Traumatic brain injury and prolactin.

IF 6.9 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Aysa Hacioglu, Fatih Tanriverdi
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Abstract

Traumatic brain injury (TBI) is a well-known etiologic factor for pituitary dysfunctions, with a prevalence of 15% during long-term follow-up. The most common hormonal disruption is growth hormone deficiency, followed by central adrenal insufficiency, central hypogonadism, and central hypothyroidism in varying order across studies. The prevalence of serum prolactin disturbances ranged widely from 0 to 85%. Prolactin release is mainly regulated by hypothalamic dopamine inhibition, and mediators such as TRH, serotonin, cytokines, and neurotransmitters have modulatory effects. Many factors, such as hypothalamic and/or pituitary gland injuries, as well as fluctuations in dopaminergic activity and other mediators and stress response, may cause derangements in serum prolactin levels after TBI. Although it is challenging to investigate the direct effects of TBI on serum prolactin levels due to many confounders, basal prolactin measurements and stimulation tests provide insight into the functionality of the hypothalamus and pituitary gland after TBI. Moreover, during the acute phase of TBI, prolactin levels appear to correlate with TBI severity. In contrast, in the chronic phase, hypoprolactinemia may function as an indirect indicator of pituitary dysfunction and reduced pituitary volume. Further investigations are needed to elucidate the pathophysiologic mechanisms underlying the prolactin trend following TBI, its significance, and its associations with other pituitary hormone dysfunctions. In this article, we re-evaluated our patients' TBI data regarding prolactin levels during prospective long-term follow-up, and reviewed the literature regarding the prevalence, pathophysiology, and clinical implications of serum prolactin disturbances during acute and chronic phases following TBI.

Abstract Image

创伤性脑损伤与催乳素
众所周知,创伤性脑损伤(TBI)是导致垂体功能障碍的病因之一,在长期随访中的发病率为 15%。最常见的激素紊乱是生长激素缺乏症,其次是中枢性肾上腺功能不全、中枢性性腺功能减退症和中枢性甲状腺功能减退症,各研究的发病顺序各不相同。血清催乳素紊乱的发生率从 0% 到 85% 不等。催乳素的释放主要受下丘脑多巴胺抑制的调节,TRH、5-羟色胺、细胞因子和神经递质等介质也有调节作用。许多因素,如下丘脑和/或垂体损伤,以及多巴胺能活动和其他介质的波动和应激反应,都可能导致创伤性脑损伤后血清催乳素水平的失调。虽然由于存在许多混杂因素,研究创伤后对血清催乳素水平的直接影响具有挑战性,但基础催乳素测量和刺激试验可帮助了解创伤后下丘脑和垂体的功能。此外,在创伤性脑损伤的急性期,催乳素水平似乎与创伤性脑损伤的严重程度相关。相反,在慢性期,低泌乳素血症可能是垂体功能障碍和垂体容量减少的间接指标。需要进一步研究以阐明创伤性脑损伤后催乳素趋势的病理生理机制、其意义及其与其他垂体激素功能障碍的关联。在这篇文章中,我们重新评估了我们的患者在前瞻性长期随访期间有关催乳素水平的 TBI 数据,并回顾了有关 TBI 后急性期和慢性期血清催乳素紊乱的患病率、病理生理学和临床意义的文献。
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来源期刊
Reviews in Endocrine & Metabolic Disorders
Reviews in Endocrine & Metabolic Disorders 医学-内分泌学与代谢
CiteScore
14.70
自引率
1.20%
发文量
75
审稿时长
>12 weeks
期刊介绍: Reviews in Endocrine and Metabolic Disorders is an international journal dedicated to the field of endocrinology and metabolism. It aims to provide the latest advancements in this rapidly advancing field to students, clinicians, and researchers. Unlike other journals, each quarterly issue of this review journal focuses on a specific topic and features ten to twelve articles written by world leaders in the field. These articles provide brief overviews of the latest developments, offering insights into both the basic aspects of the disease and its clinical implications. This format allows individuals in all areas of the field, including students, academic clinicians, and practicing clinicians, to understand the disease process and apply their knowledge to their specific areas of interest. The journal also includes selected readings and other essential references to encourage further in-depth exploration of specific topics.
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