Low testosterone is associated with disability in men with multiple sclerosis
R Bove, A Musallam, B C Healy, K Raghavan, B I Glanz, R Bakshi, H Weiner, P L De Jager, K K Miller, T Chitnis, R Bove, A Musallam, B C Healy, K Raghavan, B I Glanz, R Bakshi, H Weiner, P L De Jager, K K Miller, T Chitnis
Abstract
Background: Gonadal steroids may modulate disease course in multiple sclerosis (MS).
Objective: To assess the prevalence and clinical associations of hypogonadism in men with MS.
Methods: Male patients, aged 18-65 years, with relapsing-remitting MS (RRMS) or clinically-isolated syndrome (CIS) and their first symptom < 10 years prior were selected from a longitudinal clinical study. We measured their hormones in stored morning blood samples, and collected their Expanded Disability Status Scale (EDSS) scores every 6 months and their Symbol Digit Modalities Test (SDMT) results annually.
Results: Our analysis included 96 men with a mean age of 40 years, EDSS of 1.1 and disease duration of 4.6 years. Of these men, 39% were hypogonadal (total testosterone < 288 ng/dL); none showed compensatory elevations in luteinizing hormone. Their low testosterone levels and testosterone:estradiol ratios were negatively correlated with body mass index (BMI) and leptin, and showed no correlation with 25-hydroxy-vitamin D levels. In our primary cross-sectional analyses, there was a negative age-adjusted correlation between total testosterone and EDSS (p = 0.044). In the age-adjusted longitudinal analyses, higher baseline testosterone levels were associated with less decline in SDMT (p = 0.012).
Conclusions: Men with MS may experience hypogonadotropic hypogonadism. Low testosterone levels may be associated with worse clinical outcomes. A potential neuroprotective role for testosterone warrants further investigation.
Keywords: Body mass index; cognition; cognitive impairment; disability; hormones; hypogonadism; leptin; multiple sclerosis; testosterone.
© The Author(s), 2014.
Source: PubMed