Adults with traumatic brain injuries (TBIs) are more likely to develop diabetes and other endocrine system disorders. But scientists know far less about how this link plays out in children.
A new study of Arizona children, published in the journal Frontiers in Neurology, seeks to address that issue.
Based on diagnostic code data from the Arizona Health Care Cost Containment System, Arizona's Medicaid program, researchers found patients under 18 with traumatic brain injuries were three times as likely to be diagnosed with endocrine problems.
The authors also found an endocrine diagnosis after a TBI diagnosis occurred almost three times as often in female patients as in male patients, possibly due to a difference in reporting rates.
"When we hear about the masculine phenotype of keeping your feelings and your symptoms to yourself, the chance of you reporting them are lower. That's the prevailing hypothesis, which needs additional data and additional precision," said co-author Jonny Lifshitz, a professor at the University of Arizona College of Medicine – Phoenix.
According to the Centers for Disease Control and Prevention, TBIs account for almost half a million (473,947) emergency department visits each year by children 14 years and younger.
This is particularly concerning because the human brain continues to develop from birth, through the teenage years and beyond, into our early 20s.
"They're going through developmental processes at each point along the way. And by going through those growth processes at each point along the way, anything can be disrupted," said Lifshitz, who is also a senior research scientist at Barrow Neurological Institute at Phoenix Children's Hospital.
Survivors of childhood TBIs can face a greater risks of developmental or functional problems, including worse behavioral, social and academic outcomes, as well as pain and cardiovascular and metabolic disorders.
Some of those issues might arise from a damaged endocrine system.
The endocrine system's glands, receptors and hormones, best known for regulating growth and sexual development, also play essential roles in many systems affected by post-TBI disorders.
Moreover, previous research has drawn clear links between TBIs and later endocrine disorders in adults, likely because the hypothalamus and pituitary gland lie near the base of the skull and are vulnerable to many of the forces that cause TBIs.
Lifshitz stressed the need for parents and doctors to consider endocrine disorders when analyzing behavioral or physical problems in children.
"Those same symptoms that we would ascribe to puberty could overlap with symptoms associated with traumatic brain injury," he said.
