title: Prevalence and Etiology of Hypogonadism in Young Men With Chronic Spinal Cord Injury: A Cross-Sectional Analysis From Two University-Based Rehabilitation Centers.
abstract: BACKGROUND
  Spinal cord injury (SCI) triggers an "accelerated aging" process that may include development of hypogonadism, even among younger men with SCI; however, few studies have investigated the prevalence or etiology of hypogonadism in men with SCI. Young men with SCI also are at increased risk for developing metabolic dysfunction after injury, which may be exacerbated by concomitant testosterone (T) deficiency, thus identifying the prevalence and risk factors for T deficiency in men with SCI is important for their long-term health.
  
  
  OBJECTIVE
  To investigate the prevalence, risk factors, and etiology of T deficiency (hypogonadism) in otherwise-healthy men with chronic, motor complete SCI.
  
  
  METHODS
  Secondary cross-sectional analysis.
  
  
  METHODS
  Rehabilitation research centers in Washington, DC, and Miami, Florida.
  
  
  METHODS
  Men (n = 58) aged 18-45 years with chronic (≥1 year), motor complete SCI without comorbidities or use of testosterone therapy.
  
  
  METHODS
  Plasma concentrations of hormones were measured with standardized assays. Body composition was assessed with dual-energy x-ray absorptiometry scan.
  
  
  METHODS
  Serum total T and calculated free T.
  
  
  RESULTS
  T deficiency was more common in men after SCI than in a matched cohort of similarly-aged men without SCI (25%, SCI versus 6.7%, non-SCI, P < .001). The risk of hypogonadism appeared to be increased in men with more extensive injury and with higher percent body fat. The majority of men with SCI with low T had low serum LH levels, suggesting that central suppression of the hypothalamic-pituitary-gonadal axis may be the most common etiology of hypogonadism after SCI.
  
  
  CONCLUSIONS
  Hypogonadism is more common in young men with SCI than in similarly aged men without SCI, suggesting that SCI should be identified as a risk factor for T deficiency and that routine screening for hypogonadism should be performed in the SCI population.
  
  
  METHODS
  II.
authors.affiliation: Center for Drug Evaluation and Research, US Food and Drug Administration, 10903 New Hampshire Ave, Building 22, Room 3373, Silver Spring, MD 20993(∗). Electronic address: Shannon.sullivan@fda.hhs.gov.
authors.forename: Shannon D
authors.initials: SD
authors.lastname: Sullivan
authors.affiliation: Departments of Neurological Surgery and Rehabilitation Medicine, University of Miami Miller School of Medicine, Miami, FL(†).
authors.forename: Mark S
authors.initials: MS
authors.lastname: Nash
authors.affiliation: Department of Biostatistics and Bioinformatics, Medstar Health Research Institute, Hyattsville, MD(‡).
authors.forename: Eshetu
authors.initials: E
authors.lastname: Tefera
authors.affiliation: Department of Rehabilitation Medicine, Medstar National Rehabilitation Hospital, Washington, DC(§).
authors.forename: Emily
authors.initials: E
authors.lastname: Tinsley
authors.affiliation: Research Service, Washington, DC VA Medical Center, Washington, DC; Departments of Medicine and Rehabilitation Medicine, Georgetown University School of Medicine, Washington, DC; Departments of Medicine, Biochemistry and Molecular Medicine, George Washington University School of Medicine, Washington, DC(¶).
authors.forename: Marc R
authors.initials: MR
authors.lastname: Blackman
authors.affiliation: Department of Rehabilitation Medicine, Medstar National Rehabilitation Hospital, Washington, DC; Department of Rehabilitation Medicine, Medstar Georgetown University Hospital, Washington, DC(#).
authors.forename: Suzanne
authors.initials: S
authors.lastname: Groah
mesh_terms: D000328:Adult; D017677:Age Distribution; D003430:Cross-Sectional Studies; D005500:Follow-Up Studies; D006801:Humans; D007006:Hypogonadism / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation; D015995:Prevalence; D011782:Quadriplegia / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation; D012047:Rehabilitation Centers; D018570:Risk Assessment; D013119:Spinal Cord Injuries / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation; D013739:Testosterone / Q000378:metabolism; D055815:Young Adult
chemical_list: D013739:Testosterone