Endocrine Abstracts

Introduction: Current literature suggests that the incidence of GH deficiency (GHD) post subarachnoid haemorrhage (SAH) ranges from 0 to 37%. We present the results from a large single centre study and discuss factors that should be considered when testing for GHD in this population.

Method: One hundred survivors of SAH were screened with a glucagon stimulation test (GST) for pituitary hormone deficiency. Participants with isolated GHD were required to undergo a confirmatory arginine stimulation test (AST).

Results: The incidence of hypopituitarism detected by GST was 37%. The most common hormone deficiency was Isolated GHD (27%). The confirmatory AST reduced the incidence of GHD to 14%. There was no association between GHD and gender, age, interval to pituitary hormone testing, site of aneurysm rupture, type of intervention or presenting GCS. Patients with GHD were significantly heavier than patients without (mean weight difference 16.0 kg, P-value <0.001). They also had a higher BMI and waist hip ratio (P-value <0.001). QoL-AGHDA scores of patients diagnosed with GHD were significantly worse than patients with normal GH status (<0.0001).

Conclusion: This is the largest series assessing pituitary function in SAH survivors. The incidence of GHD is lower than previously thought due to the use of confirmatory testing. However given that GH response has been shown to be weight and BMI dependent, it is unclear if these results are truly reflective of GH status in these patients. The QoL-AGHDA questionnaire may be useful preliminary screening tool for GHD in patients with SAH.