title: Association of sex hormones and glucose metabolism with the severity of multiple sclerosis.
abstract: OBJECTIVE
  We evaluated possible associations between the severity of multiple sclerosis (MS) and levels of sex hormones as well as biochemical parameters in a sample of ambulatory patients.
  
  
  METHODS
  This cross-sectional study recruited 133 adults (52 men, 66 premenopausal and 15 postmenopausal women), with relapsing-remitting MS. Fasting venous blood samples were drawn for biochemical and hormonal evaluation. These parameters were tested for possible associations with MS severity, assessed using the Expanded Disability Status Scale (EDSS)-scores.
  
  
  RESULTS
  Follicle-stimulating hormone correlated with mean EDSS scores (r = -0.369, p = 0.038) in the premenopausal subgroup. However, this association became non-significant in the age-adjusted multivariate analysis (p = 0.141; power = 67%, type α error 0.10). Free androgen exhibited a borderline negative effect on EDSS-scores in the subgroup of men (r = -0.367, p = 0.093), which was lost after adjusting for age and duration of disease (p = 0.192; statistical power = 93%, type α error 0.05). Levels of estradiol tended to affect disability status of postmenopausal women (normal-mild vs. severe impairment: 23.33 ± 11.73pg/mL vs. 14.74 ± 6.30pg/mL, p = 0.095). Levels of sex hormones or indices of glycemic metabolism did not differ between patients presenting with EDSS scores higher or lower than the median value.
  
  
  CONCLUSIONS
  Sex hormones and indices of glucose metabolism exhibited only a middle effect on EDSS scoring, which was not independent from the presence of confounders like age and duration of MS. The present study highlights the need for additional research, in order to elucidate the role of sex hormones and insulin resistance in the course of MS.
authors.affiliation: a 1 1st Department of Neurology , University of Athens , Aiginiteio Hospital, Athens , Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Triantafyllou
authors.affiliation: b 2 2nd Department of Obstetrics and Gynecology , University of Athens , Aretaieio Hospital, Athens , Greece.
authors.forename: Pinelopi
authors.initials: P
authors.lastname: Thoda
authors.affiliation: b 2 2nd Department of Obstetrics and Gynecology , University of Athens , Aretaieio Hospital, Athens , Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Armeni
authors.affiliation: c 3 Hormonal and Biochemical Laboratory , University of Athens , Aretaieio Hospital, Athens , Greece.
authors.forename: Demetrios
authors.initials: D
authors.lastname: Rizos
authors.affiliation: c 3 Hormonal and Biochemical Laboratory , University of Athens , Aretaieio Hospital, Athens , Greece.
authors.forename: George
authors.initials: G
authors.lastname: Kaparos
authors.affiliation: b 2 2nd Department of Obstetrics and Gynecology , University of Athens , Aretaieio Hospital, Athens , Greece.
authors.forename: Areti
authors.initials: A
authors.lastname: Augoulea
authors.affiliation: b 2 2nd Department of Obstetrics and Gynecology , University of Athens , Aretaieio Hospital, Athens , Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Alexandrou
authors.affiliation: b 2 2nd Department of Obstetrics and Gynecology , University of Athens , Aretaieio Hospital, Athens , Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Creatsa
authors.affiliation: d 4 2nd Department of Neurology , University of Athens , Attiko Hospital, Athens , Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Tsivgoulis
authors.affiliation: a 1 1st Department of Neurology , University of Athens , Aiginiteio Hospital, Athens , Greece.
authors.forename: Artemios
authors.initials: A
authors.lastname: Artemiades
authors.affiliation: b 2 2nd Department of Obstetrics and Gynecology , University of Athens , Aretaieio Hospital, Athens , Greece.
authors.forename: Constantinos
authors.initials: C
authors.lastname: Panoulis
authors.affiliation: b 2 2nd Department of Obstetrics and Gynecology , University of Athens , Aretaieio Hospital, Athens , Greece.
authors.forename: Irene
authors.initials: I
authors.lastname: Lambrinoudaki
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000097:blood* / Q000503:physiopathology*; D017698:Postmenopause / Q000378:metabolism; D017697:Premenopause / Q000378:metabolism; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D012739:Gonadal Steroid Hormones
keywords: EDSS; glucose metabolism; relapsing-remitting multiple sclerosis; sex hormones