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Hou M, Gu Q, Cui J, Dou Y, Huang X, Li J, Qiao L, Nan Y. Proportion and clinical characteristics of metabolic-associated fatty liver disease and associated liver fibrosis in an urban Chinese population. Chin Med J (Engl) 2024:00029330-990000000-01194. [PMID: 39183555 DOI: 10.1097/cm9.0000000000003141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND Metabolic-associated fatty liver disease (MAFLD) is the predominant form of chronic liver disease worldwide. This study was designed to investigate the proportion and characteristics of MAFLD within the general Chinese population and to identify the contributory risk factors for liver fibrosis among MAFLD individuals. METHODS The participants were recruited from a cohort undergoing routine health evaluations at the Third Hospital of Hebei Medical University between May 2019 and March 2023. The diagnosis of MAFLD was based on the established clinical practice guidelines. The fibrosis-4 index score (FIB-4) was employed to evaluate hepatic fibrosis, with a FIB-4 score of ≥1.3 indicating significant fibrosis. Binary logistic regression analyses were used to determine risk factors associated with significant hepatic fibrosis in MAFLD. RESULTS A total of 22,970 participants who underwent comprehensive medical examinations were included in the analysis. The overall proportion of MAFLD was 28.77% (6608/22,970), with 16.87% (1115/6608) of these patients showing significant fibrosis as assessed using FIB-4. Independent risk factors for significant liver fibrosis in MAFLD patients were male (odds ratio [OR] = 0.676, 95% confidence interval [CI]: 0.558-0.821), hepatitis B surface antigen (HBsAg) positivity (OR = 2.611, 95% CI: 1.557-4.379), body mass index ≥23.00 kg/m2 (OR = 0.632, 95% CI: 0.470-0.851), blood pressure ≥130/85 mmHg (OR = 1.885, 95% CI: 1.564-2.272), and plasma glucose ≥5.6 mmol/L (OR = 1.815, 95% CI: 1.507-2.186) (all P <0.001). CONCLUSIONS The proportion of MAFLD in an urban Chinese population is 28.77%. About 16.87% of MAFLD patients presented with significant liver fibrosis.
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Affiliation(s)
- Mengmeng Hou
- Department of Traditional and Western Medical Hepatology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China
| | - Qi Gu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu 210008, China
| | - Jiawei Cui
- Department of Traditional and Western Medical Hepatology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China
| | - Yao Dou
- Department of Traditional and Western Medical Hepatology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China
| | - Xiuhong Huang
- Healthy Physical Examination Center, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China
| | - Jie Li
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu 210008, China
| | - Liang Qiao
- Storr Liver Centre, The Westmead Institute for Medical Research, The University of Sydney at Westmead Hospital, Westmead, NSW 2145, Australia
| | - Yuemin Nan
- Department of Traditional and Western Medical Hepatology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China
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Zhang Z, Chen Y, Li N, Huang C, Lin D, Wang C, Wang C, You L, Li L, Li F, Liang Y, Xiao H, Yan L, Lao G, Sun K. Gonadal hormones and metabolic syndrome in middle-aged and elderly males: results from a prospective cohort study in China. Front Endocrinol (Lausanne) 2024; 15:1365283. [PMID: 38988998 PMCID: PMC11233520 DOI: 10.3389/fendo.2024.1365283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 05/22/2024] [Indexed: 07/12/2024] Open
Abstract
Background Research has shown that gonadal hormones are involved in metabolic pathways relevant to metabolic syndrome (MetS). Nevertheless, no longitudinal study has been conducted on the association between SHBG and MetS in Chinese. The objective of our study was to determine whether there is any association between middle-aged and elderly males in China. Methods A total of 531 eligible male subjects, aged above 40 years or older, without MetS at baseline, were recruited. Sex hormone binding globulin (SHBG), total testosterone (TT), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were measured. A harmonized definition and recommended thresholds for the Chinese population were used to determine metabolic syndrome. Results During 3.2 years of follow-up, 20.7% of subjects had developed MetS. Compared with the non-MetS group, subjects in the new-onset MetS group had significantly lower SHBG (43.5 nmol/L [28.8, 74.9] vs 53.7nmol/L [33.8, 115.0], P=0.0018), TT (18.1nmol/L [13.6-21.7] vs 19.5nmol/L[15.0-23.6], P=0.0204), and LH (5.13mIU/L [3.63-7.29] vs 5.87mIU/L [4.05-8.36]) at baseline. The incidence of MetS was decreased according to elevated SHBG quartiles (Q1:26.9%, Q2:22.7%, Q3:21.1%, Q4:12.1%, P for trend =0.0035), TT (Q1: 25.2%, Q2:23.7%, Q3: 17.3%, Q4: 16.7%, P for trend=0.0425), and LH (Q1:25.0%, Q2:21.8%, Q3: 21.8%, Q4: 14.3%, P for trend=0.0411). Compared with those in quartile 4, the OR[CI] of incident MetS for participants in Quartile 1 was 2.33[1.13-4.79] after multiple adjustments. But associations between incident MetS and different quartiles of LH, TT, and FSH were not observed after multiple adjustments. In the subgroup analyses, the significant association between SHBG level and Mets was detected in subjects over 60 years or older, with normal BMI, without insulin resistance, and with eGFR ≥90 mL/min per 1.73m2. Conclusion Compared with TT, LH, and FSH, a lower level of SHBG is significantly related to the incidence of MetS among middle-aged and elderly males in China.
