Inflammatory markers and increased carotid intimal thickness in asymptomatic growth hormone naïve patients of Sheehan syndrome.

Abstract Objective The dyad of cardio-metabolic risk factors and endothelial dysfunction observed in hypopituitarism untreated for growth hormone deficiency (GHD), a characteristic of Sheehan's syndrome (SS), contributes to the increased cardiovascular mortality and morbidity. The elevated inflammatory markers reported in these patients along with conventional cardiovascular risk factors are considered pivotal contributors to coronary endothelial dysfunction and high risk for cardiovascular events. We aim to investigate the level of conventional cardiovascular risk factors, inflammatory markers and carotid artery Intima-Media Thickness (CIMT) in patients of SS compared to a group of healthy women. Methods A total of 37 SS patients fulfilling the case definition for this study and same number (n = 37) healthy age, BMI and parity matched controls were recruited for the study. The participants underwent detailed clinical, biochemical, hormone analysis and measurement of Tumor necrosis factor-alpha (TNF-α) and Interleukin-6 (IL-6) levels. CIMT assessment was also done using high-resolution echo-colour Doppler system in both cases and controls. Results Patients with SS had significantly higher mean triglyceride, total cholesterol, low-density lipoprotein cholesterol and lower high-density cholesterol concentrations. The markers of inflammation including TNF-α and IL-6 levels were significantly higher (23.41 ± 10.97 vs. 20.05 ± 2.76pg/ml; p = 0.041) for TNF- α and (37.19 ± 5.38 vs. 32.08 ± 1.18pg/ml; p = 0.004) for IL-6, compared to healthy controls. Furthermore, mean carotid intima medial thickness in patients was significantly increased in comparison to healthy controls (0.71 ± 0.07 vs. 0.59 ± 0.05mm; p = 0.001). Conclusion Our study demonstrated that patients with SS have clustering of cardiovascular risk factors that may contribute to the increased risk for cardiovascular events.