(604) Hormone Levels Following Acute Aneurysmal Subarachnoid Hemorrhage: A Matched Study of Older Adults

Introduction: Neuroactive steroids and growth hormones have been implicated in stroke and cerebral disorders; an association largely attributed to age-related decline in circulating hormones. Neurosteroid and hormone levels may also be altered by acute neurological insult. This study examined hormone levels in older patients with acute aneurysmal subarachnoid hemorrhage (aSAH) compared to a matched healthy cohort. We hypothesized that neurosteroid and hormone levels would be significantly altered by acute aSAH.

Methods: This analysis matched 24 aSAH patients >64 years of age (mn 69.5 years, 50% male, 87% Caucasian) from R01NR018160 with 24 healthy subjects (mn 68.7 years, 50% male, 87% Caucasian) from the IGNITE study R01AG053952. Demographic and clinical data came from the subject, representative, or medical record. Control samples were drawn at the time of study visits. aSAH samples were collected daily from consent-14 days after aSAH. Plasma samples were assayed for neuroactive steroids (estradiol [E2], estrone [E1], testosterone [T], progesterone [pro], androstenedione [andro]) via liquid chromatography–tandem mass spectrometry. Insulin growth factor (IGF1) was assayed via ELISA. Linear mixed model comparison of mean plasma hormone levels in aSAH and matched controls was conducted using SPSS and SAS.

Results: Plasma neuroactive steroid and growth hormone levels were significantly different between aSAH patients and the matched cohort. aSAH patients had higher mean plasma E2 (13.8 vs 9.1 pg/mL; p= .06) and E1 (134.5 vs 45.2 pg/mL; p< 0.001) levels than their matched cohort. aSAH patients also had significantly higher mean andro (1596.7 vs 394.3 pg/mL; p< 0.001) and pro (99.8 vs 21.7 pg/mL; p= 0.001) levels than their matched cohort. aSAH patients had significantly lower mean plasma T (809.4 vs 2591.9 pg/mL; p= 0.003) and IGF1 (40.8 vs 54.6 ng/ml; p= 0.007) levels than their matched cohort.

Conclusions: Hormone levels have not been well characterized after aSAH. This study of older adults found significantly higher estrogen and estrogen precursors immediately after aSAH while testosterone levels were significantly lower than the matched cohort. IGF1 levels were also significantly lower after aSAH than the matched cohort. The impact of these responses on recovery after aSAH warrants further investigation.