Article

OBJECTIVE: To define the prevalence of testosterone deficiency in persons with
chronic spinal cord injury (SCI) and to identify factors associated with this
deficiency. DESIGN: Cross-sectional study. SETTING: A U.S. Department of Veterans
Affairs SCI unit. PARTICIPANTS: Participants (n = 60) included male veterans
completing annual evaluations from July 2006 to April 2007. METHODS: In addition
to routine annual evaluation laboratory examination, which included measurements
of serum albumin levels, participants underwent measurements of serum total
testosterone, luteinizing hormone, follicle stimulating hormone, and prolactin
levels. Outcome measures included the prevalence of testosterone deficiency
(defined as total serum testosterone <325 ng/dL) and the relationship of
testosterone level with participant's age, serum albumin level, narcotic
medication use, time since injury, American Spinal Injury Association Impairment
Scale (AIS) grade, and neurologic level of injury. RESULTS: A low serum
testosterone level (<325 ng/dL) was detected in 43.3% of participants. The
testosterone level was significantly associated with severity of injury as
defined by AIS grade (t = -2.59, P = .012). The prevalence of testosterone
deficiency was significantly greater in participants with motor complete (AIS A
and B) injuries compared with those with motor incomplete (AIS C, D, and E)
injuries. Testosterone levels were significantly lower in participants who were
taking narcotic medications for pain management (t = -0.25, P < .05). There was
no relationship between the use of narcotic medications and severity of injury.
Given the small number of participants, the SCI levels, age, duration of
injuries, serum albumin levels, and serum levels of luteinizing hormone, follicle
stimulating hormone, and prolactin did not reach statistical significance in
predicting testosterone level. CONCLUSIONS: These findings confirm both a
substantial population of men with SCI and with testosterone deficiency, and a
significant association between testosterone level and severity of SCI. Measuring
serum total testosterone levels should be included in standard screenings for
patients with SCI, particularly those with motor complete injuries.
CI - Copyright (c) 2011 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS