Adolescent Females More Likely to be Diagnosed with an Endocrine Disorder After a TBI

Adolescent Females More Likely to be Diagnosed with an Endocrine Disorder After a TBI

J. Bryce Ortiz, PhD

Hormones are regulated by various brain regions and glands in the body - collectively termed the endocrine system. This system, particularly the hormones, plays a critical role in childhood growth and development. Most notably, in early adolescence, hormones govern pubertal development. In our recent study, we determined whether traumatic brain injuries (TBIs) in childhood affect the endocrine system and if this differed between females and males, because the parts of the endocrine system in the brain are vulnerable to the mechanical forces of TBI.

In the United States, childhood TBIs account for over 812,000 emergency department visits every year and are a leading cause of childhood morbidity and mortality. TBIs result from a violent blow or jolt to the head or body, and may result in damage to various brain regions, including brain regions that control the endocrine system.

In this study, we collected patient data from the Arizona Health Care Cost Containment System (AHCCCS; the Arizona Medicaid program) database and identified all patients who were diagnosed with a TBI and subsequently diagnosed with an endocrine disorder. The data revealed that pediatric TBI patients, aged 0-18, had a 3.2-fold higher odds of being diagnosed with an endocrine disorder. When looking at the difference between female and male patients, we found that females were more likely to be diagnosed with an endocrine disorder after a TBI compared to male subjects. Females were more likely to be diagnosed with an endocrine disorder at an earlier age (ages 5-8) compared to males who were diagnosed with an endocrine disorder at a later age (ages 8-12). Moreover, females had a shorter time gap between the TBI and the endocrine disorder compared to males.

Delayed diagnosis of an endocrine disorder can leave individuals with a lifetime of health care issues, including stunted growth, sugar dysregulation, obesity, hypertension, and cognitive challenges. Doctors, nurses, and all practitioners, including parents, caregivers, coaches, and trainers should screen children with TBI for endocrine disorders within six months of the injury.

References

Ortiz JB, Sukhina A, Balkan B, et al. Epidemiology of Pediatric Traumatic Brain Injury and HypothalamicPituitary Disorders in Arizona. Front. Neurol. 2020;10:1410. doi: 10.3389/fneur.2019.01410

Author Bio

J. Bryce Ortiz, PhD, is a post-doctoral researcher at the University of Arizona College of Medicine - Phoenix and Barrow Neurological Institute at Phoenix Children’s Hospital. Bryce received a BS in Psychology from Arizona State University in 2011 and a Master’s in Psychology in 2013. He then completed a PhD in Behavioral Neuroscience from Arizona State University in 2017. For Bryce’s dissertation he studied the effects of stress on the brain and behavior with a focus on the mechanisms of how individuals recover from a period of chronic stress. He also studied how hormones, including stress hormones and sex hormones, alter brain structure and function. During his postdoctoral researcher, he has been researching how hormones are affected following pediatric traumatic brain injuries and how these changes affect sleep and development.