title: Relationship between sex hormones and cognitive performance in men with substance use.
abstract: BACKGROUND
  Hypogonadism is common with opiate-like drug use and may contribute to cognitive abnormalities. With the increasing epidemic of HIV and substance use (SU) worldwide, it is important to understand the impact of these conditions on cognition, which may affect quality of life and possibly decrease adherence to treatment. We hypothesized that men with SU, by virtue of hypogonadism secondary to HIV and/or SU, may demonstrate impaired cognition.
  
  
  METHODS
  We recruited men aged 18-50 from a population of low income, inner-city individuals. Details of HIV and SU status, serum blood levels of total testosterone (TT), free testosterone (FT) and estradiol (E2) were assessed. All subjects were administered ten neuropsychological tests.
  
  
  RESULTS
  Our sample consisted of 68 men (mean age: 43.2 years (SD 5.8), African Americans: 86.6%). The recruited population was primarily from low socioeconomic status and unemployed. The mean level of TT was 553.9 ng/dL (SD 262.0), the mean level of FT was 69.5 pg/mL (SD 34.8), mean E2 was 3.2 pg/mL (SD 4.4). We found that 30.9% were hypogonadal 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, HIV, there was no statistically significant correlation between cognitive performance and sex hormone levels.
  
  
  CONCLUSIONS
  In this cross-sectional study of men with a high prevalence of SU and hypogonadism, endogenous levels of TT, FT or E2 were not related to cognitive performance. Other factors need to be identified which may contribute to poor cognitive function in the setting of SU.
authors.affiliation: Program on Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Building 10/CRC 1-3140, 10 Center Drive, Bethesda, MD 20892-1109, USA.
authors.forename: Mihail F
authors.initials: MF
authors.lastname: Zilbermint
authors.forename: Amy B
authors.initials: AB
authors.lastname: Wisniewski
authors.forename: Xiaoqiang
authors.initials: X
authors.lastname: Xu
authors.forename: Ola A
authors.initials: OA
authors.lastname: Selnes
authors.forename: Adrian S
authors.initials: AS
authors.lastname: Dobs
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D002853:Chromatography, Liquid / Q000379:methods; D003071:Cognition / Q000187:drug effects* / Q000502:physiology; D003430:Cross-Sectional Studies; D004958:Estradiol / Q000097:blood*; D015658:HIV Infections / Q000097:blood*; D006801:Humans; D007006:Hypogonadism / Q000097:blood*; D008297:Male; D013058:Mass Spectrometry / Q000379:methods; D008875:Middle Aged; D009483:Neuropsychological Tests; D011203:Poverty; D019966:Substance-Related Disorders / Q000097:blood* / Q000523:psychology; D013739:Testosterone / Q000097:blood*; D014505:Urban Population
chemical_list: D013739:Testosterone; D004958:Estradiol