Age-related prevalence of low testosterone in men with spinal cord injury

Abstract

Objective: To describe the relationship of advancing age in persons with chronic spinal cord injury (SCI) on the prevalence of low testosterone in men with SCI compared to historical normative data from able-bodied men in the general population. Design: Retrospective, cross-sectional study. Two hundred forty-three healthy, non-ambulatory outpatient men with chronic SCI from age of 21 to 78 years were included in this retrospective analysis. Results: Forty-six percent of men with SCI were identified as having low serum total testosterone concentrations (total testosterone <11.3 nmol/l). The age-related decline in SCI for total serum testosterone concentration was 0.6%/year compared to 0.4%/year in the Massachusetts Male Aging Study. Between the third and eighth decade of life, men with SCI had a 15, 39, 50, 53, 58, and 57% prevalence rate of low serum total testosterone, which is higher than values reported for each decade of life for able-bodied men in the Baltimore Longitudinal Study on Aging. Conclusion: Compared with the general population, low serum total testosterone concentration occurs earlier in life in men with SCI, at a higher prevalence by decade of life, and their age-related decline in circulating total testosterone concentration is greater. Studies of T replacement therapy in men with SCI should assist in determining the possible functional and clinical benefits from reversing low serum total testosterone concentration.

Low testosterone and non-alcoholic fatty liver disease: Evidence for their independent association in men with chronic spinal cord injury

“…LTPA, leisure time physical activity (hours/week); BMI, body mass index (Kg/m 2 ); HOMA-IR, homeostatic model assessment of insulin resistance. The association between fat mass, insulin resistance and low testosterone appears to be much more evident in men with chronic SCI, 15 who exhibit a very high prevalence of biochemical androgen deficiency, [12][13][14][15] as well as a combination of risk factors for metabolic syndrome. They exhibit a deep alteration in body composition.…”

“…In this light, men with spinal cord injury (SCI) could represent a suitable clinical model of study. A biochemical androgen deficiency has been reported in up to ∼40% of men with chronic SCI, [12][13][14][15] in whom an increased prevalence of obesity, metabolic syndrome, diabetes and CV disease has been also reported when compared to able-bodied individuals. 16,17 Nevertheless, studies focusing on NAFLD in spinal cord-injured population are lacking.…”

Effects of spinal cord injury on body composition and metabolic profile – Part I

“…43 This is accompanied with agerelated decline in total serum testosterone up to 0.6% per year. 44 Spasticity of paralyzed skeletal muscle may defend against skeletal muscle atrophy. 29,35,45,46 Those with a spastic knee extensor (modified Ashworth Score (MAS) > 2) have 22% greater knee extensor CSA and less infiltration of IMF compared to non-spastic individuals with SCI.…”

Improving Sexual Satisfaction in Persons with Spinal Cord Injuries: Collective Wisdom

“…A suggested format for assessing the medical aspects of the sexual history is shown in Table 4. Past and current illnesses that can affect sexual interest and function 13 low testosterone and decreased libido are prevalent and testing for and treating low levels is appropriate. Questioning for opiate-induced hyperalgesia and the negative sexual side effects of opiates is also important.…”