Effects of Hypopituitarism Due to Sheehan's Syndrome on Bone Mineral Density: A Multicentric Study in Asian Indians
Authors' conclusion
SS is characterized by a high prevalence of multiple pituitary hormone deficiencies, including hypoprolactinaemia. Low BMD is highly prevalent in SS compared to age, and BMI-matched controls. Despite adequate relevant hormone replacement therapy, a longer delay in diagnosing is the major determinant of low BMD in patients with SS.
Study context
- Population
- Asian Indian patients with Sheehan's syndrome on stable hormone replacement; mean age 45.3 ± 10.5 years, delay of 7.9 ± 6.3 years from onset to diagnosis
- Participants
- 110 vs 102
- Exposure
- Sheehan's syndrome (SS) on stable hormone replacement vs healthy female controls
- SSn = 110
- Controlsn = 102reference
- Outcome
- Prevalence and predictors of low BMD (DXA)
Methodological detailsmulticentric, case-control
- Multicentric
- Case-control
Main finding
As reported in the abstract
Low bone mineral density (BMD) at lumbar spine, SS vs controls
94% vs 47%
Low BMD at femoral neck, SS vs controls
80% vs 36%
Most important predictor of low lumbar spine BMD: length of delay before diagnosis, OR (95% CI) 1.002-2.206, p = 0.04
1.48
Observational data: associations, not effects.
Further findings
Bone turnover markers (P1NP, β-CTX)
- Not significantly different between the two groups
Hormone replacement in SS
- Glucocorticoid
- 94.6%
- Levothyroxine
- 90.5%
- Prior estrogen-progestin exposure
- 66.7%
Original publication
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