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Occult endocrine dysfunction in patients of cerebrovascular accident
K V S Hari Kumar1, Sandeep Kumar2, Faiz M H Ahmad3
1Department of Endocrinology, Command Hospital, Chandimandir, Panchkula, Haryana, India.
Insights
Endocrine dysfunction is common in patients with cerebrovascular accident (CVA), with sick euthyroid syndrome being the most frequent finding. These hormonal imbalances did not predict mortality within 30 days.
Area of Science:
- Endocrinology
- Neurology
- Internal Medicine
Background:
- Cerebrovascular disorders (CVA) are a leading cause of death and disability.
- Undiagnosed endocrine disorders can exacerbate CVA-related morbidity.
- This study investigates the prevalence of endocrine dysfunction in acute CVA patients.
Purpose of the Study:
- To determine the prevalence of endocrine dysfunction in patients experiencing a cerebrovascular accident.
- To identify common endocrine disorders associated with acute CVA.
- To explore the relationship between hormonal dysfunction and short-term mortality in CVA patients.
Main Methods:
- Prospective observational study of 30 CVA patients (aged 18-75) admitted within 72 hours.
- Clinical and biochemical assessment for hormonal dysfunction at admission.
- Patients categorized into ischemic (n=20) and hemorrhagic (n=10) stroke groups; 1-month mortality follow-up.
Main Results:
- 14 out of 30 patients (46.7%) exhibited endocrine disorders.
- Most common findings included sick euthyroid syndrome (n=10) and central hypothyroidism (n=10).
- Other detected dysfunctions: secondary hypogonadism (n=3), subclinical hypothyroidism (n=1), and growth hormone deficiency (n=2). No significant difference between stroke types.
Conclusions:
- Endocrine disorders are frequently observed in the acute phase of cerebrovascular accidents.
- Sick euthyroid syndrome is the most common endocrine abnormality in this population.
- Hormonal dysfunction did not correlate with stroke etiology or predict 30-day mortality, necessitating long-term follow-up.
Background:
Cerebrovascular disorders are common conditions leading to significant morbidity and mortality in the population. Occult endocrine disorders also contribute to the morbidity and we studied the prevalence of endocrine dysfunction in patients of cerebrovascular accident (CVA).
Materials And Methods:
We evaluated 30 patients of CVA (aged 18-75, admission within 72 h of symptoms and positive neuroimaging) in this prospective, observational study. All subjects were assessed clinically and biochemically for hormonal dysfunction at admission and for mortality at the end of 1 month. The patients were divided into two groups: Group 1 (infarct, n = 20) and Group 2 (hemorrhage, n = 10) and the data were analyzed with appropriate statistical tests using GraphPad Prism Software, version 6.
Results:
The study participants (24M:6F) had a mean age of 60.7 ± 11.4 years and body weight of 67.2 ± 11.4 kg. Fourteen out of 30 patients showed results consistent with an endocrine disorder, including sick euthyroid syndrome (SES) and central hypothyroidism (n = 10), secondary hypogonadism (n = 3), subclinical hypothyroidism (n = 1), and growth hormone (GH) deficiency in two patients. The endocrine conditions did not differ significantly between both the groups and nine out of 30 patients succumbed to their illness within 1 month. None of the hormonal parameters studied, could predict the 30 day mortality.
Conclusion:
Endocrine disorders are common in acute stage of CVA and commonest finding is a SES. Hormonal dysfunction did not differ based on the etiology of the CVA. Long-term follow-up is essential to understand the morbidity contributed by the hormonal alterations.
