Prevalence and Etiology of Hypogonadism in Young Men With Chronic Spinal Cord Injury: A Cross-Sectional Analysis From Two University-Based Rehabilitation Centers.

MedStar author(s):
Citation: Pm & R. 9(8):751-760, 2017 Aug.PMID: 27871967Institution: MedStar Health Research Institute | MedStar National Rehabilitation Network | MedStar Washington Hospital CenterDepartment: Medicine/Endocrinology | Physical Medicine and RehabilitationForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Hypogonadism/ep [Epidemiology] | *Hypogonadism/et [Etiology] | *Paraplegia/co [Complications] | *Quadriplegia/co [Complications] | *Spinal Cord Injuries/co [Complications] | Adult | Age Distribution | Cross-Sectional Studies | Follow-Up Studies | Humans | Hypogonadism/pp [Physiopathology] | Injury Severity Score | Male | Middle Aged | Paraplegia/di [Diagnosis] | Paraplegia/rh [Rehabilitation] | Prevalence | Quadriplegia/di [Diagnosis] | Quadriplegia/rh [Rehabilitation] | Rehabilitation Centers | Risk Assessment | Spinal Cord Injuries/di [Diagnosis] | Spinal Cord Injuries/rh [Rehabilitation] | Testosterone/me [Metabolism] | Young AdultYear: 2017ISSN:
  • 1934-1482
Name of journal: PM & R : the journal of injury, function, and rehabilitationAbstract: BACKGROUND: Spinal cord injury (SCI) triggers an "accelerated aging" process that may include development of hypogonadism, even among younger men with SCI; however, few studies have investigated the prevalence or etiology of hypogonadism in men with SCI. Young men with SCI also are at increased risk for developing metabolic dysfunction after injury, which may be exacerbated by concomitant testosterone (T) deficiency, thus identifying the prevalence and risk factors for T deficiency in men with SCI is important for their long-term health.CONCLUSIONS: Hypogonadism is more common in young men with SCI than in similarly aged men without SCI, suggesting that SCI should be identified as a risk factor for T deficiency and that routine screening for hypogonadism should be performed in the SCI population.Copyright � 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.DESIGN: Secondary cross-sectional analysis.LEVEL OF EVIDENCE: To be determined.MAIN OUTCOME MEASUREMENTS: Serum total T and calculated free T.METHODS: Plasma concentrations of hormones were measured with standardized assays. Body composition was assessed with dual-energy x-ray absorptiometry scan.OBJECTIVE: To investigate the prevalence, risk factors, and etiology of T deficiency (hypogonadism) in otherwise-healthy men with chronic, motor complete SCI.PARTICIPANTS: Men (n = 58) aged 18-45 years with chronic (>1 year), motor complete SCI without comorbidities or use of testosterone therapy.RESULTS: T deficiency was more common in men after SCI than in a matched cohort of similarly-aged men without SCI (25%, SCI versus 6.7%, non-SCI, P < .001). The risk of hypogonadism appeared to be increased in men with more extensive injury and with higher percent body fat. The majority of men with SCI with low T had low serum LH levels, suggesting that central suppression of the hypothalamic-pituitary-gonadal axis may be the most common etiology of hypogonadism after SCI.SETTING: Rehabilitation research centers in Washington, DC, and Miami, Florida.All authors: Blackman MR, Groah S, Nash MS, Sullivan SD, Tefera E, Tinsley EFiscal year: FY2018Digital Object Identifier: Date added to catalog: 2017-05-24
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Journal Article MedStar Authors Catalog Article 27871967 Available 27871967

BACKGROUND: Spinal cord injury (SCI) triggers an "accelerated aging" process that may include development of hypogonadism, even among younger men with SCI; however, few studies have investigated the prevalence or etiology of hypogonadism in men with SCI. Young men with SCI also are at increased risk for developing metabolic dysfunction after injury, which may be exacerbated by concomitant testosterone (T) deficiency, thus identifying the prevalence and risk factors for T deficiency in men with SCI is important for their long-term health.

CONCLUSIONS: Hypogonadism is more common in young men with SCI than in similarly aged men without SCI, suggesting that SCI should be identified as a risk factor for T deficiency and that routine screening for hypogonadism should be performed in the SCI population.

Copyright � 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

DESIGN: Secondary cross-sectional analysis.

LEVEL OF EVIDENCE: To be determined.

MAIN OUTCOME MEASUREMENTS: Serum total T and calculated free T.

METHODS: Plasma concentrations of hormones were measured with standardized assays. Body composition was assessed with dual-energy x-ray absorptiometry scan.

OBJECTIVE: To investigate the prevalence, risk factors, and etiology of T deficiency (hypogonadism) in otherwise-healthy men with chronic, motor complete SCI.

PARTICIPANTS: Men (n = 58) aged 18-45 years with chronic (>1 year), motor complete SCI without comorbidities or use of testosterone therapy.

RESULTS: T deficiency was more common in men after SCI than in a matched cohort of similarly-aged men without SCI (25%, SCI versus 6.7%, non-SCI, P < .001). The risk of hypogonadism appeared to be increased in men with more extensive injury and with higher percent body fat. The majority of men with SCI with low T had low serum LH levels, suggesting that central suppression of the hypothalamic-pituitary-gonadal axis may be the most common etiology of hypogonadism after SCI.

SETTING: Rehabilitation research centers in Washington, DC, and Miami, Florida.

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