{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T14:41:31Z","timestamp":1777732891811,"version":"3.51.4"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,8,18]],"date-time":"2017-08-18T00:00:00Z","timestamp":1503014400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009157","name":"National Institute on Disability, Independent Living, and Rehabilitation Research","doi-asserted-by":"publisher","award":["H133B090002"],"award-info":[{"award-number":["H133B090002"]}],"id":[{"id":"10.13039\/100009157","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006307","name":"Administration for Community Living","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006307","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012737","name":"Department of Health and Human Services, State Government of Victoria","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012737","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011061","name":"American Spinal Injury Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We reported previously that young men with chronic spinal cord injury (SCI) have a greater prevalence of testosterone deficiency compared with an age\u2010matched, healthy control population. Young men with SCI also are at increased risk for developing cardiometabolic dysfunction after injury. It is unclear whether testosterone deficiency is associated with heightened cardiometabolic risk in men with SCI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate associations among levels of testosterone in young men with chronic SCI and surrogate markers of cardiometabolic risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Secondary cross\u2010sectional analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Rehabilitation research centers in Washington, DC, and Miami, Florida.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Men (n = 58) aged 18\u201045 years with chronic (\u22651 year), motor complete SCI without comorbidities or use of testosterone therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Plasma concentrations of testosterone, lipids, inflammatory markers (C\u2010reactive protein and interleukin\u20106), percent hemoglobin A1c, glucose, and insulin were measured in a fasting state using standard assays. A 2\u2010hour oral glucose tolerance test and Framingham Risk Score were assessed for each subject. Body composition was assessed by dual X\u2010ray absorptiometry scan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measurements<\/jats:title><jats:p>Surrogate markers of cardiometabolic risk among men based on the level of total testosterone (TT; \u2264300, 301\u2010500, or &gt;500 ng\/dL) and free testosterone (fT; \u22649 or &gt;9 ng\/dL). Comparisons were made between men with normal and low TT or fT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Framingham Risk Score was significantly greater in men with low fT (<jats:italic>P<\/jats:italic> &lt; .05). Percent body fat (<jats:italic>P<\/jats:italic> &lt; .05) and waist\u2010to\u2010hip ratio (<jats:italic>P<\/jats:italic> &lt; .05) but not body mass index (<jats:italic>P<\/jats:italic> &gt; .08), were greater in men with low TT or low fT. Men with low TT or low fT had lower high\u2010density lipoprotein cholesterol levels (<jats:italic>P<\/jats:italic> &lt; .05) without differences in fasting triglycerides (<jats:italic>P<\/jats:italic> &gt; .1) or low\u2010density lipoprotein cholesterol (<jats:italic>P<\/jats:italic> &gt; .07). Men with low TT had greater levels of inflammatory markers C\u2010reactive protein (<jats:italic>P<\/jats:italic> &lt; .05) and interleukin\u20106 (<jats:italic>P<\/jats:italic> &lt; .05). Men with low TT or low fT had greater fasting glucose (<jats:italic>P<\/jats:italic> &lt; .05) and greater insulin resistance (<jats:italic>P<\/jats:italic> &lt; .04), without differences in percent hemoglobin A1c (<jats:italic>P<\/jats:italic> &gt; .8).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In young men with chronic SCI who undergo an accelerated aging process postinjury, hypogonadism is associated with an unfavorable cardiometabolic risk profile. Further research is needed to determine whether a causal relationship exists between hypogonadism and heightened cardiometabolic risk in men with SCI and whether routine screening for testosterone deficiency is warranted in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>IV<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.pmrj.2017.08.404","type":"journal-article","created":{"date-parts":[[2017,8,18]],"date-time":"2017-08-18T20:20:30Z","timestamp":1503087630000},"page":"373-381","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Relationship Between Gonadal Function and Cardiometabolic Risk in Young Men With Chronic Spinal Cord Injury"],"prefix":"10.1002","volume":"10","author":[{"given":"Shannon D.","family":"Sullivan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark S.","family":"Nash","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eshetu","family":"Tefara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Tinsley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Groah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,8,18]]},"reference":[{"key":"e_1_2_7_2_2","unstructured":"National Spinal Cord Injury Statistical Center. 2014 Annual Report Complete Public Version University of Alabama. 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