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Testosterone Levels Among Men with Spinal Cord Injury: Relationship Between Time Since Injury and Laboratory Values

Clark, Mary J. RN, MPH; Schopp, Laura H. PhD; Mazurek, Micah O. PhD; Zaniletti, Isabella MA; Lammy, Andrew B. BA, MA; Martin, Thomas A. PsyD; Thomas, Florian P. MD, MA, PhD, Faan; Acuff, Michael E. MD

American Journal of Physical Medicine & Rehabilitation: September 2008 - Volume 87 - Issue 9 - p 758-767
doi: 10.1097/PHM.0b013e3181837f4f
CME Article • 2008 Series • Number 7: SCI
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Clark MJ, Schopp LH, Mazurek MO, Zaniletti I, Lammy AB, Martin TA, Thomas FP, Acuff ME: Testosterone levels among men with spinal cord injury: relationship between time since injury and laboratory values. Am J Phys Med Rehabil 2008;87:758–767

Objectives: The objectives of the present study were to determine the prevalence of low testosterone among a sample of men with spinal cord injury and to examine the relationship among testosterone, time since injury, and select laboratory values.

Design: Participants were 102 men with spinal cord injury participating in inpatient or outpatient rehabilitation. Data included total serum testosterone level, demographic and injury information, and laboratory values.

Results: Sixty percent of men with spinal cord injury had low testosterone levels. The median testosterone level for the entire sample was 220 ng/dl (normal reference range = 241–827 ng/dl). Low testosterone was significantly associated with less time since injury, lower hemoglobin, and higher prolactin in the univariate analyses at P < 0.05.

Conclusions: The results indicate that men with spinal cord injury are at risk for low serum testosterone. Testosterone levels were also related to time since injury and hemoglobin and prolactin levels. These findings suggest the need for changes to occur in clinical practice. Guidelines are needed for when and how often testosterone monitoring should be conducted. Future research should address the pathophysiology of low testosterone and the outcomes of testosterone treatment.

From the Department of Health Psychology (MJC, LHS, TAM); Department of Educational, School and Counseling Psychology (MOM, ABL); Office of Medical Research, University of Missouri, Columbia, Missouri (IZ); Spinal Cord Injury/Dysfunction Service, St. Louis VA Medical Center, and Department of Neurology & Psychiatry, Saint Louis University, St. Louis (FPT); and Department of Physical Medicine and Rehabilitation, University of Missouri, Columbia, Missouri (MEA).

All correspondence and requests for reprints should be addressed to Michael E. Acuff, MD, One Hospital Dr. DC046.00, Columbia, MO 65211.

This work was supported by funds from the University of Missouri System Spinal Cord Injuries Research Program and the National Institute on Disability and Rehabilitation Research in the Office of Special Education and Rehabilitative Services in the U.S. Department of Education (grant H133N000012). The opinions expressed in this article are those of the authors and do not necessarily reflect those of the U.S. Department of Education.

© 2008 Lippincott Williams & Wilkins, Inc.