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Clinical impact of estradiol/testosterone ratio in patients with acute ischemic stroke

 Jung-Won Choi  ;  In Woo Ryoo  ;  Jun Yeong Hong  ;  Kyung-Yul Lee  ;  Hyo Suk Nam  ;  Won Chan Kim  ;  Seung-Hun Oh  ;  Jaeku Kang  ;  Hoi Young Lee  ;  Sang-Jun Na  ;  Ji Hoe Heo  ;  Kee Ook Lee 
 BMC NEUROLOGY, Vol.21(1) : 91, 2021-02 
Journal Title
Issue Date
Aged ; Estradiol / blood* ; Humans ; Incidence ; Ischemic Stroke / blood* ; Ischemic Stroke / epidemiology ; Male ; Middle Aged ; Odds Ratio ; Prospective Studies ; Testosterone / blood
Acute ischemic stroke ; Functional outcome ; Men ; Sex hormones ; estradiol/testosterone ratio
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.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Lee, Kyung Yul(이경열) ORCID logo https://orcid.org/0000-0001-5585-7739
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
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