University of Medicine and Science, Gil Medical Centre, Incheon, Republic of Korea.
Brain Inj. 2010;24(11):1330-5. doi: 10.3109/02699052.2010.506863.
The objective of this study is to determine the prevalence of anterior pituitary dysfunction in moderate-to-severe chronic traumatic brain injury (TBI) patients. The investigation of a relationship between pituitary hormonal status and body mass index (BMI) in TBI patients by observing changes in BMI was conducted as well as an assessment of whether there is a difference in functional outcome related to anterior pituitary dysfunction in TBI patients.
Forty-five TBI patients and 30 normal controls underwent a series of standard endocrine tests for anterior pituitary hormone function. It was studied whether changes in BMI correlated with anterior pituitary hormone levels. This study also compared changes in mini-mental state examination (K-MMSE) and functional independence measure (FIM) scores between patients in the hormone-sufficient and -deficient groups.
Anterior pituitary dysfunction was found in 31.1% of TBI patients. Changes in BMI statistically correlated with IGF-1 and basal cortisol levels. A meaningful difference was found between the hormone-sufficient and -deficient groups in light of the K-MMSE and FIM score gains.
These findings strongly suggest that patients who suffer head trauma should be routinely tested for anterior pituitary hormone deficiency.
本研究的目的是确定中重度慢性创伤性脑损伤（TBI）患者垂体前叶功能障碍的患病率。通过观察体重指数（BMI）的变化来研究TBI患者垂体激素状态与BMI之间的关系，并评估TBI患者中与垂体前叶功能障碍相关的功能结局是否存在差异。
45例TBI患者和30名正常对照者接受了一系列垂体前叶激素功能的标准内分泌测试。研究了BMI的变化是否与垂体前叶激素水平相关。本研究还比较了激素充足组和激素缺乏组患者简易精神状态检查（K-MMSE）和功能独立性测量（FIM）评分的变化。
31.1%的TBI患者存在垂体前叶功能障碍。BMI的变化与胰岛素样生长因子-1（IGF-1）和基础皮质醇水平在统计学上相关。根据K-MMSE和FIM评分增加情况，激素充足组和激素缺乏组之间存在显著差异。
这些发现强烈表明，头部受伤的患者应常规检测垂体前叶激素缺乏情况。
