Investigate The Correlation Factors Between The Levels Of Sex Hormone And Formation Of Intracranial Aneurysms

Objective: By measuring sex hormone levels in different ages of male and female patients with intracranial aneurysms and the control group (non-aneurysm patients) to explore relationship between the levels of sex hormone and the formation of intracranial aneurysm.( CA)Methods: Collect continuity 1768 cases of intracranial aneurysm patient,s ages and genders between 1992~January,2010 which has been diagnosed with intracranial aneurysms,then analysis of their peak age of onset and sex differences.Analyse brain angiography images of patients contracted with cerebral hemorrhage between Jan.2009 to Dec.2009 .All the patients were diagnosed by two of our associate chief physician.There are 173 CA patients and 177 non-aneurysm patients as the control group.The control group are patients which no intracranial aneurysm seen in magnetic resonance angiography(MRA) or digital subtraction arteriography(DSA) or CTA.All the patients must be adults. Detection of the estradiol(E2), testosterone(T), follicle-stimulating principle(FSH),lutein stimulating hormone(LH),progestone(P),Serum prolactin(PRL)concentration in all patients with their fasting blood.Some condition must be excluded from the patients of the control group:①Patients with Infection History or Hormone Drug Use History in the first 30 days,②With gynecological diseases,③With Male Diseases,④With heart, liver, kidney disease,⑤Associated with autoimmune diseases.On the basis of the relationship of menstrual cycle and estrogen,the famale patients were divided into premenapausal women, menopause women women, postmenopausal women women .The male patients were also divided into 20~49 age group,50~59-year-old group,60+age group according to the peak age of 1768 cases. To study the sex hormones relationship between CA group and the control group, The data expressed as mean±standard deviation were processed with the statistical software SPSS16.0. Quantitative and qualitative data were analyzed by the independent-sample t test, and the chi-square test and correlation analysis respectively.Result: The age distribution of 1768 cases is from the 10 years of age to 80 years old.The peak age is 50~59-year-old group(32.41%).There are 60.46 percentages in the 40~69 age group. Before the age of 40 aneurysms in patients with more men than women, but more women than men after the age of 40.Female Single aneurysms is 1.28 times the male,s.The multiple aneurysms was found in 12.78%,and the female is above triple of male.By partial correlation analysis( controlling E2,T) showed a negatively correlation with age ,γequaled -0.175,-0.820 (p<0.001).173 patients harboring saccular aneurysms were demonstrated by digital subtraction arteriogeaphy (DSA), 97(56.07%) of them are female.Of the total, premenapausal women was found in 23, 7 (30.43%) in low level; menopause women was found in 31, 15 (48.39%) in low level; postmenopausal women was found in 43, 30 (69.77%) in low level. 76 (43.93%) of them are male. 20~49 age group was found in 28, 9 (32.14%) in low level;50~59-year-old group was found in 33, 16 (48.48%) in low level; 60+age group was found in 15, 9 (60.00%) in low level.There are 177 patients in the control group. 100(56.50%) of them are female.Of the total, premenapausal women was found in 24, 4 (16.67%) in low level; menopause women was found in 32, 7 (21.88%) in low level; postmenopausal women was found in 44, 21 (47.73%) in low level. 77 (43.50%) of them are male. 20~49 age group was found in 26, 6 (23.08%) in low level;50~59-year-old group was found in 34, 7 (20.59%) in low level; 60+age group was found in 17, 4 (23.53%) in low level.The incidence rate of low E2 level in the female CA group and the female control group of total (CA group 52/97,control group 32/100 X2=9.400 p<0.05 ), menopause women (CA group 15/31,control group 7/32 X2=4.87 p<0.05 ) and postmenopausal women (CA group 30/43,control group 21/44 X2=4.355 p<0.05) has significant difference. The incidence rate of low E2 level in the CA group and the control group of premenapausal women has not statistically significant (CA group 7/23,control group 4/24 X2=1.242 p>0.05 ).The incidence rate of low T level in the male CA group and the male control group of total (CA group 34/76,control group 17/77 X2=9.400 p<0.05 ), 50~59-year-old group (CA group 16/33,control group 7/34 X2=5.781 p<0.05 ) and 60+age group (CA group 9/15,control group 4/17 X2=4.394 p<0.05) has significant difference. The incidence rate of low T level in the CA group and the control group of 20~49 age group has not statistically significant (CA group 9/28,control group 6/26 X2=0.552 p>0.05 ).The E2 level of CA group in total , menopause women and postmenopausal women is significantly lower than that of control group (p<0.05); the difference of E2 in premenapausal women has not statistically significant (p>0.05 ).The T level of CA group in total , 50~59-year-old group and 60+age group is significantly lower than that of control group (p<0.05); the difference of T in 20~49 age group has not statistically significant (p>0.05 ).The FSH level of CA group in total man,20~49 age group and 60+age group compared with control group has statistical significantly (p<0.05),the difference of FSH in50~59-year-old group has not statistically significant (p>0.05 ).The PRL level of CA group in total man, 20~49 age group and 50~59-year-old group compared with control group has statistical significantly (p<0.05), the difference of PRL in 60+age group has not statistically significant (p>0.05 ).The P and LH level of CA group in total man and every group has not statistically significant (p>0.05 ). The P level of postmenopausal women compared with control group has statistical significantly (p<0.05), the difference of P in total women, premenapausal women and menopause women has not statistically significant (p>0.05 ). The FSH level, LH level and PRL level of CA group in total women and every group has not statistically significant (p>0.05 ). Decline in sex hormone levels can trigger the changes in the pituitary - sex hormone axis, the hypothalamus - pituitary system under direct stimulation, secrete more hormones into the blood when the aneurysms rupture and blood into the brain pool space.Beacuse our CA group were ruptured aneurysms and some patients of control group were Non-aneurysmal intracerebral hemorrhage, we have no further analysis.Conclusion: The peak age of onset of aneurysms is in 50 ~ 59-year-old group.Both estradiol(E2) and testosterone(T) all decreased greatly with aging. The incidence rate of low E2 level in the female CA group of total, menopause women and postmenopausal women is higher than the control group. It is not sure that the incidence rate of low E2 level in the CA group of premenapausal women was higher than the control group. The incidence rate of low T level in the male CA group of total, 50~59-year-old group and 60+age group is higher than the male control group. It is not sure that the incidence rate of low E2 level in the CA group of 20~49 age was higher than the control group. The E2 level of CA group in total , menopause women and postmenopausal women is significantly lower than that of control group , but the difference of E2 in premenapausal women has not statistically significant.The T level of CA group in total , 50~59-year-old group and 60+age group is significantly lower than that of control group,but the difference of T in 20~49 age group has not statistically significant. It was an important facter in formation and development of intracranial aneurysm that sex hormone decrease greatly with aging and especially when it is lower than normal levels.