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Research article
Kee Ook Lee
CHA Bundang Medical Center
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6105-1085
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Sex hormones may be associated with a higher incidence of ischemic stroke or stroke-related events. In observational studies, lower testosterone concentrations are associated with infirmity, vascular disease, and adverse cardiovascular risk factors. Currently, female sexual hormones are considered neuroprotective agents. The purpose of this study was to assess the role of sex hormones and the ratio of estradiol/testosterone (E/T) in patients with acute ischemic stroke (AIS).
Methods: Between January 2011 and December 2016, 146 male patients with AIS and 152 age- and sex-matched control subjects were included in this study. Sex hormones, including estradiol, progesterone, and testosterone, were evaluated in the AIS patient and control groups. We analyzed the clinical and physiological levels of sex hormones and hormone ratios in these patients.
Results: The E/T ratio was significantly elevated among patients in the stroke group compared to those in the control group (P = 0.001). Categorization of data into tertiles revealed that patients with the highest E/T ratio were more likely to have AIS [odds ratio (OR) 3.084; 95% Confidence interval (CI): 1.616-5.886; P < 0.001) compared with those in the first tertile. The E/T ratio was also an independent unfavorable outcome predictor with an adjusted OR of 1.167 (95% CI: 1.053-1.294; P = 0.003).
Conclusions: These findings support the hypothesis that increased estradiol and reduced testosterone levels are associated with AIS in men.
Keywords
sex hormones, estradiol/testosterone ratio, acute ischemic stroke, functional outcome, men
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View the published article at BMC Neurology.
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Editorial decision: Minor revision
On 03 Feb, 2021
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On 15 Nov, 2020
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Editorial decision: Minor revision
On 01 Nov, 2020
Review #1 received
Received 18 Oct, 2020
Reviewer #1 agreed
On 15 Oct, 2020
Reviewers invited
Invitations sent on 12 Oct, 2020
Editor assigned
On 05 Oct, 2020
Submission checks complete
On 04 Oct, 2020
Editor invited
On 04 Oct, 2020
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Editorial decision: Minor revision
On 21 Sep, 2020
Review #2 received
Received 20 Sep, 2020
Editor assigned
On 10 Sep, 2020
Reviewers invited
Invitations sent on 10 Sep, 2020
Reviewer #1 agreed
On 10 Sep, 2020
Reviewer #2 agreed
On 10 Sep, 2020
Review #1 received
Received 10 Sep, 2020
Submission checks complete
On 09 Sep, 2020
Editor invited
On 09 Sep, 2020
No comments provided
Editorial decision: Major revision
On 10 Aug, 2020
Review #2 received
Received 09 Aug, 2020
Reviewer #2 agreed
On 18 Jul, 2020
Reviewers invited
Invitations sent on 09 Jun, 2020
Reviewer #1 agreed
On 09 Jun, 2020
Review #1 received
Received 09 Jun, 2020
Editor assigned
On 04 Jun, 2020
First submitted
On 03 Jun, 2020
Submission checks complete
On 03 Jun, 2020
Editor invited
On 03 Jun, 2020
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Subject Areas
Neurosurgery
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See the published version of this preprint at BMC Neurology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Kee Ook Lee
CHA Bundang Medical Center
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6105-1085
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Neurology.
Version 4
Posted 03 Dec, 2020
No community comments so far
Editorial decision: Minor revision
On 03 Feb, 2021
Editor assigned
On 15 Nov, 2020
Submission checks complete
On 15 Nov, 2020
Editor invited
On 15 Nov, 2020
No comments provided
Editorial decision: Minor revision
On 01 Nov, 2020
Review #1 received
Received 18 Oct, 2020
Reviewer #1 agreed
On 15 Oct, 2020
Reviewers invited
Invitations sent on 12 Oct, 2020
Editor assigned
On 05 Oct, 2020
Submission checks complete
On 04 Oct, 2020
Editor invited
On 04 Oct, 2020
No comments provided
Editorial decision: Minor revision
On 21 Sep, 2020
Review #2 received
Received 20 Sep, 2020
Editor assigned
On 10 Sep, 2020
Reviewers invited
Invitations sent on 10 Sep, 2020
Reviewer #1 agreed
On 10 Sep, 2020
Reviewer #2 agreed
On 10 Sep, 2020
Review #1 received
Received 10 Sep, 2020
Submission checks complete
On 09 Sep, 2020
Editor invited
On 09 Sep, 2020
No comments provided
Editorial decision: Major revision
On 10 Aug, 2020
Review #2 received
Received 09 Aug, 2020
Reviewer #2 agreed
On 18 Jul, 2020
Reviewers invited
Invitations sent on 09 Jun, 2020
Reviewer #1 agreed
On 09 Jun, 2020
Review #1 received
Received 09 Jun, 2020
Editor assigned
On 04 Jun, 2020
First submitted
On 03 Jun, 2020
Submission checks complete
On 03 Jun, 2020
Editor invited
On 03 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Neurosurgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Neurology.
Background: Sex hormones may be associated with a higher incidence of ischemic stroke or stroke-related events. In observational studies, lower testosterone concentrations are associated with infirmity, vascular disease, and adverse cardiovascular risk factors. Currently, female sexual hormones are considered neuroprotective agents. The purpose of this study was to assess the role of sex hormones and the ratio of estradiol/testosterone (E/T) in patients with acute ischemic stroke (AIS).
Methods: Between January 2011 and December 2016, 146 male patients with AIS and 152 age- and sex-matched control subjects were included in this study. Sex hormones, including estradiol, progesterone, and testosterone, were evaluated in the AIS patient and control groups. We analyzed the clinical and physiological levels of sex hormones and hormone ratios in these patients.
Results: The E/T ratio was significantly elevated among patients in the stroke group compared to those in the control group (P = 0.001). Categorization of data into tertiles revealed that patients with the highest E/T ratio were more likely to have AIS [odds ratio (OR) 3.084; 95% Confidence interval (CI): 1.616-5.886; P < 0.001) compared with those in the first tertile. The E/T ratio was also an independent unfavorable outcome predictor with an adjusted OR of 1.167 (95% CI: 1.053-1.294; P = 0.003).
Conclusions: These findings support the hypothesis that increased estradiol and reduced testosterone levels are associated with AIS in men.
Figure 1
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