Evaluation of pituitary function and metabolic parameters in patients with traumatic maxillofacial fractures.

Abstract

This study was designed to assess the pituitary functions of patients with traumatic maxillofacial fractures and compare the results with healthy controls. Thirty patients (mean age, 38.14 ± 14.15years; twenty-six male, four female) with a traumatic maxillofacial fracture at least 12months ago (mean 27.5 ± 6.5months) and thirty healthy controls (mean age, 42.77 ± 11.36years; twenty-five male, five female) were included. None of the patients were unconscious following head trauma, and none required hospitalization in intensive care. Basal pituitary hormone levels of the patients were evaluated. All patients and controls had a glucagon stimulation test and an ACTH stimulation test to evaluate the hypothalamic-pituitary-adrenal axis and the GH-IGF-1 axis. Five of thirty patients (16.6%) had isolated growth hormone (GH) deficiency based on a glucagon stimulation test (GST). The mean peak GH level after GST in patients with hypopituitarism (0.54ng/ml) was significantly lower than those without hypopituitarism (7.01ng/ml) and healthy controls (11.70ng/ml) (P < 0.001). No anterior pituitary hormone deficiency was found in the patients, except for GH. Our study is the first to evaluate the presence of hypopituitarism in patients with traumatic maxillofacial fractures. Preliminary findings suggest that hypopituitarism and GH deficiency pose significant risks to these patients, particularly during the chronic phase of their trauma. However, these findings need to be validated in larger scale prospective studies with more patients.