Saberian Sepehr, Mustroph Christian M, Atif Fahim, Stein Don, Yousuf Seema
Neurological Surgery, Morehouse School of Medicine, Atlanta, USA.
Neurological Surgery, Emory University School of Medicine, Atlanta, USA.
Cureus. 2022 Jul 26;14(7):e27296. doi: 10.7759/cureus.27296. eCollection 2022 Jul.
This review examines various aspects of traumatic brain injury (TBI) and its potential role as a causative agent for type 2 diabetes mellitus (T2DM) in the veteran population. The pituitary glands and the hypothalamus, both housed in the intracranial space, are the most important structures for the homeostatic regulation of almost every hormone in the human body. As such, TBI not only causes psychological and cognitive impairments but can also disrupt the endocrine system. It is well established that in addition to having a high prevalence of chronic traumatic encephalopathy (CTE), veterans have a very high risk of developing various chronic medical conditions. Unfortunately, there are no measures or prophylactic agents that can have a meaningful impact on this medically complex patient population. In this review, we explore several important factors pertaining to both acute and chronic TBI that can provide additional insight into why veterans tend to develop T2DM later in life. We focus on the unique combination of risk factors in this population not typically found in civilians or other individuals with a non-military background. These include post-traumatic stress disorder, CTE, and environmental factors relating to occupation and lifestyle.
本综述探讨了创伤性脑损伤(TBI)的各个方面及其在退伍军人中作为2型糖尿病(T2DM)致病因素的潜在作用。垂体和下丘脑均位于颅内空间,是人体几乎每种激素稳态调节的最重要结构。因此,TBI不仅会导致心理和认知障碍,还会扰乱内分泌系统。众所周知,退伍军人除了慢性创伤性脑病(CTE)的高患病率外,患各种慢性疾病的风险也非常高。不幸的是,没有措施或预防药物能对这个医学情况复杂的患者群体产生有意义的影响。在本综述中,我们探讨了与急性和慢性TBI相关几个重要因素,这些因素可以为退伍军人为何在晚年易患T2DM提供更多见解。我们关注的是这一人群中独特的风险因素组合,这些因素在平民或其他非军事背景的个体中通常不存在。这些因素包括创伤后应激障碍、CTE以及与职业和生活方式相关的环境因素。