DECREASED SERUM TESTOSTERONE IN MEN WITH ACUTE ISCHEMIC STROKE

Serum levels of total and free testosterone and 17 beta-estradiol were determined in 144 men with acute ischemic stroke and 47 healthy male control subjects. Blood samples from patients were drawn a mean of 3 d ays after stroke onset and also 6 months after admission in a subgroup of 45 patients. Initial stroke severity was assessed on the Scandinav ian Stroke Scale and infarct size by computed tomographic scan. Mean t otal serum testosterone was 13.8+/-0.5 nmol/L in stroke patients and 1 6.5+/-0.7 nmol/L in control subjects (P=.002); the respective values f or free serum testosterone were 40.8+/-1.3 and 51.0+/-2.2 pmol/L (P=.0 001). Both total and free testosterone were significantly inversely as sociated with stroke severity and 6-month mortality, and total testost erone was significantly inversely associated with infarct size. The di fferences in total and free testosterone levels between patients and c ontrol subjects could not be explained by 10 putative risk factors for stroke, including age, blood pressure, diabetes, ischemic heart disea se, smoking, and atrial fibrillation. Total and free testosterone leve ls tended to normalize 6 months alter the stroke. There was no differe nce between patients and control subjects in serum 17 beta-estradiol l evels. These results support the idea that testosterone affects the pa thogenesis of ischemic stroke in men.