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. 2022 Jun;18(1):71-79.
doi: 10.17925/EE.2022.18.1.71. Epub 2022 Jun 13.

Anterior Pituitary Hormones in Blood and Cerebrospinal Fluid of Patients in Neurocritical Care

Henriette Beyer  1 , Nicole Lange  1 , Armin H Podtschaske  2 , Jan Martin  2 , Lucia Albers  3 , Alexander von Werder  4 , Jürgen Ruland  5 , Gerhard Schneider  2 , Bernhard Meyer  1 , Simone M Kagerbauer  2 , Jens Gempt  1
Affiliations

Anterior Pituitary Hormones in Blood and Cerebrospinal Fluid of Patients in Neurocritical Care

Henriette Beyer et al. touchREV Endocrinol. 2022 Jun.

Abstract

Background: Anterior pituitary hormones in blood follow a circadian rhythm, which may be influenced by various factors such as intracranial pathologies. In cerebrospinal fluid (CSF), pituitary hormones have been collected only selectively and circadian rhythm has not yet been investigated. This pilot study analysed diurnal variations of anterior pituitary hormones in patients in neurocritical care to determine whether circadian rhythmicity exists in these patients. Possible influences of intracranial pathologies were also investigated. Blood and CSF concentrations were assessed simultaneously to explore the value of blood concentrations as a surrogate parameter for CSF levels.

Methods: Blood and CSF samples of 20 non-sedated patients were collected at 06:00, noon, 18:00 and midnight, and analysed for adrenocorticotropic hormone (ACTH), cortisol, thyroid-stimulating hormone (TSH) and insulin-like growth factor-1 (IGF-1) concentrations at each of the four time points. ACTH and IGF-1 were measured by sandwich chemiluminescence immunoassay. Cortisol and TSH were measured by electrochemiluminescence immunoassay.

Results: Results showed inconsistent circadian rhythms. Less than 50% of the patients showed a circadian rhythmicity of ACTH, cortisol, TSH or IGF-1. Significance of diurnal variations was only present for blood concentrations of TSH. Correlations between blood and CSF concentrations were strong for cortisol and TSH.

Conclusions: CSF concentrations were only in the measurable range in some of the patients. No clear circadian rhythmicity could be identified, except for TSH in blood. Absence of significant diurnal variations could be explained by the underlying pathologies or disturbing influences of the intensive care unit. Blood concentrations of cortisol and TSH may be suitable surrogate parameters for CSF.

Keywords: Anterior pituitary hormones; cerebrospinal fluid; circadian rhythm; neurocritical care.

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Conflict of interest statement

Disclosures: Henriette Beyer, Nicole Lange, Armin H Podtschaske, Jan Martin, Lucia Albers, Alexander von Werder, Jürgen Ruland, Gerhard Schneider, Bernhard Meyer, Simone M Kagerbauer and Jens Gempt have no financial or non-financial relationships or activities to declare in relation to this article.

Figures

Figure 1:
Figure 1:. Individual time courses of adrenocorticotropic hormone and cortisol concentrations in blood and cerebrospinal fluid
Figure 2:
Figure 2:. Individual time courses of thyroid-stimulating hormone concentrations in blood and cerebrospinal fluid
Figure 3:
Figure 3:. Individual time courses of insulin-like growth factor-1 concentrations in blood and cerebrospinal fluid
Figure 4:
Figure 4:. Hormone concentrations at the different time points
Figure 5:
Figure 5:. Scatterplots depicting correlations between blood and cerebrospinal fluid levels of adrenocorticotropic hormone, cortisol, thyroid-stimulating hormone and insulin-like growth factor-1
See this image and copyright information in PMC

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