Growth hormone deficiency (GHD) is a prevalent consequence of traumatic brain injury (TBI) that can contribute to prolonged adverse symptoms and impaired quality of life. The overlap between symptoms of GHD and chronic TBI complicates the clinical picture, highlighting the need for precise diagnostic tools. Insulin-like growth factor 1 (IGF-1), a key mediator of growth hormone (GH) activity, is frequently utilized as a surrogate marker of GH status. However, IGF-1 levels may be normal in patients with confirmed GHD. Furthermore, low or low-normal IGF-1 is not specific to GHD, and provocative testing is required to confirm GHD in most patients with suspected deficiency. To provide a pragmatic clinical framework for interpreting IGF-1 z-score z-scores improves diagnostic precision by standardizing IGF-1 levels for age and sex. Our framework aids clinicians in integrating thorough neuroendocrine evaluation with broader medical assessments, clinical considerations, and comorbidities, thereby improving diagnostic accuracy and patient management. Future research should emphasize refined screening protocols for neuroendocrine dysfunction in TBI.
Mishra et al. (Mon,) studied this question.