Decreased Serum Testosterone in Men With Acute Ischemic Stroke

Jeppesen, Lise Leth; Jørgensen, Henrik; Nakayama, Hirofumi; Raaschou, Hans Otto; Olsen, Tom Skyhøj; Winther, Kaj

doi:10.1161/01.atv.16.6.749

Cited by 143 publications

(103 citation statements)

References 41 publications

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“…Our findings are supported by a recent study finding lower levels of both total and free testosterone in men suffering acute ischemic stroke. However, a slight but not significant increase of hormone levels was noted at the 6-month followup, possibly suggesting in part an acute effect on the hypothalamic -pituitary-testicular axis (8). We also found lower levels of total and free testosterone in men with cancer, and a higher level of free testosterone in men with IHD.…”

Section: Variation With Chronic Diseasementioning

confidence: 47%

The associations of age, lifestyle factors and chronic disease with testosterone in men: the Tromso Study

et al. 2003

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Objective: To study whether lifestyle factors and/or chronic disease are associated with the age-related decline of total and free testosterone in men, or if these factors might be associated with the variation of total and free testosterone but not with their age-related decline. Design: A population-based, cross-sectional study was used. Methods: Total testosterone and sex hormone binding globulin (SHBG) levels were analyzed and free testosterone levels were calculated in 1563 men participating in the Tromsø study in 1994/1995. Anthropometric characteristics were also measured and two standardized questionnaires completed, including lifestyle factors and medical history. The data were analyzed with multiple linear regression analysis of covariance, and logistic regression. Results: Total and free testosterone were inversely associated (P ¼ 0.001 and P , 0.001), while SHBG was positively associated (P , 0.001) with age. Body mass index (BMI) was inversely associated with total (P , 0.001) and free (P ¼ 0.016) testosterone and SHBG (P , 0.001). Both total and free testosterone were positively associated with tobacco consumption (P , 0.001 and P ¼ 0.004) and total testosterone was positively associated with coffee consumption (P , 0.001). SHBG was positively associated with smoking (P ¼ 0.004) and coffee consumption (P , 0.001). Men who reported having had a stroke or having a cancer diagnosis had lower levels of total testosterone (P , 0.001 and P , 0.01) and free testosterone (P , 0.01). Conclusions: BMI and smoking are independent contributors to the variation of total and free testosterone and SHBG levels, and coffee consumption to the variation of total testosterone and SHBG. Thus, lifestyle factors can have a direct effect on circulating levels of free endogenous sex hormones and to total levels due to the effect on SHBG levels.

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Section: Variation With Chronic Diseasementioning

confidence: 47%

The associations of age, lifestyle factors and chronic disease with testosterone in men: the Tromso Study

et al. 2003

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“…Moreover, a decreased serum testosterone concentration has been shown to be associated with acute ischemic strokes, infarct size and mortality (17). These data suggest that normal testosterone levels may offer protection against the development of atherosclerosis in middle-aged men.…”

Section: European Journal Of Endocrinologymentioning

confidence: 82%

Adaptation to acute coronary syndrome-induced stress with lowering of testosterone: a possible survival factor

Pesonen

Pussinen

Huhtaniemi

2016

European Journal of Endocrinology

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Objective: The objective of this study was to explore whether circulating testosterone (T) concentration is associated with the occurrence and risk for acute coronary syndromes (ACS). Method: This case-control study included male patients with acute myocardial infarction (AMI) (nZ174) or unstable angina pectoris (UAP) (nZ90) and healthy controls (nZ238). Patients gave serum samples during the acute (nZ264) and recovery (nZ132) phases after a median of 10.5 months after the incident event. Secondary events (ACS or cardiovascular death) were registered during the following 6 years. Results: During the acute phase, AMI and UAP patients had similar significantly reduced concentrations of serum testosterone in comparison to controls. Testosterone associated inversely with weight, the degree of inflammation (i.e. C-reactive protein concentration) and signs of a chronic infection. In a multiadjusted Cox regression, when compared to testosterone concentrations considered high-normal (14.91-34.0 nmol/l), low-normal testosterone (9.26-14.90 nmol/l) in the acute phase predicted better prognosis for cardiovascular death rate with a hazard ratio (HR) of 0.17 (0.04-0.68, PZ0.012). The increased testosterone concentrations after the recovery period did not associate with future cardiovascular disease events. Conclusion: Low-normal testosterone levels in the acute phase of ACS predicted better survival. The observation may indicate better adaptation to stress in survivors and warrants further study.

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“…29 We found that serum testosterone levels decrease dramatically in all males after stroke, consistent with both previous clinical and animal studies. 30 This could be due to decreased production of testosterone (by the testes) or increased aromatizaton to estradiol in the brain, or both. Lower testicular expression of steroidogenesis-related genes has been reported after experimental stroke in rats.…”

Section: Discussionmentioning

confidence: 99%

Sex Differences in Ischemic Stroke Sensitivity Are Influenced by Gonadal Hormones, Not by Sex Chromosome Complement

Manwani

Bentivegna

Benashski

et al. 2014

J Cereb Blood Flow Metab

106

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Epidemiologic studies have shown sex differences in ischemic stroke. The four core genotype (FCG) mouse model, in which the testes determining gene, Sry, has been moved from Y chromosome to an autosome, was used to dissociate the effects of sex hormones from sex chromosome in ischemic stroke outcome. Middle cerebral artery occlusion (MCAO) in gonad intact FCG mice revealed that gonadal males (XXM and XYM) had significantly higher infarct volumes as compared with gonadal females (XXF and XYF). Serum testosterone levels were equivalent in adult XXM and XYM, as was serum estrogen in XXF and XYF mice. To remove the effects of gonadal hormones, gonadectomized FCG mice were subjected to MCAO. Gonadectomy significantly increased infarct volumes in females, while no change was seen in gonadectomized males, indicating that estrogen loss increases ischemic sensitivity. Estradiol supplementation in gonadectomized FCG mice rescued this phenotype. Interestingly, FCG male mice were less sensitive to effects of hormones. This may be due to enhanced expression of the transgene Sry in brains of FCG male mice. Sex differences in ischemic stroke sensitivity appear to be shaped by organizational and activational effects of sex hormones, rather than sex chromosomal complement.

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Decreased Serum Testosterone in Men With Acute Ischemic Stroke

Cited by 143 publications

References 41 publications

The associations of age, lifestyle factors and chronic disease with testosterone in men: the Tromso Study

The associations of age, lifestyle factors and chronic disease with testosterone in men: the Tromso Study

Adaptation to acute coronary syndrome-induced stress with lowering of testosterone: a possible survival factor

Sex Differences in Ischemic Stroke Sensitivity Are Influenced by Gonadal Hormones, Not by Sex Chromosome Complement

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