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Relationship Between Gonadal Function and Cardiometabolic Risk in Young Men With Chronic Spinal Cord Injury.

Shannon D Sullivan1,2,3,4,5, Mark S Nash1,2,3,4,5, Eshetu Tefara1,2,3,4,5

  • 1Center for Drug Evaluation and Research, US Food and Drug Administration, 10903 New Hampshire Ave, Building 22, Room 3373, Silver Spring, MD 20993.

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Testosterone deficiency in young men with spinal cord injury (SCI) is linked to increased cardiometabolic risk factors. This finding suggests hypogonadism may contribute to poor cardiovascular health post-SCI.

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Area of Science:

  • Endocrinology and Metabolism
  • Neurology and Rehabilitation Medicine

Background:

  • Young men with chronic spinal cord injury (SCI) exhibit a higher prevalence of testosterone deficiency compared to healthy peers.
  • These individuals are also at increased risk for cardiometabolic dysfunction post-injury.
  • The association between testosterone deficiency and cardiometabolic risk in SCI is not well understood.

Purpose of the Study:

  • To investigate the relationship between testosterone levels and surrogate markers of cardiometabolic risk in young men with chronic SCI.

Main Methods:

  • A secondary cross-sectional analysis was conducted on 58 men (aged 18-45) with chronic motor-complete SCI.
  • Measurements included plasma testosterone (total and free), lipids, inflammatory markers (CRP, IL-6), HbA1c, glucose, insulin, body composition, and Framingham Risk Score.
  • Participants were categorized based on total testosterone (TT) and free testosterone (fT) levels.

Main Results:

  • Low free testosterone (fT) was associated with a significantly greater Framingham Risk Score.
  • Low total testosterone (TT) or fT correlated with increased body fat percentage and waist-to-hip ratio.
  • Men with low TT or fT exhibited lower HDL cholesterol, higher fasting glucose, and increased insulin resistance, alongside elevated inflammatory markers (CRP, IL-6) with low TT.

Conclusions:

  • Hypogonadism in young men with chronic SCI is associated with an unfavorable cardiometabolic risk profile, potentially due to accelerated aging post-injury.
  • Further research is required to establish causality and determine if routine testosterone screening is beneficial for this population.