Acquired androgen deficiency as a predictor of metabolic syndrome and ischemic stroke in men

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Abstract

Background. Ischemic stroke is one of the leading causes of disability in men of working age. Stroke risk factors have gender and age characteristics. Compared with such common risk factors as arterial hypertension, dyslipidemia, atrial fibrillation, diabetes mellitus, etc., the problem of age-related acquired androgen deficiency in patients with stroke has not been studied enough.

Objective. Identification of the prevalence of acquired androgen deficiency and metabolic syndrome as significant risk factors for stroke in men.

Methods. A total of 154 patients (men, mean age – 51.5+7.5 years) with hemispheric ischemic stroke were followed-up. Clinical assessment was carried out using the National Institutes of Health Stroke Scales (NIHSS), modified Rankin Scale, standard international questionnaire “Aging Male Screening”, Beck Depression Inventory; neuroimaging, laboratory and instrumental methods studies were used to confirm the pathogenetic variant of stroke. Statistical analysis was carried out using the “IBM SPSS Statistics version 19” software package, MS Excel 2019 software (Microsoft) and GraphPad InStat3.1 program

Results. At the time of onset of ischemic stroke, clinical symptoms of androgen deficiency according to the AMS questionnaire were observed in almost all examined patients. Moreover, men with moderate (25%) and severe (57.6%) clinical symptoms of acquired androgen deficiency predominated. In the control group of non-stroke men, clinical symptoms of androgen deficiency according to the AMS questionnaire were identified in less than ¼ of the subjects, and symptoms of mild deficiency predominated. Androgen deficiency was detected using laboratory testsin 66.3% of patients. At the same time, with increasing severity of clinical symptoms of androgen deficiency according to the AMS questionnaire, the percentage of laboratory confirmation of the syndrome increased. It should be noted that androgen deficiency in patients with diabetes mellitus was 2 times more common than in patients without diabetes (50%versus 26%).

Conclusion. The results of the study show that androgen deficiency in middle-aged men is included in the structure of the metabolic syndrome along with such components as arterial hypertension, impaired glucose tolerance, dyslipidemia, obesity, which in turn are leading risk factors for ischemic stroke.

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About the authors

E. A. Koltsova

Pirogov Russian National Research Medical University

Author for correspondence.
Email: koltsovaevg@gmail.com
ORCID iD: 0000-0001-6459-2656

Cand. Sci. (Med.)

Russian Federation, Moscow

E. A. Petrova

Pirogov Russian National Research Medical University

Email: koltsovaevg@gmail.com
ORCID iD: 0000-0002-9679-7899
Russian Federation, Moscow

A. D. Kudryavceva

Tula State University, Medical Institute

Email: koltsovaevg@gmail.com
ORCID iD: 0000-0002-4533-8684
Russian Federation, Tula

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Supplementary files

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2. Fig. 1. Comparison of the severity of clinical symptoms of androgen deficiency in men with and without stroke

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3. Fig. 2. BMI value depending on the level of total testosterone

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4. Fig. 3. BMI value according to the severity of clinical symptoms of androgen deficiency according to the severity of clinical symptoms of androgen deficiency according to the severity of clinical symptoms of androgen deficiency

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