51
|
Bell MA, Campbell JD, Joice G, Sopko NA, Burnett AL. Shifting the Paradigm of Testosterone Replacement Therapy in Prostate Cancer. World J Mens Health 2018; 36:103-109. [PMID: 29623698 PMCID: PMC5924951 DOI: 10.5534/wjmh.170007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 01/03/2018] [Accepted: 01/05/2018] [Indexed: 12/27/2022] Open
Abstract
Historically, testosterone and prostate cancer have been demonstrated to have a positive association leading providers to forgo testosterone replacement therapy (TRT) in men with concurrent histories of hypogonadism and prostate cancer. This paradigm has been gradually shifting with our evolving understanding of the relationship between testosterone and prostate cancer and the gaining popularity of the saturation model. Newer data suggests improved quality of life for men with hypogonadism after TRT leading to a more tempered view of the effects of this treatment and its risk in prostate cancer. As more reports emerge of TRT in men who have either undergone definitive treatment for prostate cancer or are on active surveillance, some providers see a role for TRT in these patients despite non-consensus in clinical guidelines. It is critical that we examine evidence currently available, while we await more rigorous data to emerge.
Collapse
Affiliation(s)
- Michael A Bell
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jeffrey D Campbell
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Gregory Joice
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nikolai A Sopko
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Arthur L Burnett
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
52
|
Chen Y, Li J, Liao J, Hu Y, Zhang H, Yang X, Wang Q, Mo Z, Cheng J. Potential Protective Effect of Osteocalcin in Middle-Aged Men with Erectile Dysfunction: Evidence from the FAMHES Project. Sci Rep 2018; 8:6721. [PMID: 29712943 PMCID: PMC5928124 DOI: 10.1038/s41598-018-25011-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 04/13/2018] [Indexed: 01/11/2023] Open
Abstract
In a similar manner to erectile dysfunction (ED), osteocalcin (OC) is also said to be associated with cardiovascular disease (CVD); however, the effect of OC in ED is unclear. This study was conducted based on the Fangchenggang Area Male Health and Examination Survey (FAMHES) project that ran between September and December 2009. ED was evaluated using the International Index of Erectile Function (IIEF-5). OC was shown to be associated with mild (unadjusted: OR = 0.647; P = 0.016) or moderate (unadjusted: OR = 0.453; P = 0.007) ED. Meanwhile, higher OC levels were more prominently associated with ED (unadjusted: OR = 0.702; P = 0.014). When subdividing the groups by age, the correlation between OC and ED presented in those aged 40–49 years, even in the multi-adjusted model, for those with moderate (OR = 0.255, P = 0.044) and severe (OR = 0.065, P = 0.005) ED. The relationship between OC and ED was also associated with a high level of testosterone, non-obesity, drinking, and non-metabolic syndrome. In summary, OC may play a protective role in middle-aged (40–49 years) men with moderate-severe ED, especially those with a high level of testosterone, non-obesity, drinking, and non-metabolic syndrome.
Collapse
Affiliation(s)
- Yang Chen
- Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.,Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.,Guangxi collaborative innovation center for genomic and personalized medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi key laboratory for genomic and personalized medicine, Guangxi key laboratory of colleges and universities, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Jie Li
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,The Guangxi Zhuang Autonomous Region Family Planning Research Center, Nanning, Guangxi, China
| | - Jinling Liao
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi collaborative innovation center for genomic and personalized medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi key laboratory for genomic and personalized medicine, Guangxi key laboratory of colleges and universities, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Yanling Hu
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi collaborative innovation center for genomic and personalized medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi key laboratory for genomic and personalized medicine, Guangxi key laboratory of colleges and universities, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Haiying Zhang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi collaborative innovation center for genomic and personalized medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi key laboratory for genomic and personalized medicine, Guangxi key laboratory of colleges and universities, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Xiaobo Yang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi collaborative innovation center for genomic and personalized medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi key laboratory for genomic and personalized medicine, Guangxi key laboratory of colleges and universities, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Qiuyan Wang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi collaborative innovation center for genomic and personalized medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi key laboratory for genomic and personalized medicine, Guangxi key laboratory of colleges and universities, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Zengnan Mo
- Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.,Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.,Guangxi collaborative innovation center for genomic and personalized medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi key laboratory for genomic and personalized medicine, Guangxi key laboratory of colleges and universities, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Jiwen Cheng
- Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China. .,Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China. .,Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China. .,Guangxi collaborative innovation center for genomic and personalized medicine, Nanning, Guangxi Zhuang Autonomous Region, China. .,Guangxi key laboratory for genomic and personalized medicine, Guangxi key laboratory of colleges and universities, Nanning, Guangxi Zhuang Autonomous Region, China.
