SFEBES2013 Poster Presentations Steroids (37 abstracts)
Gonadotrophic response to operational deployment in Afghanistan
N E Hill 1, , S K Delves 2 , M Stacey 3 , A Davison 5 , R Quinton 6 , S Turner 5 , G Frost 1 , D R Wilson 3 , K G Murphy 1 , J L Fallowfield 2 & D R Woods 4
1Imperial College London, London, UK; 2Institute of Naval Medicine, Alverstoke, UK; 3Royal Centre for Defence Medicine, Birmingham, UK; 4Northumbria and Newcastle NHS Trusts, Newcastle Upon Tyne, UK; 5Newcastle Hospitals NHS Trust, Newcastle Upon Tyne, UK; 6Royal Victoria Infirmary, Newcastle Upon Tyne, UK.
Background: Military training has been associated with changes in the hypothalamic–pituitary–testicular axis that are consistent with central hypogonadism (fall in testosterone, LH and FSH concentrations). The effects on the hypothalamic–pituitary–testicular axis of deployment to a combat zone are not known. The aim of this study was to clarify this situation.
Methods: Military personnel were investigated pre-deployment (Pre-) and following 3 months in Afghanistan (Mid-deployment). Body mass, body composition and strength were measured, and androgen, thyroid hormone and leptin concentrations were analysed. Data were evaluated by students T test.
Results: Body mass (kg) decreased between Pre- (83.2±9.2 kg) and Mid-Deployment (79.2±8.2 kg) (P<0.001). During this period total testosterone concentration did not change but sex hormone binding globulin (SHBG) increased (30.7±9.7 vs 42.3±14.1 nmol/l; P<0.001) contributing to a decrease (P<0.001) in calculated free testosterone concentration of between 14.3% (measured by RIA) and 23.3% (by liquid chromatography–mass spectrometry). LH and FSH concentration increased by 14.3% (P<0.001) and 4.9% (P<0.003), respectively. Androstenedione concentration decreased by 14.5% (P=0.024) and leptin and free T3 decreased by 44% (P<0.001) and 5.6% (P=0.033) respectively. Physical strength was maintained despite the change in body mass or testosterone concentration over this 3-month period.
Conclusion: Free testosterone concentration decreased significantly during the first half of an operational deployment. There was no evidence to suggest that this is due to stress-induced central hypogonadism. Although the mechanisms for increased SHBG levels are not clear, it may be that a fall in body mass and a reduction in leptin concentration conspire to elevate SHBG and contribute to the decrease in free testosterone concentration.
Declaration of funding: This work was funded by the Ministry of Defence.
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