Decreased levels of testosterone and gonadotrophins in men with long-standing tetraplegia

Abstract

Study Design: Blood samples were frequently collected during a 24-h period from six tetraplegic men. The results were compared with those of eight able-bodied controls. Objective: Previous studies have reported conflicting results regarding the plasma concentrations of testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in tetraplegia. The objective of this study was to examine the pituitary-gonadal axis by determining the plasma concentrations and circadian variations of these hormones in men with long-standing tetraplegia. Setting: Sunnaas Hospital, Norway. Methods: The plasma concentrations of hormones were measured with standardized assays. Results: All three hormones and free testosterone index were decreased in the tetraplegic subjects compared with the able-bodied controls (Po0.05). We also determined the morning levels of hormones with regulatory effects on testosterone, LH and FSH. Whereas plasma leptin was significantly higher in the tetraplegic group, no significant differences in the morning plasma values for insulin, SHBG, GH or IGF-1, or in the 24-h urine concentrations of cortisol were detected between the two groups. The plasma concentration of LH displayed a circadian variation (Po0.05) in the tetraplegic group, but not among the able-bodied. No circadian variation was noted for the plasma concentrations of testosterone and FSH in either group. Conclusion: Our data indicate that, over time, tetraplegic male subjects might be at risk of developing hypogonadism.

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.…”

Komplikasjoner etter kronisk ryggmargsskade

“…(FSH) hos seks mannlige tetraplegikere sammenliknet med åtte funksjonsfriske (39). I andre studier er det imidlertid vist både høyere, lavere og normale plasmanivåer av testosteron, LH og FSH hos ryggmargsskadede menn (40).…”

The International Spinal Cord Injury Endocrine and Metabolic Function Basic Data Set

“…8,9 Abnormalities of the gonads may also have been present before SCI and may be exacerbated by SCI (for example, acute and chronic testicular dysfunction in males and acute ovarian dysfunction in females). [10][11][12] Therefore, it is important to document these endocrine and metabolic conditions that were present before sustaining the SCI. If the information has been documented once, it is not necessary to complete the response to this variable again, in order to avoid collecting redundant data.…”