The change in androgenic status in men with atherothrombotic stroke

Cover Page

Cite item

Full Text


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.

About the authors

Marina Yu. Maksimova

Research Center of Neurology

Author for correspondence.
ORCID iD: 0000-0002-7682-6672

D. Sci. (Med), Prof., Head, 2nd Neurology department

Russian Federation, 125367 Moscow, Volokolamskoye shosse, 80; Moscow

Aleksandra S. Moskvicheva

Research Center of Neurology

Russian Federation, Moscow

Andrey O. Chechetkin

Research Center of Neurology

ORCID iD: 0000-0002-8726-8928

D. Sci. (Med.), Head, Ultrasound diagnostic laboratory

Russian Federation, Moscow


  1. Demograficheskiy ezhegodnik Rossii. [Demographic Yearbook of Russia]. Moscow: 2015. (In Russ.)
  2. Skvortsova V.I. Rossiyskaya meditsina – primer dlya VOZ. [Russian medicine is an example for WHO]. Interview in «Nezavisimaya gazeta» 17.05.2017. (In Russ.)
  3. Suslina Z.A., Gulevskaya T.S., Maksimova M.Yu. et al. Narusheniya mozgovogokrovoobrashcheniya: diagnostika, lechenie, profilaktika. [Cerebrovascular disorders: diagnosis, treatment, prevention]. Moscow: MEDpress-inform, 2016. (In Russ.)
  4. EUGenMed Cardiovascular Clinical Study Group, Regitz-Zagrosek V., Oertelt-Prigione S., Prescott E. et al. Gender in cardiovascular diseases: impact on clinical manifestations, management, and outcomes. Eur Heart J. 2016; 37 (1): 24–34. doi: 10.1093/eurheartj/ehv598. PMID: 26530104.
  5. Yamatani H., Takahashi K., Nagase S. Sex hormones and physiological function. Nihon Rinsho.2015; 73(4): 565–70. PMID: 25936142.
  6. Pappa T., Vemmos K., Mantzou E. et al. Estradiol levels predict short-term adverse health outcomes in postmenopausal acute stroke women. Eur J Neurol. 2012; 19(10): 1300–4. doi: 10.1111/j.1468-1331.2012.03714.x. PMID: 22509950.
  7. dos Santos R.L., da Silva F.B., Ribeiro R.F. Jr. et al. Sex hormones in the cardiovascular system.Horm Mol Biol Clin Investig. 2014; 18(2): 89–103. doi: 10.1515/hmbci-2013-0048.
  8. Ranthe M.F., Andersen E.A., Wohlfahrt J. et al. Pregnancy loss and later risk of atherosclerotic disease. Circulation. 2013; 127(17): 1775–82. doi: 10.1161/CIRCULATIONAHA.112.000285. PMID: 23536362.
  9. Ostchega Y., Dillon C.F., Hughes J.P. et al. Trends in hypertension prevalence, awareness, treatment, and control in older U.S. adults: data from the National Health and Nutrition Examination Survey 1988 to 2004. J Am Geriatr Soc. 2007; 55(7): 1056–65. PMID: 17608879.
  10. Holmegard H.N., Nordestgaard B.G., Jensen G.B. et al. Sex Hormones and ischemic stroke: A prospective cohort study and meta-analyses. J Clin Endocrinol Metab. 2016; 101(1): 69–78. doi: 10.1210/jc.2015-2687. PMID: 26509870.
  11. Dehlendorff C., Andersen K.K., Olsen T.S. Sex disparities in stroke: women have more severe strokes but better survival than men. J Am Heart Assoc. 2015; 4(7): e001967. doi: 10.1161/JAHA.115.001967. PMID: 26150479.
  12. Smith G.N. The maternal health clinic: improving women's cardiovascular health. Semin perinatol. 2015; 39(4): 316–9. doi: 10.1053/j.semperi.2015.05.012. Review.
  13. Kloner R.A., Carson C. 3rd, Dobs A. et al. Testosterone and cardiovascular disease. J Am Coll Cardiol. 2016; 67(5): 545–57. doi: 10.1016/j.jacc.2015.12.005. Review. PMID: 26846952.
  14. Lunenfeld B. 20 years since the International Society of the Ageing Male (ISSAM) was founded. Aging Male. 2016; 19(4): 259–275. PMID: 27879154.
  15. Morley J.E. The diagnosis of late life hypogonadism. Aging Male. 2007; 10(4): 217–20. Review. PMID: 18033631.
  16. Muller M., van den Beld A.W., Bots M.L., et al. Endogenous sex hormones and progression of carotid atherosclerosis in elderly men. Circulation. 2004; 109(17): 2074–9. PMID: 15096452.