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Affiliation(s)
- Zhuo Zhang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yingna Chen
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Na Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chulin Huang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Diaozhu Lin
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chengzhi Wang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chunying Wang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lili You
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lingling Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Fangping Li
- Department of Endocrinology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Ying Liang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huisheng Xiao
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Li Yan
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Guojuan Lao
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Kan Sun
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Zhang JJ, Wang J, Wang XQ, Zhang XY. Gender Differences in the Prevalence and Clinical Correlates of Metabolic Syndrome in First-Episode and Drug-Naïve Patients With Major Depressive Disorder. Psychosom Med 2024; 86:202-209. [PMID: 38588496 DOI: 10.1097/psy.0000000000001293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
OBJECTIVE Major depressive disorder (MDD) is a severe psychiatric symptom worldwide, and the coexistence of MDD with metabolic syndrome (MetS) is common in clinical practice. However, gender differences in comorbid MetS in first-episode and drug-naïve (FEDN) MDD patients have not been reported. Here, we explored potential gender differences in the prevalence and clinical correlates of comorbid MetS in FEDN MDD patients. METHODS A cross-sectional study of 1718 FEDN MDD patients was conducted. Demographic and clinical data were collected. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale, and Positive and Negative Syndrome Scale positive subscale were used to evaluate depression, anxiety, and psychotic symptoms, respectively. RESULTS The prevalence of MetS was 1.645-fold higher in female MDD patients (38.50%) than in male patients (26.53%). Patients with MetS had higher HAMD score, Hamilton Anxiety Scale score, and Positive and Negative Syndrome Scale positive subscale score than patients without MetS (p values < .001). Furthermore, suicide attempts (male: odds ratio [OR] = 1.706, p = .034; female: OR = 1.639, p = .004) and HAMD score (male: OR = 1.251, p < .001; female: OR = 1.148, p < .001) were independently associated with MetS in male and female patients, whereas age of onset was independently associated with MetS only in female patients (OR = 1.744, p = .047). CONCLUSIONS Our findings suggest significant gender differences in the prevalence and clinical correlates of comorbid MetS in FEDN MDD patients. Clinical variables (suicide attempts and HAMD scores) may be independently associated with MetS in MDD patients.
