Hormonal changes in veterans with Gulf War Illness

Aims: Gulf War Illness (GWI) is a multi-system condition of complex etiology and pathophysiology without specific treatment. There is an overlap between the symptoms of GWI and endocrinopathies. This study aimed to identify hormonal alterations in 1990-91 Gulf War (GW) veterans and the relationship between GWI and hor-monal dysregulation.Main methods: Data from 81 GW veterans (54 with GWI and 27 controls without GWI) was analyzed in a cross-sectional, case-control observational study. Participants completed multiple questionnaires, neuropsychiatric assessments, and a comprehensive set of hormone assays including a glucagon stimulation test (GST) for adult growth hormone deficiency (AGHD) and a high-dose adrenocorticotropic hormone (ACTH) stimulation test for adrenal insufficiency.Key findings: The GWI group had lower quality of life and greater severity of all symptoms compared to controls. Pain intensity and pain-related interference with general activity were also higher in the GWI group. AGHD was observed in 18 of 51 veterans with GWI (35.3 %) and 2 of 26 veterans without GWI (7.7 %) (p = 0.012 for interaction). Veterans with GWI also exhibited reduced insulin-like growth factor 1 (IGF-1) levels and IGF-1 Z- scores compared to controls. One participant with GWI met the criteria for adrenal insufficiency. No significant changes were observed in other hormonal axes.Significance: The frequency of AGHD was significantly higher in veterans with GWI compared to controls. Re-combinant human growth hormone replacement therapy (GHRT) may become a breakthrough therapeutic op-tion for this subgroup. A large clinical trial is needed to evaluate the efficacy of GHRT in patients with GWI and AGHD.

Automated summary

This study aimed to identify hormonal alterations in Gulf War veterans and the relationship between Gulf War Illness (GWI) and hormonal dysregulation. The results showed that veterans with GWI had lower quality of life and greater symptom severity. AGHD was observed in 35.3% of GWI veterans, significantly higher than the 7.7% in veterans without GWI.