Session: SAT 554-583-Male Reproductive Endocrinology & Case Reports
Poster Board SAT-555
Objectives: To evaluate the prevalence and etiology (primary vs secondary) of hypogonadism in a cohort of non-elderly men with SCI.
Methods: 36 men aged 18-50 with chronic (≥1 year) SCI and no prior history of hypogonadism were evaluated as part of an ongoing, larger study. Blood was collected in the early morning after an overnight fast, stored at -80 C and subsequently assayed for total testosterone (TT) by RIA; estradiol (E2) by immunoassay; and LH, FSH, and SHBG by immunoradiometric assay. Free T (fT) was calculated using TT and SHBG. Fisher’s exact test with P<0.05 was used to compare prevalence of hypogonadism between these SCI patients and healthy, non-SCI men aged 20-49 yr in NHANES III (controls).
Results: Hypogonadism was present in 7 (19%) of the men with SCI based on TT<300 ng/dL and 12 (33%) men based on fT<9 ng/dL. 7 (19%) men with SCI had both low TT and low fT; 12 (33%) had either low TT or low fT. The overall prevalence of hypogonadism in this group of SCI men is significantly higher than the 2.3-8.7% prevalence of TT<300 ng/dL reported in healthy, non-SCI men aged 20-49 in NHANES III (p<0.0001).
In our study, higher SHBG correlated with higher TT (r=0.6, all subjects, p<0.0001; r=0.8, hypogonadal subjects, p=0.002). SHBG did not correlate with fT (r=0.2 all subjects; r=0.2, hypogonadal subjects). Among the 12 SCI men with low TT or low fT, 10 (83%) had LH and/or FSH <5 IU/L, suggesting secondary hypogonadism; 2 (17%) had LH and/or FSH >10 IU/L, suggesting primary hypogonadism. Among hypogonadal SCI men, higher E2 levels were related to lower TT (r= -0.52, P=0.08) and lower fT (r= -0.54, P=0.07), both trending toward significance. E2 had no relation to SHBG among hypogonadal SCI men.
Conclusions: Our findings of a several-fold increased prevalence of hypogonadism in nonelderly men with SCI compared to non-SCI controls, in frequent association with central hypogonadism and elevated estrogens, should prompt routine screening of reproductive axis function is in this population.
Nothing to Disclose: SDS, MM, MRB, SG
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