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Peer-reviewedCC BYAnnals of clinical and translational neurology

Acute Endocrine Alterations After Traumatic Brain Injury and 6-Month Functional Outcome.

  • Biao Xu1,2
  • Peng Guo3
  • Rui Pan1,2
  • Zhenghao Wang1,2
  • Jingchao Zhou1,4
  • Pengcheng Zhang1,2
  • Xingzhe Zhang1,4
  • Qinghua Zhang4
  • Haibin Ma2
  • Zhanfeng Niu4
4 affiliations
  1. 1The First Clinical Medical College of Ningxia Medical University, Yinchuan, Ningxia, China.
  2. 2Key Laboratory of Ningxia Stem Cell and Regenerative Medicine, Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, China.
  3. 3The 904th Hospital of the Joint Logistic Support Force of PLA, Wuxi, Jiangsu, China.
  4. 4Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China.
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Abstract

Objective

Acute multi-axis endocrine alterations after traumatic brain injury (TBI) remain incompletely characterized. This study aimed to examine their temporal patterns and explore their associations with 6-month functional outcome and early inflammatory markers.Methods

We conducted a single-center prospective observational cohort study of hospitalized adults with traumatic brain injury. Among 130 enrolled patients, 125 with complete 6-month Glasgow Outcome Scale-Extended follow-up were included. Blood samples were collected on Day 1, 7, and 14 after injury to assess hypothalamic-pituitary-adrenal, thyroid, gonadal, and growth hormone axes. Day-1 inflammatory markers were measured. Associations of individual biomarkers with unfavorable 6-month outcome were evaluated using separate Firth penalized logistic regression models adjusted for admission Glasgow Coma Scale (GCS).Results

Serum cortisol levels at 08:00 and 16:00 decreased significantly over time (Kendall's W = 0.205 [95% CI 0.085-0.388] and 0.239 [95% CI 0.126-0.408], respectively; both p < 0.001), whereas triiodothyronine, free triiodothyronine, and thyroid-stimulating hormone increased during the acute phase. Patients with unfavorable 6-month outcome had higher day-1 interleukin-6, neutrophil count, and procalcitonin levels and lower day-1 triiodothyronine and free triiodothyronine levels than those with favorable outcome. After adjustment for admission GCS in separate Firth models, interleukin-6, white blood cell count, neutrophil count, procalcitonin, day-1 triiodothyronine, and day-1 free triiodothyronine were not significantly associated with unfavorable 6-month outcome.Interpretation

Endocrine alterations after acute TBI were heterogeneous across injury severity groups and time points. Although selected day-1 inflammatory and thyroid-axis measures differed between outcome groups, their associations with unfavorable 6-month functional outcome were not statistically significant after adjustment for admission GCS. These outcome-related findings require validation in larger cohorts.

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Cite

BibTeXRIS
BibTeX
@article{xu2026acute,
  title = {{Acute Endocrine Alterations After Traumatic Brain Injury and 6-Month Functional Outcome.}},
  author = {Biao Xu and Peng Guo and Rui Pan and Zhenghao Wang and Jingchao Zhou and Pengcheng Zhang and Xingzhe Zhang and Qinghua Zhang and Haibin Ma and Zhanfeng Niu},
  journal = {Annals of clinical and translational neurology},
  year = {2026},
  month = oct,
  doi = {10.1002/acn3.70570},
  url = {https://europepmc.org/article/MED/42952457},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Acute Endocrine Alterations After Traumatic Brain Injury and 6-Month Functional Outcome.
AU  - Biao Xu
AU  - Peng Guo
AU  - Rui Pan
AU  - Zhenghao Wang
AU  - Jingchao Zhou
AU  - Pengcheng Zhang
AU  - Xingzhe Zhang
AU  - Qinghua Zhang
AU  - Haibin Ma
AU  - Zhanfeng Niu
PY  - 2026
DA  - 2026/10/29
JO  - Annals of clinical and translational neurology
DO  - 10.1002/acn3.70570
UR  - https://europepmc.org/article/MED/42952457
AB  - Objective  Acute multi-axis endocrine alterations after traumatic brain injury (TBI) remain incompletely characterized. This study aimed to examine their temporal patterns and explore their associations with 6-month functional outcome and early inflammatory markers.Methods  We conducted a single-center prospective observational cohort study of hospitalized adults with traumatic brain injury. Among 130 enrolled patients, 125 with complete 6-month Glasgow Outcome Scale-Extended follow-up were included. Blood samples were collected on Day 1, 7, and 14 after injury to assess hypothalamic-pituitary-adrenal, thyroid, gonadal, and growth hormone axes. Day-1 inflammatory markers were measured. Associations of individual biomarkers with unfavorable 6-month outcome were evaluated using separate Firth penalized logistic regression models adjusted for admission Glasgow Coma Scale (GCS).Results  Serum cortisol levels at 08:00 and 16:00 decreased significantly over time (Kendall's W = 0.205 [95% CI 0.085-0.388] and 0.239 [95% CI 0.126-0.408], respectively; both p < 0.001), whereas triiodothyronine, free triiodothyronine, and thyroid-stimulating hormone increased during the acute phase. Patients with unfavorable 6-month outcome had higher day-1 interleukin-6, neutrophil count, and procalcitonin levels and lower day-1 triiodothyronine and free triiodothyronine levels than those with favorable outcome. After adjustment for admission GCS in separate Firth models, interleukin-6, white blood cell count, neutrophil count, procalcitonin, day-1 triiodothyronine, and day-1 free triiodothyronine were not significantly associated with unfavorable 6-month outcome.Interpretation  Endocrine alterations after acute TBI were heterogeneous across injury severity groups and time points. Although selected day-1 inflammatory and thyroid-axis measures differed between outcome groups, their associations with unfavorable 6-month functional outcome were not statistically significant after adjustment for admission GCS. These outcome-related findings require validation in larger cohorts.
SN  - 2328-9503
ER  -