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Mult Scler. 2014 Oct;20(12):1584-92. doi: 10.1177/1352458514527864. Epub 2014 Apr 7.

Low testosterone is associated with disability in men with multiple sclerosis.

Author information

1
Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women's Hospital, Brookline, MA, USAHarvard Medical School, Boston, MA, USACenter for Neurologic Diseases, Harvard Medical School, Boston, MA, USA.
2
Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women's Hospital, Brookline, MA, USA.
3
Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women's Hospital, Brookline, MA, USAHarvard Medical School, Boston, MA, USAMassachusetts General Hospital Biostatistics Center, Boston, MA, USA.
4
Harvard Medical School, Boston, MA, USA.
5
Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women's Hospital, Brookline, MA, USAHarvard Medical School, Boston, MA, USA.
6
Harvard Medical School, Boston, MA, USANeuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA.
7
Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women's Hospital, Brookline, MA, USAHarvard Medical School, Boston, MA, USACenter for Neurologic Diseases, Harvard Medical School, Boston, MA, USA tchitnis@rics.bwh.harvard.edu.

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

PMID:
24710799
PMCID:
PMC4188801
DOI:
10.1177/1352458514527864
[Indexed for MEDLINE]
Free PMC Article

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