engleski

Indices on the involvement of growth hormone and insulin-like growth factor type I in the phenomenon of enhanced osteogenesis in patients with traumatic brain injury and bone fractures

Enhanced osteogenesis (fast fracture healing followed by excessive callus formation and/or heterotopic ossifications) often develops in 1 patients with traumatic brain injury (TBI) and fractures of long bones. The aim of this study was to analyse if serum changes of growth hormone (GH) and insulin-like growth factor type I (IGF-I) are related to this phenomenon, which would further suggest their involvement in posttraumatic stress and applicability in promotion of bone fracture healing. GH values were raised during the initial posttraumatic period in all the patients (those with either bone fractures or TBI alone or combined injury associated with the enhanced osteogenesis), declining to normal values afterwards. However, further increase of GH values was noticed only for patients with combined injury overlapping with the time of clinically manifested enhanced osteogenesis. Serum values of IGF- I were above normal through the entire period analysed (14 weeks) in patients with TBI only, but not if TBI was combined with bone fractures followed by enhanced osteogenesis. For these patients IGF-I values were raising up gradually during fracture healing period, similar to the patients with bone fractures alone. Correlation betveen GH and IGF-I values for each of the groups indicated mutual dependence of GH and IGF-I values dynamically changed in the particular time periods of convalescence depending on the type of injury. Thus, both GH and IGF-I appear to be related to the phenomenon of enhanced osteogenesis, while impaired regulation of their synthesis could be one of major principles of enhanced osteogenesis in patients with bone fractures and TBI. This study was supported by the Austrian National Bank research grant no. 7019.

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