FP12-5 Hypogonadism Is Associated With Increased Cardiometabolic Risk in Young Men With Chronic Spinal Cord Injury

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: FP12-Reproductive Hormones: Vital Effects Evidenced In Human Cohorts & Experimental Models
Saturday, June 15, 2013: 11:00 AM-11:30 AM
Presentation Start Time: 11:20 AM
Room 102 (Moscone Center)

Poster Board SAT-557
Shannon Danielle Sullivan*1, Hong Wang2, Marc R Blackman3 and Suzanne Groah4
1Medstar Washington Hospital Center, Washington, DC, 2Medstar Health Research Institute, Hyattesville, MD, 3Washington DC VAMC, Bethesda, MD, 4Medstar National Rehabilitation Hospital, Washington, DC
Background: 300,000 individuals with spinal cord injury (SCI) currently reside in the U.S., with injuries most commonly occuring in men between the ages of 15 and 24. Men with SCI undergo an accelerated aging process post-injury, characterized by development of sarcopenic obesity and metabolic syndrome, which together heighten overall cardiovascular disease (CVD) risk. Indeed, CVD is a leading cause of death among men with SCI who achieve long-term post-injury survival. Hypogonadism is also a frequent complication of SCI in men, which may contribute to development of sarcopenic obesity and metabolic syndrome post-injury.  To date, however, few studies have investigated the prevalence or cardiometabolic consequences of T deficiency in men with SCI. 

Methods: In this pilot study, we investigated the prevalence of T deficiency in 36 young (age 18-50 years) men with chronic (≥ 1 yr) SCI and the relationships between total T (TT) and free T (fT) and cardiometabolic risk components, including body composition [BMI, waist-to-hip ratio (WHR), central body fat %], insulin sensitivity [insulin sensitivity index (ISI), fasting and 2hr blood glucose on oral glucose tolerance test (OGTT), HbA1C%, SHBG], lipid profiles [fasting total cholesterol (TC), HDL, LDL, VLDL, and triglycerides (TG)], and systemic inflammation (hsCRP, IL-6) in a subset (n=14) of these men.  Due to small sample size for correlation analyses, the non-parametric Spearman Correlation coefficient was used to calculate correlations between TT/fT and cardiometabolic risk factors.  Correlation coefficients [r] ≥ 0.3 were considered fair to strong correlations; P<0.05 was considered significant.

Results: The prevalence of low T, defined as serum TT<300 ng/dL and/or serum fT< 9 ng/dL, was 33% (n=12/36).  14 of these 36 men with SCI have undergone the cardiometabolic risk assessments listed above, 36% (n=5/14) of whom had TT<300 ng/dL [(n=2)(mean±s.d. TT, 458±163; range 120-686 ng/dL)] or fT<9 ng/dL [(n=3) (mean±s.d. fT, 11.0±3.7; range 2.6-16.0 ng/dL)].  Among these 14 men, TT was significantly related to the calculated fT (r = 0.81, P<0.01).  Low TT was associated with less favorable BMI (r= -0.37), WHR (r= -0.74), TG (r= -0.33), HDL (r= 0.83), VLDL (r= -0.42), FBG (r= -0.60), 2hr OGTT glc (r= -0.36), ISI (r= 0.49), SHBG (r= 0.67), and % central fat (r= -0.41). Low fT was associated with less favorable WHR (r= -0.74), HDL (r= 0.66), FBG (r= -.30), 2hr OGTT glc (r= -0.34), and % central fat (r= -0.34). Associations of TT with CRP, IL-6, and HbA1C%, and of fT with BMI, TG, VLDL, CRP, IL-6, ISI, and HbA1C were poor (r<0.3).

Conclusion: T deficiency is common in young men with chronic SCI and is associated with increased cardiometabolic risk. Thus, screening for hypogonadism is warranted in this population, and the effects of physiologic T replacement therapy on cardiometabolic risk reduction and prevention of CVD should be investigated.

Nothing to Disclose: SDS, HW, MRB, SG

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm