Detection of Growth Hormone Deficiency in Adults with Chronic Traumatic Brain Injury
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This study examined the prevalence of growth hormone deficiency (GHD) in patients with traumatic brain injury (TBI) during the post-acute phase of recovery and whether GHD was associated with increased disability, decreased independence, and depression. A secondary objective was to determine the accuracy of insulin-like growth factor-1 (IGF-1) levels in predicting GHD in patients with TBI. Anterior pituitary function was assessed in 235 adult patients with TBI through evaluation of fasting morning hormone levels. GH levels were assessed through provocative testing, specifically the glucagon stimulation test. GHD was diagnosed in a significant number of patients, with 45% falling into the severe GHD (≤3 μg/L) category. IGF-1 levels were not predictive of GHD. Patients with GHD were more disabled and less independent compared with those patients who were not GHD. Those patients with more severe GHD also showed decreased levels of cortisol and testosterone. Symptoms of depression were also more prevalent in this group. In addition, patients with severe GHD had delayed admission to post-acute rehabilitation. This study confirms the high prevalence of GHD in patients with TBI and the necessity to monitor clinical symptoms and perform provocative testing to definitively diagnose GHD.
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Patients with normal IGF-1 levels can be diagnosed as having GHD on provocative testing.
“Evaluation for growth hormone deficiency often requires GH stimulation; while IGF-1 was used as a screening test for years, it is now clear that patients with normal IGF-1 levels can be diagnosed as having GHD on provocative testing [11, 69, 70].”
From Neuroendocrine Disruptions Following Head Injury (2023) · cites this paper as [69]
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Endocrine therapies and hormonal dysfunction after traumatic brain injury: A scoping review
Smith, C., Zhang, Z., Ranganathan, S., & Yuen, K. C. J. (2026) · Growth Hormone & IGF Research · doi:10.1016/j.ghir.2026.101728
- Authors
- Kreber, L. A., Griesbach, G. S., & Ashley, M. J.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Kreber, Lisa A.
- Venue
- Journal of Neurotrauma
- Publisher
- SAGE Publications
- Published
- 2016-09
- Volume
- 33
- Issue
- 17
- Pages
- 1607-1613
- ISSN
- 0897-7151 (ISSN-L)
- 1557-9042
- PMC
- PMC5011623
- OpenAlex
- W2178350749
- Cited by
- 44
- References
- 50
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 3 · 2023: 4 · 2022: 2 · 2021: 2 · 2020: 3 · 2019: 7 · 2018: 6 · 2017: 5 · 2016: 1
- FWCI
- 3.48
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Neurotrauma (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- growth hormone deficiency, traumatic brain injury, chronic traumatic brain injury, insulin-like growth factor I, glucagon stimulation test, anterior pituitary function, disability, functional independence, depression, cortisol, testosterone, post-acute rehabilitation, provocation tests
- MeSH terms
- Brain Injuries, Traumatic, Adult, Chronic Disease, Female, Humans, Hypopituitarism, Insulin-Like Growth Factor I, Male, Middle Aged, Prevalence, Human Growth Hormone, Recovery of Function
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