| |
Collapse
|
53
|
Rasmussen R, Midttun M, Kolenda T, Ragle AM, Sørensen TW, Vinther A, Zerahn B, Pedersen M, Overgaard K. Therapist-Assisted Progressive Resistance Training, Protein Supplements, and Testosterone Injections in Frail Older Men with Testosterone Deficiency: Protocol for a Randomized Placebo-Controlled Trial. JMIR Res Protoc 2018; 7:e71. [PMID: 29500160 PMCID: PMC5856930 DOI: 10.2196/resprot.8854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 10/11/2017] [Accepted: 10/11/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Fall accidents are a major cause of mortality among the elderly and the leading cause of traumatic brain injury. After a fall, many elderly people never completely recover and need help in coping with everyday life. Due to the increasing older population in the world, injuries, disabilities, and deaths caused by falls are a growing worldwide problem. Muscle weakness leads to greatly increased risk of falling, decreased quality of life, and decline in functional capacity. Muscle mass and muscle power decrease about 40% from age 20 to 80 years, and the level of testosterone decreases with age and leads to impaired muscle mass. In addition, 20% of men older than 60 years-and 50% older than 80 years-have low levels of testosterone. Treatments after a fall are significant financial burdens on health and social care, and it is important to find treatments that can enhance function in the elderly people. OBJECTIVE The purpose of this study is to investigate whether testosterone and progressive resistance training alone or combined can improve muscle strength and reduce the risk of falls in older men. Additionally, we will examine whether such treatments can improve quality of life, functional capacity, including sexual function, and counteract depression. METHODS This is a randomized placebo-controlled, double-blind trial in which frail older men with testosterone deficiency are treated with testosterone supplemental therapy and therapist-assisted progressive resistance training for 20 weeks, with the possibility to continue treatment for 1 year. Four study arms of 48 participants each are provided based on factorial assignment to testosterone supplemental therapy and progressive resistance training. The 4 groups are as follows: controls given placebo injections without physical exercise for 20 weeks, testosterone-alone group given testosterone injections without physical exercise for 20 weeks, training-alone group given placebo injections for 20 weeks combined with 16 weeks of progressive strength training, and combination group given testosterone injections for 20 weeks combined with 16 weeks of progressive strength training. Performance in the 30-second chair stand test to measure improvement of general strength, balance, and power in lower extremities is the primary endpoint. Secondary endpoints comprising tests of cognition, muscle strength, and quality of life are applied before and after the training. RESULTS Funding was provided in October 2016. Results are expected to be available in 2020. Sample size was calculated to 152 participants divided into 4 equal-sized groups. Due to age, difficulty in transport, and the time-consuming intervention, up to 25% dropouts are expected; thus, we aim to include at least 192 participants. CONCLUSIONS This investigation will evaluate the efficacy of testosterone supplemental therapy alone or combined with progressive resistance training. Additionally, improvements in quality of life and cognition are explored. TRIAL REGISTRATION Clinicaltrials.gov NCT02873559; https://clinicaltrials.gov/ct2/show/NCT02873559 (Archived by WebCite at http://www.webcitation.org/6x0BhU2p3).
Collapse
Affiliation(s)
- Rune Rasmussen
- Department of Neurology, University Hospital of Copenhagen, Herlev Hospital, Herlev, Denmark
| | - Mette Midttun
- Medical Department O, University Hospital of Copenhagen, Herlev Hospital, Herlev, Denmark
| | - Tine Kolenda
- Medical Department O, University Hospital of Copenhagen, Herlev Hospital, Herlev, Denmark
| | - Anne-Mette Ragle
- Medical Department O, University Hospital of Copenhagen, Herlev Hospital, Herlev, Denmark
| | - Thea Winther Sørensen
- Medical Department O, University Hospital of Copenhagen, Herlev Hospital, Herlev, Denmark
| | - Anders Vinther
- Department of Rehabilitation, University Hospital of Copenhagen, Herlev Hospital, Herlev, Denmark
| | - Bo Zerahn
- Department of Clinical Physiology and Nuclear Medicine, University Hospital of Copenhagen, Herlev Hospital, Herlev, Denmark
| | - Maria Pedersen
- Department of Clinical Physiology and Nuclear Medicine, University Hospital of Copenhagen, Herlev Hospital, Herlev, Denmark
| | - Karsten Overgaard
- Department of Neurology, University Hospital of Copenhagen, Herlev Hospital, Herlev, Denmark
| |
Collapse
|
57
|
Kellesarian SV, Malmstrom H, Abduljabbar T, Vohra F, Kellesarian TV, Javed F, Romanos GE. "Low Testosterone Levels in Body Fluids Are Associated With Chronic Periodontitis". Am J Mens Health 2016; 11:443-453. [PMID: 27645514 PMCID: PMC5675296 DOI: 10.1177/1557988316667692] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
There is a debate over the association between low testosterone levels in body fluids and the occurrence of chronic periodontitis (CP). The aim of the present systematic review was to assess whether low testosterone levels in body fluids reflect CP. In order to identify studies relevant to the focus question: “Is there a relationship between low testosterone levels in body fluids and CP?” an electronic search without time or language restrictions was conducted up to June 2016 in indexed databases using different keywords: periodontitis, chronic periodontitis, periodontal diseases, testosterone, and gonadal steroid hormones. A total of eight studies were included in the present systematic review. The number of study participants ranged from 24 to 1,838 male individuals with ages ranging from 15 to 95 years. Seven studies measured testosterone levels in serum, two studies in saliva, and one study in gingiva. Four studies reported a negative association between serum testosterone levels and CP. Two studies reported a positive association between decreased testosterone levels in serum and CP. Increased levels of salivary testosterone among patients with CP were reported in one study; whereas one study reported no significant difference in the concentration of salivary testosterone between patients with and without CP. One study identified significant increase in the metabolism of testosterone in the gingiva of patients with CP. Within the limits of the evidence available, the relationship between low testosterone levels and CP remains debatable and further longitudinal studies and control trials are needed.
Collapse
Affiliation(s)
| | | | | | - Fahim Vohra
- 2 King Saud University, Riyadh, Saudi Arabia
| | | | - Fawad Javed
- 1 University of Rochester, Rochester, NY, USA
| | - Georgios E Romanos
- 4 University of Frankfurt, Frankfurt, Germany.,5 Stony Brook University, Stony Brook, NY, USA
| |
Collapse
|