Aerobic capacity and growth hormone deficiency after traumatic brain injury

J Clin Endocrinol Metab. 2008 Jul;93(7):2581-7. doi: 10.1210/jc.2008-0368. Epub 2008 Apr 15.

Abstract

Context: GH deficiency occurs in approximately 20% of all individuals who suffer from a moderate to severe traumatic brain injury.

Objective: This study determined whether GH deficiency secondary to traumatic brain injury had an effect on aerobic capacity.

Design: Subjects were screened for GH deficiency by the glucagon stimulation test and performed a maximal treadmill exercise test.

Setting: Patients were studied in the postacute recovery phase after traumatic brain injury.

Participants: Thirty-five individuals were studied. Groups were formed as follows: normal GH axis, greater than 8 ng/ml response (n = 12); insufficient, GH 3-8 ng/ml response (n = 11); and deficient, less than 3 ng/ml response (n = 12).

Intervention: There was no intervention.

Main outcome measure: Aerobic capacity was assessed by measuring expired gases during a graded treadmill exercise test. One-way and two-way ANOVAs were carried out on all peak and submaximal cardiorespiratory variables, respectively. Appropriate post hoc comparisons followed as necessary.

Results: Significantly higher peak oxygen consumption was found in traumatic brain injury subjects with GH normal vs. GH insufficient and deficient [26.4 +/- 6.9, 20.8 +/- 4.6, and 19.7 +/- 5.0, respectively (P < 0.05)]. Submaximal oxygen consumption was significantly higher in the GH normal group. All other variables were statistically similar.

Conclusions: This study shows that individuals with traumatic brain injury with normal GH secretion have below normal aerobic capacity and those patients who have GH insufficiency/deficiency are further deconditioned. Studies of GH replacement in these subjects should be conducted to assess whether GH therapy can improve cardiorespiratory fitness and prevent secondary disability.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Brain Injuries / metabolism*
  • Exercise Test
  • Exercise*
  • Human Growth Hormone / deficiency*
  • Human Growth Hormone / therapeutic use
  • Humans
  • Middle Aged
  • Oxygen Consumption

Substances

  • Human Growth Hormone