{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:59:33Z","timestamp":1791381573240,"version":"4.3.3"},"reference-count":81,"publisher":"SAGE Publications","issue":"13","license":[{"start":{"date-parts":[[2014,7,1]],"date-time":"2014-07-01T00:00:00Z","timestamp":1404172800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:p>\n                    Hypopituitarism is common after moderate and severe traumatic brain injury (TBI). Herein, we address the association between mild TBI (mTBI) and pituitary and metabolic function in retired football players. Retirees 30\u201365 years of age, with one or more years of National Football League (NFL) play and poor quality of life (QoL) based on Short Form 36 (SF-36) Mental Component Score (MCS) were prospectively enrolled. Pituitary hormonal and metabolic syndrome (MetS) testing was performed. Using a glucagon stimulation test, growth hormone deficiency (GHD) was defined with a standard cut point of 3\u2009ng\/mL and with a more stringent body mass index (BMI)-adjusted cut point. Subjects with and without hormonal deficiency (HD) were compared in terms of QoL, International Index of Erectile Function (IIEF) scores, metabolic parameters, and football career data. Of 74 subjects, 6 were excluded because of significant non-football-related TBIs. Of the remaining 68 subjects (mean age, 47.3\u00b110.2 years; median NFL years, 5; median NFL concussions, 3; mean BMI, 33.8\u00b16.0), 28 (41.2%) were GHD using a peak GH cutoff of &lt;3\u2009ng\/mL. However, with a BMI-adjusted definition of GHD, 13 of 68 (19.1%) were GHD. Using this BMI-adjusted definition, overall HD was found in 16 (23.5%) subjects: 10 (14.7%) with isolated GHD; 3 (4.4%) with isolated hypogonadism; and 3 (4.4%) with both GHD and hypogonadism. Subjects with HD had lower mean scores on the IIEF survey (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    =0.016) and trended toward lower scores on the SF-36 MCS (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    =0.113). MetS was present in 50% of subjects, including 5 of 6 (83%) with hypogonadism, and 29 of 62 (46.8%) without hypogonadism (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    =0.087). Age, BMI, median years in NFL, games played, number of concussions, and acknowledged use of performance-enhancing steroids were similar between HD and non-HD groups. In summary, in this cohort of retired NFL players with poor QoL, 23.5% had HD, including 19% with GHD (using a BMI-adjusted definition), 9% with hypogonadism, and 50% had MetS. Although the cause of HD is unclear, these results suggest that GHD and hypogonadism may contribute to poor QoL, erectile dysfunction, and MetS in this population. Further study of pituitary function is warranted in athletes sustaining repetitive mTBI.\n                  <\/jats:p>","DOI":"10.1089\/neu.2013.3212","type":"journal-article","created":{"date-parts":[[2014,2,19]],"date-time":"2014-02-19T15:17:48Z","timestamp":1392823068000},"page":"1161-1171","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":92,"title":["Prevalence of Pituitary Hormone Dysfunction, Metabolic Syndrome, and Impaired Quality of Life in Retired Professional Football Players: A Prospective Study"],"prefix":"10.1177","volume":"31","author":[{"given":"Daniel F.","family":"Kelly","sequence":"first","affiliation":[{"name":"John Wayne Cancer Institute at Saint John's Health Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlene","family":"Chaloner","sequence":"additional","affiliation":[{"name":"John Wayne Cancer Institute at Saint John's Health Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Evans","sequence":"additional","affiliation":[{"name":"Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Mathews","sequence":"additional","affiliation":[{"name":"University of North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pejman","family":"Cohan","sequence":"additional","affiliation":[{"name":"UCLA School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Wang","sequence":"additional","affiliation":[{"name":"Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Swerdloff","sequence":"additional","affiliation":[{"name":"Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myung-Shin","family":"Sim","sequence":"additional","affiliation":[{"name":"John Wayne Cancer Institute at Saint John's Health Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihey","family":"Lee","sequence":"additional","affiliation":[{"name":"John Wayne Cancer Institute at Saint John's Health Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew J.","family":"Wright","sequence":"additional","affiliation":[{"name":"Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Kernan","sequence":"additional","affiliation":[{"name":"UCLA Semel Institute for Neuroscience and Human Behavior"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garni","family":"Barkhoudarian","sequence":"additional","affiliation":[{"name":"John Wayne Cancer Institute at Saint John's Health Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin C.J.","family":"Yuen","sequence":"additional","affiliation":[{"name":"Oregon Health and Science University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Guskiewicz","sequence":"additional","affiliation":[{"name":"University of North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2014,7,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001199-200609000-00001"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00042752-200401000-00003"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/1941738110383963"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/1941738110391413"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000175725.75780.DD"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1249\/mss.0b013e3180383da5"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0511"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2004.02094.x"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-0504"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/0897715041269713"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-924254"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2000.93.5.0743"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2005.02250.x"},{"key":"e_1_3_3_15_2","first-page":"2752","article-title":"Prevalence of neuroendocrine dysfunction in patients recovering from traumatic brain injury","volume":"86","author":"Lieberman S.A.","year":"2001","unstructured":"Lieberman S.A., , Oberoi A.L., , Gilkison C.R., , Masel B.E., , and Urban R.J. 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