Role of endogenous testosterone concentration in pediatric stroke.
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Ann Neurol. 2009 Dec;66(6):754-8
Authors: Normann S, de Veber G, Fobker M, Langer C, Kenet G, Bernard TJ, Fiedler B, Sträter R, Goldenberg NA, Nowak-Göttl U
Previous studies have indicated a male predominance in pediatric stroke.
To elucidate this gender disparity, total testosterone concentration was measured in children with arterial ischemic stroke (AIS; n = 72), children with cerebral sinovenous thrombosis (CSVT; n = 52), and 109 healthy controls.
Testosterone levels above the 90th percentile for age and gender were documented in 10 children with AIS (13.9%) and 10 with CSVT (19.2%), totaling 16.7% of patients with cerebral thromboembolism overall, as compared with only 2 of 109 controls (1.8%; p = 0.002).
In multivariate analysis with adjustment for total cholesterol level, hematocrit, and pubertal status, elevated testosterone was independently associated with increased disease risk (odds ratio [95% confidence interval]: overall = 3.98 [1.38-11.45]; AIS = 3.88 [1.13-13.35]; CSVT = 5.50 [1.65-18.32]).
Further adjusted analyses revealed that, for each 1nmol/l increase in testosterone in boys, the odds of cerebral thromboembolism were increased 1.3-fold.
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Testosterone, Estrogens, Progesterone, DHEA have some effect on blood clotting – estradiol in particular. Estradiol has many metabolic routes of formation from precursors such as testosterone and DHEA. Estradiol is measured preferably by the brain over testosterone in determining testosterone production. I wished they measured other reproductive hormones as well. For example, did the children with testosterone levels in the 90th percentile also have high estradiol level – thus increasiing the risk for stroke?