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Affiliation(s)
- Jian-Jun Zhang
- From the Shanxi Key Laboratory of Chinese Medicine Encephalopathy, National International Joint Research Center for Molecular Chinese Medicine (J.-J. Zhang, X.-Q. Wang), Shanxi University of Chinese Medicine, Jinzhong; CAS Key Laboratory of Mental Health (J.-J. Zhang, X.Y. Zhang), Institute of Psychology, Beijing; School of Nursing (J. Wang), Tianjin University of Traditional Chinese Medicine, Tianjin; and Department of Psychology (X.Y. Zhang), University of Chinese Academy of Sciences, Beijing, China
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Huang R, Wang Y, Yan R, Ding B, Ma J. Sex Hormone Binding Globulin is an Independent Predictor for Insulin Resistance in Male Patients with Newly Diagnosed Type 2 Diabetes Mellitus. Diabetes Ther 2023; 14:1627-1637. [PMID: 37462840 PMCID: PMC10499719 DOI: 10.1007/s13300-023-01445-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 06/30/2023] [Indexed: 09/14/2023] Open
Abstract
INTRODUCTION This study explored the correlation between sex hormones, sex hormone binding globulin (SHBG), and insulin resistance in male patients with newly diagnosed type 2 diabetes mellitus (T2DM). METHODS A total of 48 male patients with newly diagnosed T2DM were enrolled in this study between March 2022 and December 2022. Clinical characteristics, sex hormones, and SHBG levels were collected. All enrolled subjects received intensive hypoglycemic treatment with insulin pump for 1 week to achieve glycemic control, then the steady-state glucose infusion rate (GIR), an indicator of insulin sensitivity, was determined by the hyperinsulinemic-euglycemic clamp. Correlation analysis and multivariate logistic regression analysis were performed to explore the association of clinical characteristics, sex hormones, and SHBG with insulin sensitivity. The optimal cutoff value to predict insulin resistance was calculated using receiver operating characteristic (ROC) curve. RESULTS According to the GIR cut-point value of 5.700 mg/(kg min), there were 40 patients with insulin resistance (IR group) and 8 patients without (non-IR group). The IR group exhibited lower testosterone and SHBG levels than the non-IR group (all p < 0.050). Correlation analysis showed that insulin sensitivity was positively associated with testosterone and SHBG, while negatively associated with body mass index, fasting blood glucose, alanine aminotransferase, aspartate aminotransferase, total cholesterol, triglyceride, and apolipoprotein B (all p < 0.050). Multivariate logistic regression analysis demonstrated that SHBG is an independent predictor for insulin resistance (p = 0.029). Further ROC curve analysis revealed that the optimal cutoff value of SHBG to predict insulin resistance is 17.200 nmol/L, with the corresponding area under the curve (AUC) and its 95% confidence interval (CI) being 0.813 and 0.691-0.934. CONCLUSIONS SHBG is an independent predictor for insulin resistance in male patients with newly diagnosed T2DM. TRIAL REGISTRATION NUMBER KY20220314-01.
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Affiliation(s)
- Rong Huang
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, No.32 Gongqingtuan Road, Nanjing, 210012, China
| | - Ying Wang
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, No.32 Gongqingtuan Road, Nanjing, 210012, China
| | - Rengna Yan
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, No.32 Gongqingtuan Road, Nanjing, 210012, China
| | - Bo Ding
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, No.32 Gongqingtuan Road, Nanjing, 210012, China.
| | - Jianhua Ma
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, No.32 Gongqingtuan Road, Nanjing, 210012, China.
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Wu S, Wu Y, Fang L, Zhao J, Cai Y, Xia W. A negative association between triglyceride glucose-body mass index and testosterone in adult males: a cross-sectional study. Front Endocrinol (Lausanne) 2023; 14:1187212. [PMID: 37361537 PMCID: PMC10289259 DOI: 10.3389/fendo.2023.1187212] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/15/2023] [Indexed: 06/28/2023] Open
Abstract
Background and objectives Insulin resistance (IR) is closely related to the decline or deficiency of testosterone in males. Triglyceride glucose-body mass (TyG-BMI) is considered to be a novel indicator of IR. We conducted this analysis to investigate the association between TyG-BMI and male testosterone, and to explore whether its ability to predict testosterone deficiency is superior to HOMA-IR and TyG. Methods This was a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES, 2011-2016). The TyG-BMI index was calculated from serum triglyceride, fasting plasma glucose and BMI. The association of TyG-BMI with male testosterone was estimated by weighted multivariable regression. Results We included 3394 participants for the final analysis. After adjusting for confounders, TyG-BMI was found to show an independent negative association with testosterone (β=-1.12, 95%CI: -1.50, -0.75, P<0.0001). Multivariate-adjusted beta also showed testosterone levels were significantly lower in the two highest TyG-BMI group (Q3, Q4) compared to the lowest group (Q1). Similar results were seen in all of the subgroup populations by stratified analysis (all P-interaction >0.05). Furthermore, ROC curve analysis indicated that the area under the curve of TyG-BMI index (0.73, 95% CI: 0.71, 0.75) was larger than that of HOMA-IR index (0.71, 95% CI: 0.69, 0.73) and TyG index (0.66, 95% CI: 0.64, 0.68). Conclusion Our result suggested a negative association between TyG-BMI index and testosterone in adult males. The predictability of the TyG-BMI index for testosterone deficiency is better than that of HOMA-IR index and TyG index.
