Endocrine Abstracts

Hypogonadism is prevalent with opiate-like drug use and might be a factor in cognitive abnormalities. With the increasing substance use (SU) worldwide, it is critical to recognize its impact on cognition, which may decrease adherence to treatment and alter quality of life. We hypothesized that men with SU, by virtue of hypogonadism secondary to HIV and/or drug use, may demonstrate impaired cognitive function.

We recruited men aged 18–50 from a low-income population in Baltimore, Maryland. Details of HIV and SU status, blood levels of total testosterone (TT), free testosterone (FT) and estradiol (E₂) were assessed. All subjects were administered ten neuropsychological tests that tested cognition, visuomotor and visuospatial abilities, graphomotor and psychomotor speed, and verbal learning and memory.

Our sample consisted of 68 men (mean age: 43.2 (S.D. 5.8), African Americans: 86.6%). The studied population was primarily uneducated and unemployed. The mean level of TT was 553.9 ng/dl (S.D. 262.0), median 507 ng/dl, the mean level of FT was 69.5 pg/ml (S.D. 34.8), median 70.5 pg/ml, mean E₂ was 3.2 pg/ml (S.D. 4.4), median 2.1 pg/ml. We found that 30.9% were hypogonadal (TT<300 ng/dl or FT<50 pg/ml) and it was associated with higher SU.

We observed some relationships between sex hormones and cognitive domains, however, after adjustment for age, drug use category, education, depression, and HIV, there was no statistically significant correlation between cognitive performance and sex hormone levels.

In this cross-sectional study of men with a high prevalence of SU and hypogonadism (30.9%), endogenous levels of TT, FT or E₂ were not related to cognitive performance. Future research should identify alternative factors that affect poor cognitive functioning in the setting of SU.

Non-users = no substance use in the past three years Occasional users = cocaine and/or heroin use less than three times per week Heavy users and methadone = methadone, cocaine and/or heroin use more than three times per week or being on methadone maintenance

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This work was supported, however funding details unavailable.