Wednesday, 20 August 2014

Low Testicular functionincreases your risk of MS

Pakpoor J, Goldacre R, Schmierer K, Giovannoni G, Goldacre MJ.
Testicular hypofunction and multiple sclerosis risk: A record-linkage study. Ann Neurol. 2014. doi: 10.1002/ana.24250. [Epub ahead of print]

The influence of gonadal hormones on multiple sclerosis is not well characterised and has thus far been investigated primarily in animal models or as a proposed therapeutic approach. We investigated a potential association between testicular hypofunction, as a proxy for low testosterone levels, and multiple sclerosis risk through analysis of linked English national Hospital Episode Statistics from 1999 to 2011. We report a strong positive association between testicular hypofunction and subsequent multiple sclerosis, rate ratio 4.62 (95% confidence interval 2.3-8.24, p<0.0001). Future work should aim more directly to elucidate the relationship between testosterone levels and MS in both males and females.


It has been shown in EAE that sex hormones can influence susceptibility to autoimmunity and it is very clear that sex is a risk factor for MS,with a ratio of about 2:1-5:1 females to males affected. The ProfG put on his mining hat and went off to Oxford to search health records...or should I say Julia did the slog and looked at the relationship between low testis function, which probably means low sperm count, that may relate to lower balance of female to male sex hormones.  It was found that you were about 4-5 times more likely to get MS if you had low testicular function. It does not mean that if you are a male with MS that you have a low sperm count. 
Does this equate to actual testosterone levels. Seems like a new project....surely the US military measure testosterone of their boys so should be simple to do. However even simplery stick "testosterone and multiple sclerosis" and pubmed.


OBJECTIVE: To assess the prevalence and clinical associations of hypogonadism in men with MS.
METHODS: Male patients, aged 18-65 years, with relapsing-remitting MS (RRMS) or clinically-isolated syndrome (CIS) and their first symptom < 10 years prior were selected from a longitudinal clinical study. We measured their hormones in stored morning blood samples, and collected their Expanded Disability Status Scale (EDSS) scores every 6 months and their Symbol Digit Modalities Test (SDMT) results annually.
RESULTS:
Our analysis included 96 men with a mean age of 40 years, EDSS of 1.1 and disease duration of 4.6 years. Of these men, 39% were hypogonadal (total testosterone < 288 ng/dL); none showed compensatory elevations in luteinizing hormone. Their low testosterone levels and testosterone:estradiol ratios were negatively correlated with body mass index (BMI) and leptin, and showed no correlation with 25-hydroxy-vitamin D levels. In our primary cross-sectional analyses, there was a negative age-adjusted correlation between total testosterone and EDSS (p = 0.044). In the age-adjusted longitudinal analyses, higher baseline testosterone levels were associated with less decline in SDMT (p = 0.012).
CONCLUSIONS: Men with MS may experience hypogonadotropic hypogonadism. Low testosterone levels may be associated with worse clinical outcomes. 

See ProfGs comments on this one. Proving cause and effect is an issue


CoI: Study performed by TeamG

1 comment:

  1. Is it posible that ms produce testicular hypofunction lesion on brain etc , or viruses witch lead to ms , chicken or egg question ?

    ReplyDelete

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