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Affiliation(s)
- Shenghao Wu
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yanhong Wu
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lizi Fang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Junzhao Zhao
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yaoyao Cai
- Department of Obstetrics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Weiting Xia
- Department of Gynecology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Interaction between gut microbiota and sex hormones and their relation to sexual dimorphism in metabolic diseases. Biol Sex Differ 2023; 14:4. [PMID: 36750874 PMCID: PMC9903633 DOI: 10.1186/s13293-023-00490-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/30/2023] [Indexed: 02/09/2023] Open
Abstract
Metabolic diseases, such as obesity, metabolic syndrome (MetS) and type 2 diabetes (T2D), are now a widespread pandemic in the developed world. These pathologies show sex differences in their development and prevalence, and sex steroids, mainly estrogen and testosterone, are thought to play a prominent role in this sexual dimorphism. The influence of sex hormones on these pathologies is not only reflected in differences between men and women, but also between women themselves, depending on the hormonal changes associated with the menopause. The observed sex differences in gut microbiota composition have led to multiple studies highlighting the interaction between steroid hormones and the gut microbiota and its influence on metabolic diseases, ultimately pointing to a new therapy for these diseases based on the manipulation of the gut microbiota. This review aims to shed light on the role of sexual hormones in sex differences in the development and prevalence of metabolic diseases, focusing on obesity, MetS and T2D. We focus also the interaction between sex hormones and the gut microbiota, and in particular the role of microbiota in aspects such as gut barrier integrity, inflammatory status, and the gut-brain axis, given the relevance of these factors in the development of metabolic diseases.
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Darmadi D, Pakpahan C, Ruslie RH, Amanda B, Ibrahim R. The sex life of male patients with cirrhosis and its organic factors: What we have got so far? PLoS One 2023; 18:e0280915. [PMID: 36730272 PMCID: PMC9894452 DOI: 10.1371/journal.pone.0280915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 01/11/2023] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE The purpose of this study was to examine the sex lives of male cirrhotic patients organic factors affect them. METHOD We did an observational study of 220 cirrhotic men's satisfaction with their sexual lives. Assessment of sex satisfaction was carried out using the New Sexual Satisfaction Scale. The frequency of intercourse and masturbation was estimated. Then, the levels of albumin, total bilirubin, vitamin D, and sex steroids were examined. Ascites and sarcopenia subgroups of our patients were stratified. RESULTS Along with sex steroids, albumin, total bilirubin, and vitamin D all had an impact on how satisfying sex was (r = 0.22), (r = 0.24), and (r = -0.17) affected sex satisfaction. There were strong positive correlations between vitamin D (r = 0.33), albumin (r = 0.59), and free testosterone, along with a negative correlation between total bilirubin (r = -0.63) and free testosterone. An imbalance in sex steroid levels was observed, leading to decreased frequency of intercourse(p < 0.0001), weakened erections(p < 0.0001), and reduced quality of orgasm (p < 0.0001). Significant new sex behavior changes were found, such as an increase in masturbation. Physical limitations such as ascites and sarcopenia also impacted the decreasing sex life. CONCLUSION The sex life of cirrhotic men is affected. The decrease in the frequency of intercourse and sexual satisfaction is noticeable in male patients and leads to increased masturbation. Free Testosterone, vitamin D, albumin, and bilirubin play role in their sex life. In addition, ascites and sarcopenia not only affect their sex life but also hamper the quality of their well-being.
