Advertisement

Journal of Endocrinological Investigation

, Volume 27, Issue 11, pp RC28–RC32 | Cite as

Boxing as a sport activity associated with isolated GH deficiency

  • F. Kelestimur
  • F. Tanriverdi
  • H. Atmaca
  • K. Unluhizarci
  • A. Selcuklu
  • F. F. Casanueva
Rapid Communication

Abstract

Traumatic brain injury (TBI) has long been known as a cause of hypopituitarism, and it is characterized by a high prevalence of neuroendocrine abnormalities. Boxing, one of the most common combative sports, may also result in TBI. As far as we know, pituitary functions including GH status have not been investigated in boxers. Therefore, in this preliminary study, we have assessed the pituitary functions in boxers. Eleven actively competing or retired male boxers with a mean age of 38.0±3.6 yr and 7 age-, sex- and BMI-matched healthy non-boxing controls were included in the study. Biochemical and basal hormonal parameters including IGF-I levels were measured. To assess GH secretory status in boxers and healthy controls, GHRH (1 μg/kg) + GHRP-6 (1 μg/kg) test was performed. After GHRH + GHRP-6 test, mean peak GH level in boxers and in controls were 10.9±1.7 and 41.4±6.7 μg/l, respectively (p<0.05). Peak GH levels in 5 (45%) boxers were found to be lower than 10 μg/l and considered as severe GH deficient. In the control group, mean IGF-I levels (367±18.8 ng/ml) were significantly higher than that obtained in boxers (237±23.3 ng/dl) (p< 0.01). All the other pituitary hormones were normal including ADH as no signs and symptoms of diabetes insipidus. There was a significant negative correlation between peak GH levels and boxing duration, and between peak GH levels and number of bouts. In conclusion, we think that boxing is a cause of TBI, and GH deficiency is very common among boxers. Further studies including large number of boxers, both professional and amateur, are needed to clarify pituitary dysfunction in boxers.

Key-words

Boxer GH deficiency traumatic brain injury GHRH+GHRP-6 test pituitary 

References

  1. 1.
    Lieberman SA, Oberoi AL, Gilkison CR, Masel BE, Urban RJ. Prevalence of neuroendocrine dysfunction in patients recovering from traumatic brain injury. J Clin Endocrinol Metab 2001, 86: 2752–6.PubMedGoogle Scholar
  2. 2.
    Whitman S, Coonley-Hoganson R, Desai BT. Comparative head trauma experiences in two socioeconomically different chicago-area communities: a population study. Am J Epidemiol 1984, 119: 570–80.PubMedGoogle Scholar
  3. 3.
    Kelly DF, Gonzalo IT, Cohan P, Berman N, Swerdloff R, Wang C. Hypopituitarism following traumatic brain injury and aneurysmal subarachnoid hemorrhage: a preliminary report. J Neurosurg 2000, 93: 743–52.PubMedCrossRefGoogle Scholar
  4. 4.
    Daniel PM, Treip CS. The Pathology of the pituitary gland in head injury. Mod Trends Endocrinol 1961, 2: 55–68.Google Scholar
  5. 5.
    Kornblum RN, Fisher RS. Pituitary lesions in craniocerebral injuries. Arch Pathol 1969, 88: 242–8.PubMedGoogle Scholar
  6. 6.
    Iglesias P, Gomez-Pan A, Diez JJ. Spontaneous recovery from post-traumatic hypopituitarism. J Endocrinol Invest 1996, 19: 320–3.PubMedCrossRefGoogle Scholar
  7. 7.
    Hillier SL, Hiller JE, Metzer J. Epidemiology of traumatic brain injury in South Australia. Brain Inj 1997, 11: 649–59.PubMedCrossRefGoogle Scholar
  8. 8.
    Powell JW. Cerebral concussion: causes, effects, and risks in sports. J Athl Train 2001, 36: 307–11.PubMedCentralPubMedGoogle Scholar
  9. 9.
    Zhang L, Ravdin LD, Relkin N, Zimmerman RD, Jordan B, Lathan WE, Ulug AM. Increased diffusion in the brain of professional boxers: a preclinical sign of traumatic brain injury? AJNR Am J Neuroradiol 2003, 24: 52–7.PubMedGoogle Scholar
  10. 10.
    Popovic V, Leal A, Micic D, et al. GH-releasing hormone and GH-releasing peptide-6 for diagnostic testing in GH-deficient adults. Lancet 2000, 356: 1137–42.PubMedCrossRefGoogle Scholar
  11. 11.
    Altman R, Pruzanski W. Post-traumatic hypopituitarism. Anterior pituitary insufficiency following skull fracture. Ann Intern Med 1961, 55: 149–54.PubMedCrossRefGoogle Scholar
  12. 12.
    Richard I, Rome J, Lemene B, Louis F, Perrouin-Verbe B, Mathe JF. Post-traumatic endocrine deficits: analysis of a series of 93 severe traumatic brain injuries. Ann Readapt Med Phys 2001, 44: 19–25.PubMedCrossRefGoogle Scholar
  13. 13.
    Benvenga S, Vigo T, Ruggeri RM, et al. Severe head trauma in patients with unexplained central hypothyroidism. Am J Med 2004, 116: 767–71.PubMedCrossRefGoogle Scholar
  14. 14.
    Kelestimur F. Sheehan’s Syndrome. Pituitary 2003, 6: 181–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Valenta LJ and De Feo DR. Post-traumatic hypopituitarism due to a hypothalamic lesion. Am J Med 1980, 68: 614–7.PubMedCrossRefGoogle Scholar
  16. 16.
    Ohhashi G, Tani S, Murakami S, Kamio M, Abe T, Ohtuki J. Problems in health management of professional boxers in Japan. 2002, 36: 346–52.Google Scholar
  17. 17.
    Agha A, Tormey W, Mylotte D, et al. Neuroendocrine dysfunction in the acute phase of traumatic brain injury. Clin Endocrinol.(Oxf) 2004, 60: 584–91.CrossRefGoogle Scholar
  18. 18.
    Consensus guidelines for the diagnosis and treatment of adults with growth hormone deficiency: summary statement of the Growth Hormone Research Society Workshop on adult growth hormone deficiency. J Clin Endocrinol Metab 1998, 83: 379–81.Google Scholar
  19. 19.
    Bates AS, Evans AJ, Jones P, Clayton RN. Assessment of GH status in adults with GH deficiency using serum growth hormone, serum insulin-like growth factor-I and urinary growth hormone excretion. Clin Endocrinol (Oxf) 1995, 42: 425–30.CrossRefGoogle Scholar
  20. 20.
    Molitch ME. Diagnosis of GH deficiency in adults—how good do the criteria need to be? J Clin Endocrinol Metab 2002, 87: 473–6.PubMedGoogle Scholar

Copyright information

© Italian Society of Endocrinology (SIE) 2004

Authors and Affiliations

  • F. Kelestimur
    • 1
  • F. Tanriverdi
    • 1
  • H. Atmaca
    • 3
  • K. Unluhizarci
    • 1
  • A. Selcuklu
    • 2
  • F. F. Casanueva
    • 4
  1. 1.Department of EndocrinologyErciyes University Medical SchoolKayseriTurkey
  2. 2.Department of NeurosurgeryErciyes University Medical SchoolKayseriTurkey
  3. 3.Department of EndocrinologyKaraelmas University Medical SchoolZonguldakTurkey
  4. 4.Department of Medicine School of Medicine and Complejo Hospitalario Universitario de SantiagoSantiago de Compostela UniversitySantiago de CompostelaSpain

Personalised recommendations