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Pituitary ; 18(3): 312-8, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24879499

RESUMO

BACKGROUND: Increased clustering of metabolic risk factors has been demonstrated in patients with hypopituitarism on standard replacement therapy. This usually has been attributed to persistent growth hormone deficiency, though contribution from underlying etiology of hypopituitarism cannot be underestimated. We, therefore, studied conventional metabolic risk factors and pro inflammatory markers in a cohort of hypopituitary patients in whom the etiology was Sheehan's syndrome. MATERIAL & METHODS: We studied 30 GH naive patients with Sheehan's syndrome (SS) on standard replacement therapy and compared with healthy age, BMI and parity matched controls. All subjects were normotensive, non-diabetic, non-smokers and none had history of any acute or chronic illness. We recorded height, weight, BMI, waist circumference and waist hip ratio, besides measuring biochemical parameters like lipid profile, fasting plasma glucose and insulin, sVCAM-1, ICAM-1 and hsCRP. RESULTS: Metabolic syndrome and impaired glucose tolerance were more common with SS patients. Similarly total cholesterol (mean ± SD, 5.21 ± 0.98 vs 4.57 ± 0.88, P = 0.00), LDL-cholesterol (3.15 ± 0.90 vs 2.67 ± 0.75, P = 0.02), triglycerides (2.14 ± 1.00 vs 1.43 ± 0.45, P = 0.00) and pro-inflammatory markers i.e. hsCRP (3.95 ± 2.58 vs 1.45 ± 2.77, P = 0.00) were significantly higher in patients with SS. hsCRP positively correlated with fasting insulin (r = 0.40, P = 0.02), HOMA-IR (r = 0.38, P = 0.03) and negatively with HDL (r = - 0.33, P = 0.05). CONCLUSIONS: GH naïve SS patients on standard replacement therapy have increased clustering of metabolic and pro-inflammatory risk factors.


Assuntos
Glucocorticoides/uso terapêutico , Terapia de Reposição Hormonal , Hipopituitarismo/tratamento farmacológico , Inflamação/etiologia , Resistência à Insulina , Síndrome Metabólica/etiologia , Tiroxina/uso terapêutico , Adulto , Fatores Etários , Biomarcadores/sangue , Glicemia/metabolismo , Índice de Massa Corporal , Estudos de Casos e Controles , Doença Crônica , Quimioterapia Combinada , Estrogênios/uso terapêutico , Feminino , Hormônio do Crescimento Humano/sangue , Hormônio do Crescimento Humano/deficiência , Humanos , Hipopituitarismo/sangue , Hipopituitarismo/complicações , Hipopituitarismo/diagnóstico , Inflamação/sangue , Inflamação/diagnóstico , Mediadores da Inflamação/sangue , Insulina/sangue , Lipídeos/sangue , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Paridade , Gravidez , Progestinas/uso terapêutico , Resultado do Tratamento
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