Endocrine Abstracts

Background: Men suffering from spinal cord injury (SCI) were at increased risk for cardiovascular diseases (CVD). SCI subjects showed an higher value of carotid intima media thickness (cIMT) at ultrasound, a surrogate markers of sub-clinical atherosclerosis. Furthermore, SCI men exhibited an higher prevalence of androgen deficiency compared to general population.

Objectives: To investigate the relationship between total testosterone (TT) levels and cIMT in men with chronic SCI.

Materials and methods: In this observational and cross-sectional study, cIMT of 60 men with chronic (> 1 years) SCI, aged 56.0 (25th–75th: 46.0–67.2) years, was evaluated with neck ultrasonography. All patients underwent a complete neurological exam, as well as biochemical and hormonal assessment. Comorbidity was scored by Charlson comorbidity index (CCI). Physical activity was assessed by self-administered tool leisure time physical activity (LTPA).

Results: At linear univariate regression analysis cIMT waspositively associated with age (β = 0.09, 95% CI : 0.04, –0.15; P = 0.008), calculated LDL cholesterol level (β = 0.09, 95% CI : 0.03, 0.14; P = 0.003) and HOMA-index (β = 0.03, 95% CI : 0.001, 0.06; P = 0.04). An inverse association were found between cIMT and TT serum levels (β = −0.04, 95% CI : –0.06, –0.15; P = 0.001). Multivariate regression analysis, with variables identified at previous analysis, demonstrated that only TT levels were independently associatedto cIMT(β = −0.03, 95% CI : –0.04, –0.009; P = 0.009). SCI men with androgen deficiency (TT < 303 ng/dl) showed an higher value of the cIMT (0.15; 25–75th : 0.12–0.24) compared to SCI men with normal androgen status (0.12, 25–75th :0.09, 0.16; P = 0.03). In our group, an inverse correlation was found between TT and cIMT (r = −0.52; P = 0.003).

Discussion: The relationship between androgen levels and CVD is still debated in the general population. Although, weak evidence suggested that hypogonadal able-walking men were at increased risk to develop CVD, less is known about potential putative association between endogenous testosterone and cardiovascular risk in SCI patients.

Conclusion: Lower TT levels were independently associated to higher burden of cIMT in male suffering from chronic spinal cord injury.