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. 2014 Oct;20(12):1584-92.
doi: 10.1177/1352458514527864. Epub 2014 Apr 7.

Low testosterone is associated with disability in men with multiple sclerosis

R Bove  1 , A Musallam  2 , B C Healy  3 , K Raghavan  4 , B I Glanz  5 , R Bakshi  5 , H Weiner  1 , P L De Jager  1 , K K Miller  6 , T Chitnis  7
Affiliations

Low testosterone is associated with disability in men with multiple sclerosis

R Bove et al. Mult Scler. 2014 Oct.

Abstract

Background: Gonadal steroids may modulate disease course in multiple sclerosis (MS).

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. A potential neuroprotective role for testosterone warrants further investigation.

Keywords: Body mass index; cognition; cognitive impairment; disability; hormones; hypogonadism; leptin; multiple sclerosis; testosterone.

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