  17. Svartberg J., Jenssen T., Sundsfjord J. et al. The associations of endogenous testosterone and sex hormone-binding globulin with glycosylated hemoglobin levels, in community dwelling men. The Tromsø Study. Diabetes Metab. 2004; 30(1): 29–34. PMID: 15029095.
  18. Yeap B.B., Hyde Z., Almeida O.P. et al. Lower testosterone levels predict incident stroke and transient ischemic attack in older men. J Clin Endocrinol Metab. 2009; 94(7): 2353–9. doi: 10.1210/jc.2008-2416. PMID: 19351733.
  19. Kim C., Cushman M., Kleindorfer D. et al. A review of the relationships between endogenous sex steroids and incident ischemic stroke and coronary heart disease events. Curr Cardiol Rev. 2015; 11(3): 252–60. PMID: 25563292.
  20. Reeves M.J., Bushnell C.D., Howard G. et al. Sex differences in stroke: epidemiology, clinical presentation, medical care, and outcomes. Lancet neurology. 2008; 7: 915–26. PMID: 18722812 doi: 10.1016/S1474-4422(08)70193-5.
  21. Appelros P., Stegmayr B., Terént A. Sex differences in stroke epidemiology: a systematic review.Stroke. 2009; 40: 1082–90. doi: 10.1161/STROKEAHA.108.540781.
  22. Wang Y., Rudd A.G., Wolfe C.D. Age and Ethnic Disparities in Incidence of Stroke Over Time: The South London Stroke Register. Stroke. 2013; 44(12): 3298–304. doi: 10.1161/STROKEAHA.113.002604.
  23. Kapoor D., Jones T.H. Androgen deficiency as a predictor of metabolic syndrome in aging men: an opportunity for intervention? Drugs & aging. 2008; 25: 357–69. PMID: 18447401.
  24. Kupelian V., Hayes F.J., Link C.L. et al. Inverse association of testosterone and the metabolic syndrome in men is consistent across race and ethnic groups. The Journal of clinical endocrinology and metabolism. 2008; 93: 3403–10. PMID: 18559915 doi: 10.1210/jc.2008-0054.
  25. Shores M.M., Smith N.L., Forsberg C.W. et al. Testosterone treatment and mortality in men with low testosterone levels. The Journal of clinical endocrinology and metabolism. 2012; 97: 2050–8. PMID: 22496507 doi: 10.1210/jc.2011-2591.
  26. Spitzer M., Huang G., Basaria S. et al. Risks and benefits of testosterone therapy in older men. Nature reviews Endocrinology. 2013; 9: 414–24. PMID: 23591366 doi: 10.1038/nrendo.2013.73.
  27. Quillinan N., Deng G., Grewal H. et al. Androgens and stroke: good, bad or indifferent? Exp Neurol. 2014; 259: 10–5. doi: 10.1016/j.expneurol.2014.02.004.
  28. Ohlsson C., Barrett-Connor E., Bhasin S. et al. High serum testosterone is associated with reduced risk of cardiovascular events in elderly men. The MrOS (Osteoporotic Fractures in Men) study in Sweden. J. Am. Coll. Cardiol. 2011; 58(16): 1674–1681. doi: 10.1016/j.jacc.2011.07.019.
  29. Soisson V., Brailly-Tabard S., Helmer C. et al. A J-shaped association between plasma testosterone and risk of ischemic arterial event in elderly men: the French 3C cohort study. Maturitas. 2013; 75(3): 282–288. doi: 10.1016/j.maturitas.2013.04.012.
  30. Ruige J.B., Mahmoud A.M., De Bacquer D. et al. Endogenous testosterone and cardiovascular disease in healthy men: a meta-analysis. Heart. 2011; 97(11): 870–875. doi: 10.1136/hrt.2010.210757.
  31. Haring R., Teng Z., Xanthakis V. et al. Association of sex steroids, gonadotrophins, and their trajectories with clinical cardiovascular disease and all-cause mortality in elderly men from the Framingham Heart Study. Clin. Endocrinol. (Oxf) 2013; 78(4): 629–634. doi: 10.1111/cen.12013.

Supplementary files

Supplementary Files

Copyright (c) 2017 Maksimova M.Y., Moskvicheva A.S., Chechetkin A.O.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77-83204 от 12.05.2022.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies