PDF(Pubmed)
Abstract：
Background: One intriguing aspect of stroke is its higher incidence in men as compared to women. Endogenous sex hormones, testosterone and estradiol, may be responsible for this difference. This research aims to study serum testosterone and estradiol levels in men with acute ischemic stroke (AIS) and to correlate these levels with National Institutes of Health Stroke Scale (NIHSS) score and infarct size in computed tomography (CT). Methods: 100 male patients with AIS and 100 age-matched controls were included in this case-control study. Patients with hemorrhagic stroke, taking hormonal preparations, or suffering from chronic illnesses like tuberculosis (TB), cancer, etc. were excluded. Complete history was obtained including presence of established risk factors and physical examination was done in cases and controls with informed written consent. Severity of stroke in cases was assessed by the NIHSS. CT scan of brain was performed within 72 hours of patient\'s admission to hospital. The infarct size was measured in centimeters as the largest visible diameter of the infarct on CT scan. Fasting blood samples were obtained for routine investigations and estimating estradiol and testosterone levels. Results: Mean total testosterone level in cases (223.30 ± 143.44 ng/dl) was significantly lower than that of controls (515.34 ± 172.11 ng/dl) (P < 0.001), while estradiol levels had no significant statistical difference (P = 0.260). A significant inverse correlation was found between total testosterone levels and stroke severity (r = -0.581, P < 0.001) and also, total testosterone levels and infarct size (r = -0.557, P < 0.001). Estradiol levels in patients had no significant correlation with stroke severity (P = 0.618) or infarct size (P = 0.463). Conclusion: Low testosterone levels are associated with increased stroke severity and infarct size in men. Further studies are required to establish whether low testosterone is a cause or effect of ischemic stroke and also to explore the potential benefits of testosterone supplementation in men with AIS.
摘要：
背景：中风的一个有趣的方面是其在男性中的发病率高于女性。内源性性激素,睾酮和雌二醇,可能是造成这种差异的原因。这项研究旨在研究急性缺血性卒中（AIS）男性的血清睾酮和雌二醇水平，并将这些水平与美国国立卫生研究院卒中量表（NIHSS）评分和计算机断层扫描（CT）的梗死面积相关联。方法：本病例对照研究包括100例男性AIS患者和100例年龄匹配的对照。出血性中风患者，服用荷尔蒙制剂，或患有慢性疾病，如结核病（TB），癌症,等。被排除在外。获得完整的病史，包括存在已确定的危险因素，并在知情书面同意的情况下对病例和对照进行体格检查。病例中卒中的严重程度由NIHSS评估。患者入院后72小时内进行脑部CT扫描。以厘米为单位测量梗死面积,作为CT扫描上梗死的最大可见直径。获取空腹血样进行常规调查并估计雌二醇和睾丸激素水平。结果：病例的平均总睾酮水平（223.30±143.44ng/dl）明显低于对照组（515.34±172.11ng/dl）（P<0.001），雌二醇水平差异无统计学意义(P=0.260)。总睾酮水平与卒中严重程度呈显著负相关(r=-0.581,P<0.001),总睾酮水平和梗死面积(r=-0.557,P<0.001)。患者的雌二醇水平与卒中严重程度（P=0.618）或梗死面积（P=0.463）无显著相关性。结论：低睾酮水平与男性卒中严重程度和梗死面积增加有关。需要进一步的研究来确定低睾酮是否是缺血性卒中的原因或影响，并探索男性AIS患者补充睾酮的潜在益处。
