Cardiovascular Risk Factors in Sheehan's Syndrome: A Case-Control Study.

Indian Journal of Endocrinology and Metabolism Pub Date : 2024-05-01 Epub Date: 2024-06-26 DOI:10.4103/ijem.ijem_297_23

Mayur Agrawal, Subhash C Yadav, Swish K Singh, Sheo Kumar, Krishnarpan Chatterjee, Naveen K Garg

{"title":"Cardiovascular Risk Factors in Sheehan's Syndrome: A Case-Control Study.","authors":"Mayur Agrawal, Subhash C Yadav, Swish K Singh, Sheo Kumar, Krishnarpan Chatterjee, Naveen K Garg","doi":"10.4103/ijem.ijem_297_23","DOIUrl":null,"url":null,"abstract":"Introduction: Obesity, dyslipidaemia and insulin resistance are associated with hypopituitarism. The association between these conditions and Sheehan's syndrome (SS) caused by post-partum pituitary gland necrosis is poorly understood. This study aimed to assess cardiovascular risk surrogate markers in SS patients, and we compared clinical, biochemical and radiological testing with healthy controls.Methods: In this cross-sectional study, we studied 45 patients with SS on standard replacement therapy and compared them with healthy controls. All subjects underwent anthropometric, inflammatory marker and hormonal measurement (adrenocorticotropic hormone (ACTH), stimulated cortisol, insulin-like growth factor-1 (IGF-1), thyroxine (T4), follicle-stimulating hormone (FSH), luteinising hormone (LH), oestradiol (E2), prolactin (Prl), insulin, interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP)). Carotid intima-media thickness (CIMT), flow-mediated dilation (FMD) and echocardiography were also performed.Results: The mean age and body mass index (BMI) of SS patients were 48.1 ± 10.0 years and 24.3 ± 4.3 kg/m2, respectively, while those of controls were 44.6 ± 12.0 years and 24.6 ± 3.2 kg/m2, respectively. Systolic blood pressure was significantly higher in SS (124.6 ± 20.8 vs. 117.0 ± 18.6 mm of Hg, P < 0.05). All SS patients were hypothyroid, and all except one were hypocortisolaemic. Triglyceride (TG) levels were significantly higher in SS patients (165.6 ± 83.3 vs. 117.2 ± 56.1, P < 0.01), but no difference in the prevalence of metabolic syndrome (MetS) was found. hs-CRP (9.1 (5.2-18.5) vs. 1.5 (0.6-2.8), P < 0.001) and IL-6 (4.9 (3.7-7.3) vs. 3.1 (2.0-4.2), P < 0.001) were significantly higher in SS patients. CIMT was significantly increased in SS patients, but no difference in FMD was found. Echocardiography revealed no significant difference in left ventricular (LV) dimensions, interventricular thickness, posterior wall thickness, ejection fraction, LV mass and diastolic function.Conclusion: SS patients show increased cardiovascular risk with hypertension, dyslipidaemia and increased atherosclerotic and inflammatory markers.","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 3","pages":"260-267"},"PeriodicalIF":0.0000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288506/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Endocrinology and Metabolism","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/ijem.ijem_297_23","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/26 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Obesity, dyslipidaemia and insulin resistance are associated with hypopituitarism. The association between these conditions and Sheehan's syndrome (SS) caused by post-partum pituitary gland necrosis is poorly understood. This study aimed to assess cardiovascular risk surrogate markers in SS patients, and we compared clinical, biochemical and radiological testing with healthy controls.

Methods: In this cross-sectional study, we studied 45 patients with SS on standard replacement therapy and compared them with healthy controls. All subjects underwent anthropometric, inflammatory marker and hormonal measurement (adrenocorticotropic hormone (ACTH), stimulated cortisol, insulin-like growth factor-1 (IGF-1), thyroxine (T4), follicle-stimulating hormone (FSH), luteinising hormone (LH), oestradiol (E2), prolactin (Prl), insulin, interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP)). Carotid intima-media thickness (CIMT), flow-mediated dilation (FMD) and echocardiography were also performed.

