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This study examined plasma levels of biologically active sex hormones and their association with ALS odds and survival in cases (females\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009131, males\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009189) and controls (females\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009138, males\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009150) from the University of Michigan Pranger ALS Clinic. Higher 11\u2010ketotestosterone levels were associated with increased ALS odds. In females, higher estrone, androstenedione, and 11\u2010hydroxyandrostenedione were associated with increased ALS odds, while elevated estrone and estradiol predicted shorter survival. These findings highlight the potential significance of sex hormones in ALS.\n                  <\/jats:p>","DOI":"10.1002\/acn3.70281","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T03:39:38Z","timestamp":1766115578000},"page":"612-617","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Sex Hormones Associate With Amyotrophic Lateral Sclerosis Risk and Survival"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8780-6637","authenticated-orcid":false,"given":"Stephen A.","family":"Goutman","sequence":"first","affiliation":[{"name":"Department of Neurology University of Michigan  Ann Arbor Michigan USA"},{"name":"NeuroNetwork for Emerging Therapies University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9453-8819","authenticated-orcid":false,"given":"David G.","family":"Stouffer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7966-1322","authenticated-orcid":false,"given":"Dae\u2010Gyu","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Michigan  Ann Arbor Michigan USA"},{"name":"NeuroNetwork for Emerging Therapies University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jihyun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Michigan  Ann Arbor Michigan USA"},{"name":"NeuroNetwork for Emerging Therapies University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3543-4007","authenticated-orcid":false,"given":"Benjamin J.","family":"Murdock","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Michigan  Ann Arbor Michigan USA"},{"name":"NeuroNetwork for Emerging Therapies University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6815-6181","authenticated-orcid":false,"given":"Richard J.","family":"Auchus","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes University of Michigan  Ann Arbor Michigan USA"},{"name":"Department of Pharmacology University of Michigan  Ann Arbor Michigan USA"},{"name":"Endocrinology and Metabolism Section, Medicine Service, LTC Charles S. Kettles Veterans Affairs Medical Center  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-023-00867-2"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01272-7"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00414-2"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00465-8"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004390"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-012-6665-5"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000200241"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsbmb.2025.106717"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-020-0336-x"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgaa343"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2020.05.008"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(01)00688-8"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-1864"},{"issue":"4","key":"e_1_2_10_15_1","first-page":"22","article-title":"Correlation of Testosterone Levels With Progression of Amyotrophic Lateral Sclerosis: A Cross Section Study","volume":"37","author":"Sane H.","year":"2019","journal-title":"Advance Research Journal of Multidisciplinary Discoveries"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1371891"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880181222"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.33549\/physiolres.934516"},{"key":"e_1_2_10_19_1","first-page":"1","article-title":"Identifying Potential Targets for Prevention and Treatment of Amyotrophic Lateral Sclerosis Based on a Screen of Medicare Prescription Drugs","volume":"21","author":"Pfeiffer R. 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