Sažetak | Background: Recent studies have highlighted the potential role of hormonal imbalances in various health conditions, including cardiovascular events. This study investigates the relation-ship between serum hormone levels such as testosterone, in patients diagnosed with TIA. By analyzing hormones and other known biomarkers, this research aims to identify potential en-docrine factors associated with TIA occurrence, contributing to a better understanding of TIA pathogenesis and potentially paving the way for future preventative strategies.
Methods: Fifty patients admitted to the Department of Neurology at the University Hospital Split, Firule in Croatia between 2001 and 2002 were retrospectively included in this study after being stratified for age (older than fifty years) and gender (male). Twenty-five patients who were admitted for TIA were assigned to the TIA group and twenty-five patients who were admitted for a non-TIA/stroke neurological condition were assigned to the control group. The results of their blood samples and ultrasound of both internal carotid arteries were statistically analyzed and compared.
Results: When comparing both patient groups, the median LH levels in the TIA group were significantly lower compared to the control group (U = 159, P = 0.003). A potential inverse correlation was found between progesterone levels and the severity of internal carotid artery stenosis in TIA patients (p(25) = -0.437, P = 0.029). A Spearman correlation performed in the control group between age and hypertension status with atherosclerotic changes was statisti-cally significant, (p(25) = 0.795, P < 0.001) and (p(25) = 0.480, P = 0.015), respectively.
Linear regression analyses revealed, in the control group, HDL showed a positive correlation with testosterone levels (b = 12.52, t(23) = 2.50, P = 0.020). 17OH P, a precursor to testos-terone, positively predicted testosterone levels (b =2.17, t(23) = 3.73, P = 0.001), and proges-terone levels were positively associated with DHEA levels (b = 1.76, t(23) = 2.91, P = 0.008). In the TIA group, a bidirectional correlation was found between DHEA and testosterone. DHEA explained 35% of testosterone variation (R2 = 0.350), and the regression coefficient was significant (b = 1.25, t(23) = 3.52, P = 0.002). Conversely, testosterone explained 35% of DHEA variation (R2 = 0.350), and the regression coefficient was significant (b = 0.281, t(23) = 3.52, P = 0.002).
Conclusion: This study found a significantly lower median LH level in the TIA group com-pared to the control group, potentially due to acute stress and neurological dysfunction. While the study couldn't confirm previous findings of lowered testosterone and DHEA levels post-TIA, it did reveal a bidirectional influence between these hormones in the TIA group, suggest-ing a significant hormonal shift. The study also confirmed existing literature linking older age and hypertension to atherosclerotic changes and demonstrated progesterone's negative influ-ence on severe stenosis of the internal carotid artery in the TIA group, supporting its potential neuroprotective role. Further research is needed to explore the use of LH, DHEA, and testos-terone levels in TIA and stroke screening, monitoring, and recovery. |
Sažetak (hrvatski) | Cilj istraživanja: Nedavne studije istaknule su potencijalnu ulogu hormonske neravnoteže u različitim zdravstvenim stanjima, uključujući kardiovaskularne događaje. Ova studija istražuje odnos između razine hormona u serumu, poput testosterona, u bolesnika s dijagnozom tranzitorne ishemijske atake. Analizom hormona i drugih poznatih biomarkera, ovo istraživanje ima za cilj identificirati potencijalne endokrine čimbenike povezane s pojavom TIA, doprinoseći boljem razumijevanju patogeneze TIA i potencijalno otvarajući put budućim preventivnim strategijama.
Ispitanici i metode: U ovu retrospektivnu studiju uključeno je pedeset pacijenata starijih od pedeset godina, primljenih u Kliniku za neurologiju KBC-a Split, bolnica Firule, između 2001. i 2002. godine. U skupinu s TIA uključeno je dvadeset i pet pacijenata primljenih zbog TIA, a u kontrolnu skupinu dvadeset i pet pacijenata primljenih zbog neuroloških stanja koja nisu TIA/moždani udar. Statistički su analizirani i uspoređeni rezultati njihovih uzoraka krvi i ultrazvuka obje karotidne arterije.
Rezultati: Usporedbom obje skupine pacijenata, medijan razine LH u skupini s TIA bio je značajno niži u usporedbi s kontrolnom skupinom (U = 159, P = 0,003). Pronađena je potencijalna inverzna korelacija između razine progesterona i težine stenoze karotidne arterije u bolesnika s TIA (P = -0,437, P = 0,029). Spearmanova korelacija provedena u kontrolnoj skupini između dobi i hipertenzije s aterosklerotskim promjenama bila je statistički značajna, (P = 0,795, P < 0,001) i (P = 0,480, P = 0,015). Linearna regresijska analiza u kontrolnoj skupini pokazala je pozitivnu korelaciju između HDL-a i razine testosterona (b = 12,52, t = 2,50, P = 0,020). 17OH progesteron, prekursor testosterona, pozitivno je predvidio razinu tes-tosterona (b = 2,17, t = 3,73, P = 0,001), a razina progesterona bila je pozitivno povezana s razinama DHEA (b = 1,76, t = 2,91, P = 0,008). U skupini s TIA pronađena je dvosmjerna korelacija između DHEA i testosterona. DHEA je objasnio 35% varijacije testosterona (R2 = 0,350), a koeficijent regresije bio je značajan (b = 1,25, t = 3,52, P = 0,002). Obrnuto, testos-teron je objasnio 35% varijacije DHEA (R2 = 0,350), a koeficijent regresije bio je značajan (b = 0,281, t = 3,52, P = 0,002). |