Abstract

Introduction: The objective of the current retrospective study was to determine the prevalence of growth hormone deficiency (GHD) in middle-aged patients with ischemic and hemorrhagic stroke who were at least 3 months post-stroke. It was hypothesized a large percentage of patients with stroke would exhibit growth hormone deficiency, as well as, other hormone deficiencies. A secondary objective was to determine if chronic health conditions often associated with stroke were associated with neuroendocrine dysfunction. Methods: Clinical records from 139 adult patients (from 2009-2017), who were in the post-acute phase of their recovery, were obtained to analyze findings from standard endocrine blood tests. Patients with a pre-stroke history of endocrine anomalies were excluded from the study. Growth hormone was assessed by the glucagon stimulation test (GST). Results: GHD was identified in 54% of the patients with stroke during the chronic phase of recovery. Patients with GHD took longer to be admitted to post-acute rehabilitation compared to patients with normal GH levels. Patients with GHD also had lower levels of follicle stimulating hormone (FSH), triiodothyronine (T3), luteinizing hormone (LH) and sex hormone binding globulin. Body mass index was higher in patients with GHD. Conclusions: There is a considerable risk of developing hypopituitarism, particularly GHD, following ischemic or hemorrhagic stroke. In this relatively large sample of middle-aged stroke patients, GHD was associated with decreased levels of T3 and gonadotrophic hormones. Co-morbidities for stroke and neuroendocrine dysfunction overlap and may have implications for recovery following stroke and warrant further investigation.

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