Compensated Hypogonadism Identified in Males with Cluster Headache: A Prospective Case-Controlled Study.
Ann Neurol
; 95(6): 1149-1161, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38558306
ABSTRACT
OBJECTIVE:
Androgens have been hypothesized to be involved in the pathophysiology of cluster headache due to the male predominance, but whether androgens are altered in patients with cluster headache remains unclear.METHODS:
We performed a prospective, case-controlled study in adult males with cluster headache. Sera were measured for hormones including testosterone, luteinizing hormone (LH), and sex hormone-binding globulin in 60 participants with episodic cluster headache (during a bout and in remission), 60 participants with chronic cluster headache, and 60 age- and sex-matched healthy controls. Free testosterone (fT) was calculated according to the Vermeulen equation. Shared genetic risk variants were assessed between cluster headache and testosterone concentrations.RESULTS:
The mean fT/LH ratio was reduced by 35% (95% confidence interval [CI] 21%-47%, p < 0.0001) in patients with chronic cluster headache and by 24% (95% CI 9%-37%, p = 0.004) in patients with episodic cluster headache compared to controls after adjusting for age, sleep duration, and use of acute medication. Androgen concentrations did not differ between bouts and remissions. Furthermore, a shared genetic risk allele, rs112572874 (located in the intron of the microtubule associated protein tau (MAPT) gene on chromosome 17), between fT and cluster headache was identified.INTERPRETATION:
Our results demonstrate that the male endocrine system is altered in patients with cluster headache to a state of compensated hypogonadism, and this is not an epiphenomenon associated with sleep or the use of acute medication. Together with the identified shared genetic risk allele, this may suggest a pathophysiological link between cluster headache and fT. ANN NEUROL 2024;951149-1161.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Testosterona
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Hormônio Luteinizante
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Cefaleia Histamínica
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Hipogonadismo
Limite:
Adult
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article