Testosterone Affects MS Outcomes in Men - Multiple Sclerosis (MS) Information, and resources

This report is part of a 12-month Clinical Context series.

By Cole Petrochko, Staff Writer, MedPage Today

Published: March 21, 2013

Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

SAN DIEGO — A higher testosterone level was associated with less disability and better cognitive outcomes in patients with recent-onset relapsing remitting multiple sclerosis, researchers reported here.

Male MS patients had a significant negative association between testosterone levels and leptin (R=-0.22, P=0.029), as well as between androgen index and vitamin D (R=-0.248, P=0.012), according to Riley Bove, MD, of Brigham and Women’s Hospital in Boston, Mass., and colleagues.

After adjusting for patient age and disease duration, leptin levels were also significantly associated with disability scores (R=0.24, P=0.017), Bove said during a poster session at the American Academy of Neurology meeting.

Bove noted that a patient’s sex influences MS disease risk and course, which may be affected by hormonal differences, as well as metabolism and vitamin D.

Prior research has shown that testosterone may be neuroprotective and anti-inflammatory, but levels of the hormone may be lower in MS patients than in healthy controls, Bove said.

To explore the issue, the researchers analyzed testosterone associations early in the MS course using a sample of 100 male patients with relapsing-remitting MS who were enrolled in the CLIMB (Comprehensive Longitudinal Investigations of MS at the Brigham and Women’s Hospital) study.

At baseline, participants were ages 18 to 65 with a mean age of 39.4, had a mean body mass index (BMI) of 28.8, mean disease duration of 4.55 years, mean expanded disability status scale scores of 1.08, and were in the 94th percentile of disease category. Most participants (95 of the 100) were white.

The research team recorded patient demographic characteristics and MS history. They assessed hormone levels from stored serum and plasma at baseline and over 30 days after steroid use, and included measures of leptin, luteinizing hormone, testosterone, and androgen, as well as vitamin D.

Participants also underwent tests for disability and cognitive status. Cognitive status was measured through the Symbol Digit Modalities Test.

In addition to effects on disability, higher testosterone was significantly associated with less cognitive decline (P=0.007).

Higher testosterone was predictive of smaller 2-year declines in cognitive function, and vitamin D levels were not associated with disability.

The researchers also pointed out a “high prevalence of hypogonadism in men with MS early in their disease course (41% with testosterone lower than 300 ng/dL).”

They acknowledged that their research was limited by a short study period, and that future studies should replicate the current study’s tests over a longer time span with a longitudinal assessment of hormonal changes.

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