Article

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. OBJECTIVE:
To investigate the prevalence, risk factors, and etiology of T deficiency
(hypogonadism) in otherwise-healthy men with chronic, motor complete SCI. DESIGN:
Secondary cross-sectional analysis. SETTING: Rehabilitation research centers in
Washington, DC, and Miami, Florida. PARTICIPANTS: Men (n = 58) aged 18-45 years
with chronic (>/=1 year), motor complete SCI without comorbidities or use of
testosterone therapy. METHODS: Plasma concentrations of hormones were measured
with standardized assays. Body composition was assessed with dual-energy x-ray
absorptiometry scan. MAIN OUTCOME MEASUREMENTS: Serum total T and calculated free
T. 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. 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. LEVEL OF EVIDENCE: II.
CI - Copyright (c) 2017 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS