SAT-042 Prevalence And Predictors Of Pituitary Dysfunction Following Traumatic Brain Injury Due To Road Traffic Accidents In Adult Male Population: A Prospective Study

Abstract Disclosure: C. Gandhi: None. S. Sankanagoudar: None. S. Tiwari: None. M. Garg: None. D.K. Jha: None. R. Shukla: None. Background: Traumatic Brain Injury (TBI) survivors experience neurocognitive deficits, metabolic disturbances, and reduced quality of life due to undiagnosed hypopituitarism, yet, pituitary function assessment is not a part of routine protocol. This study aims to study the prevalence, type, and trend of pituitary dysfunction while identifying specific predictors (trauma severity, CT severity, copeptin, anti-GFAP antibody) and to observe changes in body composition at baseline and 6-months in male subjects with TBI due to Road Traffic Accidents. Methodology: This 6-month prospective study included 70 patients. TBI severity (GCS score), CT severity (Marshall and Rotterdam score), Pituitary hormone assessment including copeptin, and BMD-DXA was done within 5 days post-trauma. At the 6-month follow-up, 44 patients were reassessed, pituitary hormones including a Glucagon Stimulation test, anti-GFAP antibody and repeat BMD-DXA was done. Results: In the acute phase, 83% had pituitary dysfunction, most common being low testosterone in 81% while cortisol was least affected in 2.9% only. Diffuse axonal injury correlated positively with prolactin (r=0.27, p=0.02). Basal cistern obliteration was identified as an independent predictor of pituitary dysfunction (p=0.03). On follow-up, 75% had pituitary dysfunction with isolated deficits (59%) more common than multiple axes involvement (16%). GHD was observed in 57%, although none had IGF-1 levels below -2 SDS. Peak GH showed no correlation with baseline or follow-up IGF-1. Baseline copeptin did not predict long-term pituitary dysfunction. Anti-GFAP antibodies at 6-month were positive in 70% but showed no association with GHD or hypopituitarism. TBI severity, Rotterdam score (p<0.01), Marshall score (p<0.01) and basal cistern obliteration (p<0.01) were significantly associated with the number of axes in acute and long-term phase. Basal skull fractures (p=0.03) were identified as independent predictor of GHD, while cerebral oedema (p=0.06) and contusions (p=0.08) demonstrated possible association. Elevated baseline LH [18.71 vs 2.28, p=0.04] was observed in patients who succumbed to TBI. Body-composition analysis revealed increase in appendicular lean mass/height2 with no significant changes in body fat, lean mass or visceral adipose tissue on follow-up. Conclusion: Trend was towards recovery of gonadotroph and thyrotroph axis with new-onset deficits in somatotroph and corticotroph axes. Radiological parameters emerged as strong predictors, while copeptin and anti-GFAP antibodies did not predict pituitary dysfunction. Severe trauma was associated with multiple axes involvement. IGF-1 in adult GHD were found to be unreliable, emphasizing the need for dynamic testing. Acute phase LH may serve as a potential biomarker for mortality. An increase in appendicular lean mass indicates some recovery in physical strength over time. Presentation: Saturday, July 12, 2025