Endocrine Abstracts

Introduction: Sheehan’s syndrome (SS) is postpartum hypopituitarism caused by necrosis of the pituitary gland. Patients with SS have varying degrees of anteriorpituitary hormone deficiency and have an increased mortality from cardiovascular disease. Inadequate hormone replacement is one of the possible causes of this increased mortality. The aim of our study was to assess metabolic and cardiovascular outcome in patients with SS.

Methods: In a retrospective study, we included 80 patients with hypopituitarism due to SS. Metabolic disorders were determined and cardiovascular risk was assessed using Framingham score. 10-year CVD risk was categorized into low risk: <10%, moderate risk: (10–20) and high risk: >20%.

Results: The study population had a mean age of 41.6±11.31 years and a mean follow up period of 23.4±11.2 years. All of the participants had hypogonadotropic hypogonadism and adrenal insufficiency, while 79 (98.8%) patients had secondary hypothyroidism. Somatotropic function was investigated in only seven patients and was deficient in all of them. The mean BMI was 26.55±5.04 kg/m². Obesity was found in 15% and overweight in 35% of patients. Prevalences of hypertension, hyperlipidaemia, diabetes mellitus and smoking were 22%, 25%, 21% and 14%, respectively. In all patients, the mean Framingham score was 5.85±5.69. The cardiovascular risk was low, moderate and high in 85%, 11% and 3.7% of patients, respectively. The Framingham score was correlated with age (r=0.55, P<0.001), fasting plasma glucose (r=0.42, P=0.02) and systolic blood pressure (r=0.32, P=0.04).

Conclusion: Patients with SS exhibit a higher cardiovascular risk. The increased cardiovascular morbidity could be attributed to inadequate estrogen or thyroid hormone treatment, also unsubstituted GHdeficiency is probably an important contributing factor.