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Pituitary-testicular axis dysfunction in burned men.

A V Vogel, G T Peake, R T Rada

    The Journal of Clinical Endocrinology and Metabolism
    |April 1, 1985
    PubMed
    Summary
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    Burned men experience significantly low testosterone levels, with severity correlating to the decline. This suggests a central defect in luteinizing hormone (LH) release, potentially linked to pain or opiate use.

    Area of Science:

    • Endocrinology
    • Trauma Medicine
    • Andrology

    Background:

    • Severe burns can significantly impact physiological functions.
    • Hormonal imbalances are common in critically ill patients.
    • Testosterone plays a crucial role in male health.

    Purpose of the Study:

    • To investigate hormonal changes, specifically testosterone and luteinizing hormone (LH), in adult men hospitalized for burn treatment.
    • To determine the relationship between burn severity and hormonal levels.
    • To explore potential causes of observed hypogonadism in burn patients.

    Main Methods:

    • Measurement of plasma total testosterone, free testosterone, LH, and sex hormone-binding globulin (SHBG).
    • Analysis of hormonal levels in adult men admitted for burn treatment.

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  • Correlation of hormonal levels with burn severity.

    • Main Results:

    • 37 out of 41 patients exhibited below-normal total testosterone levels.
    • Rapid decline in free and total testosterone post-burn, with slow recovery.
    • Lower testosterone levels correlated with increased burn severity.
    • Luteinizing hormone (LH) levels were subnormal in the initial days post-burn, then remained low-normal.
    • Sex hormone-binding globulin (SHBG) levels were normal or slightly low.

    Conclusions:

    • Burn injury leads to significant hypogonadism in adult men.
    • Evidence suggests a central defect in LH release contributing to pituitary-testicular hypofunction.
    • Severe pain and opiate analgesic use may be contributing factors to the observed hormonal dysfunction.