Acquired androgen deficiency as a predictor of metabolic syndrome and ischemic stroke in men
- 作者: Koltsova E.A.1, Petrova E.A.1, Kudryavceva A.D.2
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隶属关系:
- Pirogov Russian National Research Medical University
- Tula State University, Medical Institute
- 期: 卷 30, 编号 9/10 (2023)
- 页面: 214-219
- 栏目: Endocrinology
- URL: https://journals.eco-vector.com/2073-4034/article/view/624945
- DOI: https://doi.org/10.18565/pharmateca.2023.9-10.214-219
- ID: 624945
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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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作者简介
E. Koltsova
Pirogov Russian National Research Medical University
编辑信件的主要联系方式.
Email: koltsovaevg@gmail.com
ORCID iD: 0000-0001-6459-2656
Cand. Sci. (Med.)
俄罗斯联邦, MoscowE. Petrova
Pirogov Russian National Research Medical University
Email: koltsovaevg@gmail.com
ORCID iD: 0000-0002-9679-7899
俄罗斯联邦, Moscow
A. Kudryavceva
Tula State University, Medical Institute
Email: koltsovaevg@gmail.com
ORCID iD: 0000-0002-4533-8684
俄罗斯联邦, Tula
参考
- Bhasin S., Cunningham G.R., Hayes F.J., et al. Testosterone therapy in adult men with androgen deficiency syndromes: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2010 Jun;95(6):2536-59. Doi: 10.1210/ jc.2009-2354.
- Wang C., Nieschlag E., Swerdloff R., et al., Investigation, treatment and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA and ASA recommendations. Eur J Endocrinol. 2008;159:507–14. doi: 10.1530/EJE-08-0601
- Morley et al. Validation of a screening questionnaire for androgen deficiency in aging males. Metabolism. 2000;49:1239–42. doi: 10.1053/meta.2000.8625.
- Svartberg J., Jenssen T., Sundsfjord J., et al. Association of endogenous testosterone with blood pressure and left ventricular mass in men. The Tromso Study. Eur J Endocrinol. 2004;50(1):65–71. doi: 10.1016/s1262-3636(07)70086-1.
- Muller M., Grobbee D.E., den Tonkelaar I., et al. Endogenous sex hormones and metabolic syndrome in aging men. J Clin Endocrinol Metab. 2005;90:2618–23. Doi: 10.1210/ jc.2004-1158.
- Chubb S.A., Hyde Z., Almeida O.P., et al. Lower sex hormone-binding globulin is more strongly associated with metabolic syndrome than lower total testosterone in older men: the Health In Men Study. Eur J Endocrinol. 2008;158:785–72. doi: 10.1530/EJE-07-0893.
- 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):2353–59. doi: 10.1210/jc.2008-2416.
- Kevin S. Channer Testosterone replacement in hypogonadal men with type 2 diabetes and/or metabolic syndrome (the TIMES2 study). Diabetes care 2011;34(4):828–37. doi: 10.2337/dc10-1233.
- Chen R.Y., Wittert G.A., Andrews G.R. Relative androgen deficiency in relation to obesity and metabolic status in older men. Diabetes Obes Metab. 2006;8(4):429–35. doi: 10.1111/j.1463-1326.2005.00532.x.
- Wranicz JK, Cygankiewicz I, Rosiak M, Kula P, Kula K, Zareba W. The relationship between sex hormones and lipid profile in men with coronary artery disease. Int J Cardiol. 2005;101(1):105–10. doi: 10.1016/j.ijcard.2004.07.010.
- Makinen J., Jarvisalo M.J., Pollanen P., et al. Increased carotid atherosclerosis in andropausal middle-aged men. J Am Coll Cardiol. 2005;45:1603–608. doi: 10.1016/j.jacc.2005.01.052.
- Paul D.M., Kevin S.C. Testosterone and cardiovascular disease in men. Asian J Andrology. 2012;14(3):428–35. doi: 10.1038/aja.2012.21.
- Kevin S. Channer Endogenous testosterone levels and cardiovascular disease in healthy men. Heart (British Cardiac Society). 2011;97(11):867–69. doi: 10.1136/hrt.2010.217414.
- Taggart H., Sheridan B., Stout R.W. Sex hormone levels in younger male stroke survivors. Atherosclerosis. 1980;35(1):123–25. doi: 10.1016/0021-9150(80)90034-9.
- Xuelong Li, Xianliang Li, Fang Fang , et al. Is Metabolic Syndrome Associated with the Risk of Recurrent Stroke: A Meta-Analysis of Cohort Studies. J Stroke Cerebrovasc Dis. 2017;26(12):2700–705. doi: 10.1016/j.jstrokecerebrovasdis.2017.03.014.
- Khaw K.T., Dowsett M., Folkerd E., et al. Endogenous testosterone and mortality due to all causes, cardiovascular disease, and cancer in men. Circulation. 2007;116:2694–01. doi: 10.1161/CIRCULATIONAHA.107.719005.
- Laughlin G.A., Barrett-Connor E., Bergstrom J. Low serum testosterone and mortality in older men. J Clin Endocrinol Metab. 2008;93:68–75. doi: 10.1210/jc.2007-1792.
- Araujo A.B., Kupelian V., Page S.T., et al. Sex steroids and all-cause and cause-specific mortality in men. Arch Intern Med. 2007;167:1252–60. doi: 10.1001/archinte.167.12.1252.
- Haddad R.M., Kennedy C.C., Caples S.M., et al. Testosterone and cardiovascular risk in men: a systematic review and meta-analysis of randomized placebo-controlled trials. Mayo Clin Proc. 2007;82:29–39. doi: 10.4065/82.1.29.
- Скворцова В.И., Кольцова Е.А., Кимельфельд Е.И. Ишемический инсульт у больных молодого возраста Журнал неврологии и психиатрии им. С.С. Корсакова. Инсульт. 2009;10:3–14.
- Muller M., Grobbee D.E., den Tonkelaar I., et al. Endogenous sex hormones and metabolic syndrome in aging men. J Clin Endocrinol Metab. 2005;90:2618–23. doi: 10.1210/jc.2004-1158.
- Vitvitsky V., Prudova A., Stabler S., et al. Testosterone regulation of renal cystathionine beta-synthase: implications for sex-dependent differences in plasma homocysteine levels. Am J Physiol Renal Physiol. 2007;293(2):F594–600. doi: 10.1152/ajprenal.00171.2007.
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