Role of endogenous testosterone concentration in pediatric stroke

• Published in: Annals of neurology Vol. 66; no. 6; pp. 754 - 758
• Main Authors: Normann, Sandra, de Veber, Gabrielle, Fobker, Manfred, Langer, Claus, Kenet, Gili, Bernard, Timothy J., Fiedler, Barbara, Sträter, Ronald, Goldenberg, Neil A., Nowak-Göttl, Ulrike
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.12.2009; Wiley-Liss
• Subjects: Adolescent; Age Factors; Biological and medical sciences; Child; Child, Preschool; Cholesterol - blood; Cholesterol - cerebrospinal fluid; Female; Hematocrit - methods; Humans; Infant; Infant, Newborn; Male; Medical sciences; Multivariate Analysis; Neurology; Odds Ratio; Pediatrics; Retrospective Studies; Sex Factors; Sinus Thrombosis, Intracranial - blood; Stroke - blood; Testosterone - blood; Vascular diseases and vascular malformations of the nervous system; Human; Pediatrics; Stroke; Nervous system diseases; Androgen; Cardiovascular disease; Cerebral disorder; Vascular disease; Testosterone; Central nervous system disease; Testicular hormone; Sex steroid hormone; Child; Cerebrovascular disease
• ISSN: 0364-5134; 1531-8249; 1531-8249
• DOI: 10.1002/ana.21840

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. Ann Neurol 2009;66:754–758