1 Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City.
2 Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei.
Am J Mens Health. 2019 May-Jun;13(3):1557988319847097. doi: 10.1177/1557988319847097.
The current study aimed to investigate whether low testosterone predicted the recurrence and clinical outcomes after acute ischemic stroke (AIS) in males. From June 2015 through August 2017, the study prospectively enrolled 110 male AIS patients. All received detailed evaluations at admission and were followed for at least 1 year. The cumulative incidence, overall survival, length of hospital stay, and the percentage of previous stroke were compared between subjects with testosterone <440 ng/dl and >440 ng/dl. The median age was 62 years (range, 35-93 years). The median serum testosterone at admission was 438 [203] ng/dl (range, 44-816 ng/dl); 55 patients (50%) had testosterone <440 ng/dl and were considered as low testosterone. The median follow-up was 23 months. During the period, 12 recurrences and 10 deaths occurred. The 1-year and 3-year cumulative recurrence rate were 8.3% and 11.9%, respectively; the 1-year and 3-year overall survival were 96.3% and 84.6%, respectively. The cumulative recurrence rates were similar between the two testosterone groups (log-rank test, p = .88). Low testosterone was associated with poor survival with marginal significance (log-rank test, p = .079). Men with low testosterone had a higher percentage of previous stroke (29.1% versus 12.7%, p = .035). The mean lengths of hospital stay were similar between the two testosterone groups (16.6 ± 15.8 days versus 14.0 ± 10.6, p = .31). Total testosterone at admission fails to predict stroke recurrence. However, men with low testosterone at admission are more likely to have previous stroke and may have a higher all-cause mortality rate after AIS.
本研究旨在探讨男性急性缺血性脑卒中（AIS）后低睾酮是否预测复发和临床结局。2015 年 6 月至 2017 年 8 月，前瞻性纳入 110 例男性 AIS 患者。所有患者在入院时均接受详细评估，并至少随访 1 年。比较睾酮＜440ng/dl 和＞440ng/dl 患者的累积复发率、总生存率、住院时间和既往卒中比例。中位年龄为 62 岁（范围，35-93 岁）。入院时中位血清睾酮为 438[203]ng/dl（范围，44-816ng/dl）；55 例（50%）患者睾酮＜440ng/dl，被认为是低睾酮。中位随访时间为 23 个月。在此期间，发生 12 例复发和 10 例死亡。1 年和 3 年累积复发率分别为 8.3%和 11.9%，1 年和 3 年总生存率分别为 96.3%和 84.6%。两组累积复发率相似（log-rank 检验，p=.88）。低睾酮与生存不良相关，但差异无统计学意义（log-rank 检验，p=.079）。低睾酮组既往卒中比例较高（29.1%比 12.7%，p=.035）。两组住院时间的平均值相似（16.6±15.8 天比 14.0±10.6 天，p=.31）。入院时总睾酮不能预测卒中复发。然而，入院时低睾酮的男性更有可能发生既往卒中，并且在发生 AIS 后全因死亡率可能更高。
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