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Affiliation(s)
- Darmadi Darmadi
- Faculty of Medicine, Department of Internal Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Cennikon Pakpahan
- Faculty of Medicine, Andrology Study Program, Universitas Airlangga, Surabaya, Indonesia
- Faculty of Medicine, Department of Biomedical Sciences, Universitas Airlangga, Surabaya, Indonesia
| | - Riska Habriel Ruslie
- Faculty of Medicine, Department of Child Health, Universitas Prima Indonesia, Medan, Indonesia
| | - Bella Amanda
- Faculty of Medicine, Andrology Study Program, Universitas Airlangga, Surabaya, Indonesia
- Faculty of Medicine, Department of Biomedical Sciences, Universitas Airlangga, Surabaya, Indonesia
| | - Raditya Ibrahim
- Faculty of Medicine, Andrology Study Program, Universitas Airlangga, Surabaya, Indonesia
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Andlib N, Sajad M, Kumar R, Thakur SC. Abnormalities in sex hormones and sexual dysfunction in males with diabetes mellitus: A mechanistic insight. Acta Histochem 2023; 125:151974. [PMID: 36455338 DOI: 10.1016/j.acthis.2022.151974] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 11/29/2022]
Abstract
Diabetes is a considerate metabolic disorder that can lead to a series of complications, involving the malfunctioning of the reproductive system of males. It has been observed that there is a gradual rise in male diabetic patients and almost half of the diabetic males have low semen quality and decrease reproductive function. In diabetic conditions, prolonged hyperglycemia leads to oxidative stress, diabetic neuropathy, and insulin resistance. Insulin resistance and its deficiency can impair the hypothalamus, pituitary gland, gonads, and perigonads. This causes a decrease in the secretion of gonadal steroids such as GnRH (gonadotropin-releasing hormone), FSH (follicle-stimulating hormone), LH (luteinizing hormone), and Testosterone. Moreover, it also causes damage to the testicles, spermatogenic and stromal cells, seminiferous tubules, and various structural injuries to male reproductive organs. During spermatogenesis, glucose metabolism plays an important role, because the fundamental activities of cells and their specific features, such as motility and mature sperm fertilization activity, are maintained by glucose metabolism. All these activities can influence the fertility and reproductive health of males. But the glucose metabolism is primarily disrupted in diabetic conditions. Until now, there has been no medicine focusing on the reproductive health of diabetic people. In this chapter, we review the consequences of diabetes on the reproductive system of males and all the pathways involved in the dysfunction of the reproductive system. This will help interpret the effects of DM on male reproductive health.
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Affiliation(s)
- Nida Andlib
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, New Delhi 110025, India; Department of Reproductive Biomedicine, The National Institute of Health, and Family Welfare, Baba Gang Nath Marg, Munirka, New Delhi 110067, India
| | - Mohd Sajad
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, New Delhi 110025, India; Department of Reproductive Biomedicine, The National Institute of Health, and Family Welfare, Baba Gang Nath Marg, Munirka, New Delhi 110067, India
| | - Rajesh Kumar
- Department of Reproductive Biomedicine, The National Institute of Health, and Family Welfare, Baba Gang Nath Marg, Munirka, New Delhi 110067, India
| | - Sonu Chand Thakur
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, New Delhi 110025, India.
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Du N, Ji AL, Liu XL, Tan CL, Huang XL, Xiao H, Zhou YM, Tang EJ, Hu YG, Yao T, Yao CY, Li YF, Zhou LX, Cai TJ. Association between short-term ambient nitrogen dioxide and type 2 diabetes outpatient visits: A large hospital-based study. ENVIRONMENTAL RESEARCH 2022; 215:114395. [PMID: 36150443 DOI: 10.1016/j.envres.2022.114395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/09/2022] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
Type 2 diabetes (T2DM) as a non-communicable disease imposes heavy disease burdens on society. Limited studies have been conducted to assess the effects of short-term air pollution exposure on T2DM, especially in Asian regions. Our research aimed to determine the association between short-term exposure to ambient nitrogen dioxide (NO2) and outpatient visits for T2DM in Chongqing, the largest city in western China, based on the data collected from November 28, 2013 to December 31, 2019. A generalized additive model (GAM) was applied, and stratified analyses were performed to investigate the potential modifying effects by age, gender, and season. Meanwhile, the disease burden was revealed from attributable risk. Positive associations between short-term NO2 and daily T2DM outpatient visits were observed. The strongest association was observed at lag 04, with per 10 μg/m3 increase of NO2 corresponded to increased T2DM outpatient visits at 1.57% [95% confidence interval (CI): 0.48%, 2.65%]. Stronger associations were presented in middle-aged group (35-64 years old), male group, and cool seasons (October to March). Moreover, there were 1.553% (8664.535 cases) of T2DM outpatient visits attributable to NO2. Middle-aged adults, males, and patients who visited in cool seasons suffered heavier burdens. Conclusively, short-term exposure to NO2 was associated with increased outpatient visits for T2DM. Attention should be paid to the impact of NO2 on the burden of T2DM, especially for those vulnerable groups.
