Jung-Won Choi1, In Woo Ryoo2, Jun Yeong Hong2, Kyung-Yul Lee3, Hyo Suk Nam3, Won Chan Kim1, Seung-Hun Oh1, Jaeku Kang4, Hoi Young Lee4, Sang-Jun Na2, Ji Hoe Heo3, Kee Ook Lee5,6. 1. Department of Neurology, CHA Bundang Medical Center, CHA University, 59, Yatap-ro, Bundang-gu, Gyunggi-do, 13496, Seongnam, Republic of Korea. 2. Department of Neurology, Konyang University College of Medicine, Daejeon, Korea. 3. Department of Neurology, Yonsei University College of Medicine, Seoul, Korea. 4. Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon, Korea. 5. Department of Neurology, CHA Bundang Medical Center, CHA University, 59, Yatap-ro, Bundang-gu, Gyunggi-do, 13496, Seongnam, Republic of Korea. niceiatros@cha.ac.kr. 6. Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon, Korea. niceiatros@cha.ac.kr.
Abstract
BACKGROUND: Sex hormones may be associated with a higher incidence of ischemic stroke or stroke-related events. In observational studies, lower testosterone concentrations are associated with infirmity, vascular disease, and adverse cardiovascular risk factors. Currently, female sexual hormones are considered neuroprotective agents. The purpose of this study was to assess the role of sex hormones and the ratio of estradiol/testosterone (E/T) in patients with acute ischemic stroke (AIS). METHODS: Between January 2011 and December 2016, 146 male patients with AIS and 152 age- and sex-matched control subjects were included in this study. Sex hormones, including estradiol, progesterone, and testosterone, were evaluated in the AIS patient and control groups. We analyzed the clinical and physiological levels of sex hormones and hormone ratios in these patients. RESULTS: The E/T ratio was significantly elevated among patients in the stroke group compared to those in the control group (P = 0.001). Categorization of data into tertiles revealed that patients with the highest E/T ratio were more likely to have AIS [odds ratio (OR) 3.084; 95% Confidence interval (CI): 1.616-5.886; P < 0.001) compared with those in the first tertile. The E/T ratio was also an independent unfavorable outcome predictor with an adjusted OR of 1.167 (95% CI: 1.053-1.294; P = 0.003). CONCLUSIONS: These findings support the hypothesis that increased estradiol and reduced testosterone levels are associated with AIS in men.
BACKGROUND: Sex hormones may be associated with a higher incidence of ischemic stroke or stroke-related events. In observational studies, lower testosterone concentrations are associated with infirmity, vascular disease, and adverse cardiovascular risk factors. Currently, female sexual hormones are considered neuroprotective agents. The purpose of this study was to assess the role of sex hormones and the ratio of estradiol/testosterone (E/T) in patients with acute ischemic stroke (AIS). METHODS: Between January 2011 and December 2016, 146 male patients with AIS and 152 age- and sex-matched control subjects were included in this study. Sex hormones, including estradiol, progesterone, and testosterone, were evaluated in the AIS patient and control groups. We analyzed the clinical and physiological levels of sex hormones and hormone ratios in these patients. RESULTS: The E/T ratio was significantly elevated among patients in the stroke group compared to those in the control group (P = 0.001). Categorization of data into tertiles revealed that patients with the highest E/T ratio were more likely to have AIS [odds ratio (OR) 3.084; 95% Confidence interval (CI): 1.616-5.886; P < 0.001) compared with those in the first tertile. The E/T ratio was also an independent unfavorable outcome predictor with an adjusted OR of 1.167 (95% CI: 1.053-1.294; P = 0.003). CONCLUSIONS: These findings support the hypothesis that increased estradiol and reduced testosterone levels are associated with AIS in men.
Entities:
Keywords:
Acute ischemic stroke; Functional outcome; Men; Sex hormones; estradiol/testosterone ratio
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