ArticleBiology of sex differences2021
Increased P450 aromatase levels in post-menopausal women after acute ischemic stroke.
Article in Biology of sex differences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 17 citations in OpenAlex.
- Late-follicular androgen and estrogen rise associated with clinical pregnancy in IVF/ICSI with granulosa cell studies.Reproduction & fertility · 2026Article
- Increased expression of aromatase after focal cerebral ischemia: Relevance to neuroprotection and functional recovery.Neuroprotection (Chichester, England) · 2026Article
- Aromatase, testosterone, TMPRSS2: determinants of COVID-19 severity.Biology of sex differences · 2024Article
- Ethnic and Gender Variations in Ischemic Stroke Patterns among Arab Populations in Northern Israel: A Preliminary Exploration towards Culturally Aware Personalized Stroke Care.Journal of personalized medicine · 2024Article
- The influence of gender on the epidemiology of and outcome from sepsis associated acute kidney injury in ICU: a retrospective propensity-matched cohort study.European journal of medical research · 2024Article
- Article
- The aging ovary impairs acute stroke outcomes.Journal of neuroinflammation · 2023Article
- Sex Differences in the Evaluation and Treatment of Stroke.Handbook of experimental pharmacology · 2023Review
- The impact of 17β-estradiol on the estrogen-deficient female brain: from mechanisms to therapy with hot flushes as target symptoms.Frontiers in endocrinology · 2023Review
- Brain-Derived Estrogen and Neurological Disorders.Biology · 2022Review
- Application of Multimodal Magnetic Resonance Imaging in Green Channel of Acute and Hyperacute Ischemic Stroke.Contrast media & molecular imaging · 2022Article
- Targeting 17β-estradiol biosynthesis in neural stem cells improves stroke outcome.Frontiers in cellular neuroscience · 2022Article
- No sex differences in the incidence, risk factors and clinical impact of acute kidney injury in critically ill patients with sepsis.Frontiers in immunology · 2022Article
- Aromatase in the Human Brain.Androgens: clinical research and therapeutics · 2021Review
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundSex differences in stroke have been attributed to the neuroprotective effects of estrogen, yet most clinical trials of estrogen supplementation for stroke prevention have failed. The contribution of sex hormones to stroke outcome remains a subject of debate. Aromatization of testosterone to estradiol in neural tissue leads to sexual differentiation. Emerging data suggests aromatase activity increases in response to brain injury, and increased aromatase expression is seen in the ischemic penumbra in animal models. The objective of this study was to examine the levels of endogenous sex steroids after acute ischemic stroke and determine if levels of sex steroids were associated with acute stroke outcomes.
methodsPeripheral blood from ischemic stroke patients and controls was collected under an approved IRB within 24 h of symptom onset. 17β-estradiol, testosterone, and aromatase levels were measured in the serum of both men and women using ELISA. Hormone levels were compared in men vs. women in stroke and control groups and correlated with outcomes (NIHSS and change in the modified Rankin Scale (mRS), defined as the difference of premorbid and discharge mRS) using multivariate regression.
resultsWe found no significant difference in estradiol levels 24 h after stroke in men (p = 0.86) or women (p = 0.10). In men, testosterone significantly decreased after stroke as compared with controls (1.83 ± 0.12 vs. 2.86 ± 0.65, p = 0.01). Aromatase levels were significantly increased in women after stroke as compared with controls (2.27 ± 0.22 vs. 0.97 ± 0.22, p = 0.002), but not in men (p = 0.84). Estradiol levels positively correlated with change in mRS in both women (r = 0.38, p = 0.02) and men (r = 0.3, p = 0.04).
conclusionsEstradiol levels correlated with functional outcomes (change in mRS) in both men and women, at least in the acute phase (24 h) of stroke. However, no significant difference in estradiol levels is seen 24 h post-stroke in men or women. Testosterone levels decrease at 24 h after stroke in men. As seen in animal models, aromatase levels increase after acute ischemic stroke, but this was only true for women. These indicate an active aromatization process in post-menopausal women after acute ischemic stroke.
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