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Affiliation(s)
- Ning Du
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Ai-Ling Ji
- Department of Preventive Medicine, Chongqing Medical and Pharmaceutical College, Chongqing, 401331, China
| | - Xiao-Ling Liu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Chun-Lei Tan
- Department of Quality Management, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Xiao-Long Huang
- Medical Department, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Hua Xiao
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Yu-Meng Zhou
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - En-Jie Tang
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Yue-Gu Hu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Ting Yao
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University School of Medicine, Xi'an, Shaanxi, China
| | - Chun-Yan Yao
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Ya-Fei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Lai-Xin Zhou
- Medical Department, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China.
| | - Tong-Jian Cai
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China.
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Saleki K, Banazadeh M, Saghazadeh A, Rezaei N. Aging, testosterone, and neuroplasticity: friend or foe? Rev Neurosci 2022; 34:247-273. [PMID: 36017670 DOI: 10.1515/revneuro-2022-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/03/2022] [Indexed: 11/15/2022]
Abstract
Neuroplasticity or neural plasticity implicates the adaptive potential of the brain in response to extrinsic and intrinsic stimuli. The concept has been utilized in different contexts such as injury and neurological disease. Neuroplasticity mechanisms have been classified into neuroregenerative and function-restoring processes. In the context of injury, neuroplasticity has been defined in three post-injury epochs. Testosterone plays a key yet double-edged role in the regulation of several neuroplasticity alterations. Research has shown that testosterone levels are affected by numerous factors such as age, stress, surgical procedures on gonads, and pharmacological treatments. There is an ongoing debate for testosterone replacement therapy (TRT) in aging men; however, TRT is more useful in young individuals with testosterone deficit and more specific subgroups with cognitive dysfunction. Therefore, it is important to pay early attention to testosterone profile and precisely uncover its harms and benefits. In the present review, we discuss the influence of environmental factors, aging, and gender on testosterone-associated alterations in neuroplasticity, as well as the two-sided actions of testosterone in the nervous system. Finally, we provide practical insights for further study of pharmacological treatments for hormonal disorders focusing on restoring neuroplasticity.
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Affiliation(s)
- Kiarash Saleki
- Student Research Committee, Babol University of Medical Sciences, 47176 47745 Babol, Iran.,USERN Office, Babol University of Medical Sciences, 47176 47745 Babol, Iran.,Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), 14197 33151 Tehran, Iran
| | - Mohammad Banazadeh
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), 14197 33151 Tehran, Iran.,Pharmaceutical Sciences and Cosmetic Products Research Center, Kerman University of Medical Sciences, 76169 13555 Kerman, Iran
| | - Amene Saghazadeh
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), 14197 33151 Tehran, Iran.,Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, 14197 33151 Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, 14197 33151 Tehran, Iran.,Department of Immunology, School of Medicine, Tehran University of Medical Sciences, 14176 13151 Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), 14197 33151 Tehran, Iran
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11
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He Z, Yin G, Li QQ, Zeng Q, Duan J. Diabetes Mellitus Causes Male Reproductive Dysfunction: A Review of the Evidence and Mechanisms. In Vivo 2021; 35:2503-2511. [PMID: 34410936 DOI: 10.21873/invivo.12531] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/09/2021] [Accepted: 06/15/2021] [Indexed: 01/05/2023]
Abstract
The metabolic disorders caused by diabetes can lead to various complications, including dysfunction of the male reproductive system. In patients with diabetes, long-term hyperglycemia results in diabetic vascular neuropathy, oxidative stress injury, abnormal zinc metabolism, and insulin resistance syndrome. In addition, insulin deficiency and resistance in diabetes can damage the hypothalamus, pituitary gland, gonads, and perigonads. This can reduce the secretion of sex hormones including gonadotropin-releasing hormone, follicle stimulating hormone, luteinizing hormone, and testosterone, and can lead to testicular atrophy, stromal cell atrophy, seminiferous tubule damage, spermatogenic cell damage, and other structural injuries of the male reproductive organs. These actions can affect male fertility and reproductive health. Herein, we review studies that report a causative role of diabetes in male reproductive function. We also discuss the evidence-based mechanisms involved in the processes of diabetes-related male sexual and reproductive dysfunction as well as the progress in treatment.
