Endocrine Abstracts

Aim: To examine the endothelial functions of patients with Sheehan syndrome (SS) and to eveluate the effects of hormone replacement treatment except growth hormone on endothelial functions.

Subjects and methods: Twenty-four patients with Sheehan syndrome (PSS) aged 40.83±6.43 yr and 25 healthy control women aged 41.13±6.51 yr (C) were included. Endothelial functions were evaluated with high resolution ultrasonography (flow mediated dilatation:FMD) and serum nitric oxide (NO) levels before and after the treatment [15 months with prednisolon (5–7.5 mg/d), L-thyroxin (100–200 μg/d), and conjugated estradiol (0.625 mg/d)- medroxyprogesteron acetate (5 mg/d) patients <40 years].

Results: 1-Before treatmentBaseline (16.87±4.04 μol/L and 11.8±2.14 μol/L) and stimulated NO levels were higher (18.79±4.4 and 14.92±2.44); whereas, baseline arterial diameter (3.74±0.68 mm, 4.62±0.42 mm, P=0,0001), FMD stimulated NO increment ratio (13.16±5.57% and 26.38±8.89%, P=0,0001) and arterial dilation ratio (13.42±6.57% and 18.93±5.64, P=0,003) of PSS were lower than C group.

2- After treatment: Elevation of baseline (17.58±4.3 vs 11.8±2.14) and stimulated NO levels of PSS (21.12±4.85 vs 11.92±2.44, P=0.0001) insisted on. On the contrary FMD stimulated arterial dilation ratio of PSS increased to the similar level of C group with treatment. FMD stimulated NO levels (18.79±4.4 vs 21.12±4.85), NO increment ratios (13.16±5.57% and 22.83±8.57%) and FMD stimulated arterial dilation ratio increased with treatment significantly (13.42±6.57% vs 21.73±10.13%) (P=0,0001).

Conclusions: 1- Although patients with Sheehan syndrome had high NO levels, they had small FMD stimulated NO increments and arterial dilation ratio. 2-Increased but little effective NO may responsible for this result. 3- HRT apart from GH may restore endothelial functions in patients with Sheehan’s syndrome.