A Chinese research team has determined that levels of follicle-stimulating hormone (FSH) are higher in men with idiopathic pulmonary arterial hypertension (IPAH) and these levels strongly predict survival and disease severity.
The study, published in the American Journal of Men’s Health, retrospectively reviewed the records of 116 men with IPAH who were hospitalized between 2016 and 2020, along with 53 men without IPAH as matched controls. The patients with IPAH had significantly higher plasma FSH levels than the controls, and the nonsurvivors of IPAH had higher FSH concentrations than survivors.
Furthermore, plasma FSH levels were significantly correlated with measures of disease severity in all patients, including the 6-minute walk test and World Health Organization functional class, as well as with poorer hemodynamic indicators including cardiac output, mean pulmonary artery pressure, and pulmonary vascular resistance. In this cohort, the researchers found that the 6-minute walk test, cardiac output, and FSH levels were all independent predictors of patient survival.
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“Increased FSH levels were clearly associated with severity and were an independent predictor for lower survival and poorer cardiac and vascular functioning of male patients with IPAH,” the researchers wrote. “However, the specific mechanism underlying this deterioration remains to be determined.” The Kaplan-Meier analysis showed that relative FSH levels <5.94 predicted a significantly better prognosis than that of patients with levels ≥5.94.
Exploration of the possible roles of sex hormones in the pathogenesis of IPAH, pulmonary arterial hypertension, and other conditions is ongoing. While pulmonary arterial hypertension has a higher prevalence among women than men, men generally have a poorer prognosis.
FSH levels have also been found to be associated with altered vascular function in patients with cancer, accelerated progress of atherosclerosis, and blood flow-mediated vasodilation in women. In addition, a higher risk of morbidity and mortality has also been observed in female IPAH patients of reproductive age who have high FSH expression.
Wang Q, Sun YY, Huang YX, Wang L, Miao YQ, Yuan P. Prognostic value of follicle-stimulating hormone levels in predicting survival in men with idiopathic pulmonary arterial hypertension. Am J Mens Health. 2022;16(1):15579883211067084. doi:10.1177/15579883211067084