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中风康复后的中年成年人中生长激素缺乏症的患病率

Prevalence of growth hormone deficiency in middle-age adults recovering from stroke.

作者信息

Kreber Lisa A, Ashley Mark J, Masel Brent E, Singh Charan K, Randle Kevin D, Johnson Christine, Helvie Richard, Ashley Matthew J, Griesbach Grace S

机构信息

Centre for Neuro Skills, Bakersfield, CA, USA.

School of Health Sciences, Southern Illinois University, Carbondale, IL, USA.

出版信息

Brain Inj. 2020;34(2):276-280. doi: 10.1080/02699052.2019.1682195. Epub 2019 Oct 29.

DOI:10.1080/02699052.2019.1682195
PMID:31661639
Abstract

: The prevalence of chronic growth hormone deficiency (GHD) and its association with other hormonal deficiencies was determined in middle-aged patients post-stroke with and without consideration of body mass index (BMI).: Clinical records were reviewed to determine pituitary function at least 3 months post-stroke. Patients with a history of endocrine anomalies were excluded. GHD was determined by utilizing standard peak GH cutoffs following the glucagon stimulation test. A secondary analysis was conducted with stricter BMI-adjusted cutoffs. The accuracy of IGF-1 in predicting GHD was also examined.: GHD was diagnosed in 54% of patients (≥5.0 μg/L), with 32% falling into the severe (≤3 μg/L) category. Patients with GHD had lower levels of FSH, T3, LH, and SHBG. Analyzes of BMI-adjusted GH levels, revealed that 14% of patients were GHD. These patients had higher prolactin. IGF-1 values were not predictive of GHD. Latency to be admitted to post-acute rehabilitation was greater in patients with GHD.: Evidence suggests patients with stroke may be at risk for developing GHD. GHD was associated with decreased levels of other hormones. Co-morbidities for stroke and neuroendocrine dysfunction overlap and may have implications for recovery following stroke.

摘要

在考虑和不考虑体重指数(BMI)的情况下,确定了中年中风患者慢性生长激素缺乏(GHD)的患病率及其与其他激素缺乏的关联。

回顾临床记录以确定中风后至少3个月的垂体功能。排除有内分泌异常病史的患者。通过在胰高血糖素刺激试验后使用标准的生长激素峰值临界值来确定生长激素缺乏。采用更严格的BMI调整临界值进行二次分析。还检查了胰岛素样生长因子-1(IGF-1)预测生长激素缺乏的准确性。

54%的患者被诊断为生长激素缺乏(≥5.0μg/L),其中32%属于严重缺乏(≤3μg/L)类别。生长激素缺乏患者的促卵泡生成素(FSH)、三碘甲状腺原氨酸(T3)、促黄体生成素(LH)和性激素结合球蛋白(SHBG)水平较低。对BMI调整后的生长激素水平分析显示,14%的患者存在生长激素缺乏。这些患者的催乳素水平较高。IGF-1值不能预测生长激素缺乏。生长激素缺乏患者进入急性后期康复的延迟时间更长。

有证据表明中风患者可能有发生生长激素缺乏的风险。生长激素缺乏与其他激素水平降低有关。中风和神经内分泌功能障碍的合并症相互重叠,可能对中风后的恢复产生影响。

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