The change in androgenic status in men with atherothrombotic stroke

Introduction. Last years special attention is paid to the age-related and gender aspects of pathogenesis of cerebrovascular disease.

Objective. To investigate the androgenic status in men with atherothrombotic stroke.

Materials and methods. There were 25 man, involved in our study (mean age 53 [45; 57]) with atherothrombotic stroke in carotid system, who were observed for the initial 48 hours since the development of neurological symptoms. The laboratory study included the estimation of blood lipid profile, carbohydrate metabolism and androginic status beside the general blood analysis and clinical urine examination. The level of free testosterone was determined by the calculation method using a nomogram according to Vermeulen (normal range 225 pmol/l or more). The levels of luteinizing hormone (normal range 2,5–11,0 U/l) (for exclusion primary hypogonadizme), the levels of testosterone (normal range 11,0–33,3 nM) and estradiol (normal range 73-206 pmol/l) were determined on an automatic chemiluminescent analyzer. Hypogonadizme was diagnosed by the level of total testosterone <12 nM or the level of free testosterone <225 pmol/l. The 14 patients (mean age 55 [49; 59]) with a chronical cerebrovascular insufficiency and without laboratory signs of lipid storage disease and carbohydrate metabolism disorder or age-related hypogonadizme composed a comparison group.

Results. The laboratory signs of androgen deficiency were detected by 72% patients with atherothrombotic stroke. Correlation link was established between androgenic deficit (total testosterone not less than 12 nM), diabetes mellitus type II (r=0.514, р=0.008) and alcohol overuse (r=0.535, р=0.033). A negative correlation relationship was established between the level of free testosterone and the body-weight index (r=–0.442, р=0.022). The lowest levels of total and free testosterone, Ме 7.2 [4.2; 9.8] nM and 135 [59; 181] pmol/l respectively, were observed in a group of patients with a combination of atherothrombotic stroke and metabolic syndrome. There was no statistically significant correlation of acquired hypogonadism and blood lipid levels.

Conclusion. The laboratory signs of acquired androgenic deficit were revealed in 72% of men (mean age 53.0 [45; 57]) with atherothrombotic stroke. The lowest values of total and free testosterone were observed in patients with the syndrome of multiple metabolic disorders.