Sex Hormones and Ischemic Stroke: A Prospective Cohort Study and Meta-Analyses

Holmegard, Haya N.; Nordestgaard, Børge G.; Jensen, Gorm; Tybjærg‐Hansen, Anne; Benn, Marianne

doi:10.1210/jc.2015-2687

Cited by 85 publications

(57 citation statements)

References 39 publications

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“…Male hypogonadism is strongly associated with central adiposity, insulin resistance, MetS, type 2 diabetes, and stroke in multiple populations, although it remains unclear in many of these studies if low TT is causative or a biomarker of poor metabolic health (Holmegard et al, 2016, Moriarty-Kelsey et al, 2010, Traish, 2014, Zitzmann, 2009). Historically, many clinical features of KS, including cardiometabolic dysfunction, have been attributed to long-standing hypogonadism.…”

Section: Discussionmentioning

confidence: 99%

Gonadal function is associated with cardiometabolic health in pre‐pubertal boys with Klinefelter syndrome

et al. 2016

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The most common sex chromosome aneuploidy, Klinefelter syndrome (KS), is associated with primary gonadal failure and increased morbidity and mortality from cardiometabolic disorders in adulthood. Children with KS also have a high prevalence of metabolic syndrome (MetS). To assess the relationship of gonadal and cardiometabolic function in children with KS, we evaluated serum hormones (gonadotropins, inhibin B (INHB), anti-mullerian hormone (AMH), total testosterone (TT)), and features of MetS (waist circumference, fasting lipid panel, fasting blood glucose (FBG), and blood pressure) in 93 prepubertal boys with KS age 4–12 years (mean 7.7 ± 2.5 years). The cohort was grouped by age and tanner stage, and biomarkers were compared to normal ranges. 80% of this prepubertal cohort had ≥1 feature of metabolic syndrome (MetS) and 11% had ≥3 features of MetS. Risk of MetS was independent of age and body mass index. Sertoli cell dysfunction was common with 18% having an INHB below the normal range. A low INHB was associated with higher FBG, triglycerides, and LDL and lower HDL (p<0.05). An INHB <50 ng/dl yielded a sensitivity of 83% and a specificity of 79% for having ≥3 features of MetS. INHB and AMH positively correlated with each other (p<0.001), and high AMH was protective of MetS. TT was below the lower limit of normal in 49% of subjects, with mean values significantly lower than expected (3.3 ng/dl versus 4.9 ng/dl, p<0.0001), however no convincing relationship between TT and MetS was seen. In conclusion, gonadal and cardiometabolic dysfunction are prevalent in prepubertal boys with KS. Although the relationship of testosterone deficiency and MetS is well known, this study is the first to report an association between impaired sertoli cell function and cardiometabolic risk.

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Section: Discussionmentioning

confidence: 99%

Gonadal function is associated with cardiometabolic health in pre‐pubertal boys with Klinefelter syndrome

et al. 2016

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“…Although some studies have reported negative associations between low testosterone levels and the risk of ischemic stroke and of all-cause, CVD, and cancer mortality; the question of whether these associations are causal, or whether testosterone is an important biomarker of overall male health, has yet to be fully investigated (Haring et al 2010;Holmegard et al 2016).…”

Section: Effects Of Testosteronementioning

confidence: 99%

Sex Differences in Health and Survival

Oksuzyan

Gumà

Doblhammer

2018

A Demographic Perspective on Gender, Family and Health in Europe

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“…A limited number of follow-up studies have focused on testosterone levels and stroke and the results have been conflicting (33)(34)(35)(36). The study by Yeap et al observed a protective effect of testosterone on the risk of stroke.…”

Section: Cardiovascular Diseasementioning

confidence: 99%