Results: The mean age and body mass index (BMI) of SS patients were 48.1 ± 10.0 years and 24.3 ± 4.3 kg/m², respectively, while those of controls were 44.6 ± 12.0 years and 24.6 ± 3.2 kg/m², respectively. Systolic blood pressure was significantly higher in SS (124.6 ± 20.8 vs. 117.0 ± 18.6 mm of Hg, P < 0.05). All SS patients were hypothyroid, and all except one were hypocortisolaemic. Triglyceride (TG) levels were significantly higher in SS patients (165.6 ± 83.3 vs. 117.2 ± 56.1, P < 0.01), but no difference in the prevalence of metabolic syndrome (MetS) was found. hs-CRP (9.1 (5.2-18.5) vs. 1.5 (0.6-2.8), P < 0.001) and IL-6 (4.9 (3.7-7.3) vs. 3.1 (2.0-4.2), P < 0.001) were significantly higher in SS patients. CIMT was significantly increased in SS patients, but no difference in FMD was found. Echocardiography revealed no significant difference in left ventricular (LV) dimensions, interventricular thickness, posterior wall thickness, ejection fraction, LV mass and diastolic function.

Conclusion: SS patients show increased cardiovascular risk with hypertension, dyslipidaemia and increased atherosclerotic and inflammatory markers.

查看原文本刊更多论文

希恩综合征的心血管风险因素：病例对照研究

导言肥胖、血脂异常和胰岛素抵抗与垂体功能减退症有关。这些情况与产后垂体坏死引起的希恩综合征（SS）之间的关系尚不清楚。本研究旨在评估SS患者的心血管风险替代标记物，并将临床、生化和放射学检测结果与健康对照组进行比较：在这项横断面研究中，我们对 45 名接受标准替代疗法的 SS 患者进行了研究，并将他们与健康对照组进行了比较。所有受试者都接受了人体测量、炎症标志物和激素测量（促肾上腺皮质激素（ACTH）、刺激皮质醇、胰岛素样生长因子-1（IGF-1）、甲状腺素（T4）、胰岛素样生长因子-1（IGF-1））、甲状腺素 (T4)、卵泡刺激素 (FSH)、黄体生成素 (LH)、雌二醇 (E2)、催乳素 (Prl)、胰岛素、白细胞介素-6 (IL-6) 和高敏 C 反应蛋白 (hs-CRP)）。此外，还进行了颈动脉内膜中层厚度（CIMT）、血流介导的扩张（FMD）和超声心动图检查：SS 患者的平均年龄和体重指数（BMI）分别为（48.1 ± 10.0）岁和（24.3 ± 4.3）千克/平方米，而对照组的平均年龄和体重指数（BMI）分别为（44.6 ± 12.0）岁和（24.6 ± 3.2）千克/平方米。SS 患者的收缩压明显较高（124.6 ± 20.8 vs. 117.0 ± 18.6 mm Hg，P < 0.05）。所有 SS 患者均甲状腺功能减退，除一人外，其余均皮质醇血症。SS 患者的甘油三酯（TG）水平明显更高（165.6 ± 83.3 vs. 117.2 ± 56.1，P < 0.01），但代谢综合征（MetS）的发病率没有差异。在 SS 患者中，hs-CRP（9.1 (5.2-18.5) vs. 1.5 (0.6-2.8)，P < 0.001）和 IL-6 （4.9 (3.7-7.3) vs. 3.1 (2.0-4.2)，P < 0.001）显著升高。SS 患者的 CIMT 明显增加，但 FMD 没有发现差异。超声心动图显示，SS 患者的左心室（LV）尺寸、室间隔厚度、后壁厚度、射血分数、左心室质量和舒张功能均无明显差异：结论：SS 患者的心血管风险增加，表现为高血压、血脂异常、动脉粥样硬化和炎症指标增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Indian Journal of Endocrinology and Metabolism Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

2.10

自引率

0.00%

发文量

期刊介绍： The Indian Journal of Endocrinology and Metabolism (IJEM) aims to function as the global face of Indian endocrinology research. It aims to act as a bridge between global and national advances in this field. The journal publishes thought-provoking editorials, comprehensive reviews, cutting-edge original research, focused brief communications and insightful letters to editor. The journal encourages authors to submit articles addressing aspects of science related to Endocrinology and Metabolism in particular Diabetology. Articles related to Clinical and Tropical endocrinology are especially encouraged. Sub-topic based Supplements are published regularly. This allows the journal to highlight issues relevant to Endocrine practitioners working in India as well as other countries. IJEM is free access in the true sense of the word, (it charges neither authors nor readers) and this enhances its global appeal.