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Affiliation(s)
- Zubin He
- 924 Hospital of PLA Joint Logistic Support Force, Guilin, P.R. China
| | - Guochao Yin
- Guilin Rehabilitation and Recuperation Center, Guilin, P.R. China
| | - Qingdi Quentin Li
- Scientific Review Branch, Division of Extramural Research and Training, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, NC, U.S.A
| | - Qiongfang Zeng
- 924 Hospital of PLA Joint Logistic Support Force, Guilin, P.R. China
| | - Jinliang Duan
- 924 Hospital of PLA Joint Logistic Support Force, Guilin, P.R. China;
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12
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Park HM, Kim H, Lee HS, Lee YJ. Inverse association between serum bilirubin level and testosterone deficiency in middle-aged and older men. Sci Rep 2021; 11:8026. [PMID: 33850200 PMCID: PMC8044079 DOI: 10.1038/s41598-021-87220-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 03/08/2021] [Indexed: 11/28/2022] Open
Abstract
Low serum bilirubin levels have been associated with increased risk of cardiovascular disease (CVD) and metabolic syndrome. Testosterone deficiency could also contribute to increased risk of CVD and metabolic syndrome. Therefore, this study aimed to examine the relationship between serum bilirubin level and testosterone deficiency in 1284 Korean men aged 45 to 70 years. Serum bilirubin level was categorized into quartiles: Q1 ≤ 0.7, Q2 0.8-0.9, Q3 1.0-1.1, and Q4 ≥ 1.2 mg/dL. Testosterone deficiency was defined as level less than 8.0 nmol/L, as suggested by the position statement of International Society of Andrology. The overall prevalence of testosterone deficiency was 5.8% and significantly decreased with the quartiles from Q1 to Q4. Compared with the referent fourth quartile (serum bilirubin ≥ 1.2 mg/dL), the ORs (95% CIs) for testosterone deficiency was 2.29 (1.04-4.94) for the first quartile after adjusting for age, fasting glucose, triglyceride, HDL-cholesterol, leukocyte count, hemoglobin, smoking status, and alcohol intake. We found inversely graded associations of serum bilirubin level with testosterone deficiency. These findings suggest that low bilirubin level may be interpreted as a state of testosterone deficiency in middle-aged and older men.
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Affiliation(s)
- Hye-Min Park
- Department of Family Medicine, Chaum Medical Checkup Center Samseongdong Branch, Cha University, Seoul, Republic of Korea
- Department of Medicine, Graduate School of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Haeyoung Kim
- Department of Integrative Medicine, Major in Digital Healthcare, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yong-Jae Lee
- Department of Family medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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13
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Liu L, Liu S, Song Q, Luo D, Su Y, Qi X, Wang Q, Ning J, Lv Y, Guan Q. Association of Metabolic Obesity Phenotypes and Total Testosterone in Chinese Male Population. Diabetes Metab Syndr Obes 2021; 14:399-408. [PMID: 33542639 PMCID: PMC7853434 DOI: 10.2147/dmso.s293259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 12/22/2020] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Obesity and metabolic syndrome have been reported to exert an impact on the male reproductive system with decreasing levels of serum total testosterone (TT); however, the effect of different metabolic obesity phenotypes on testosterone has been poorly studied. We aimed to evaluate the association of metabolic obesity phenotypes and total testosterone levels in a Chinese male population. METHODS We performed a retrospective study based on an epidemiological investigation, a total of 4,081 male individuals aged from 40-75 years old were recruited. The population was classified as metabolically healthy normal weight (MHNW), metabolically healthy overweight/obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy overweight/obese (MUO) according to normal weight (BMI<25.0) and overweight/obesity (BMI≥25.0) with or without metabolic syndrome. RESULTS We collected 563 hypotestosteronemia among 4,081 male individuals. The odds ratios (ORs) (95% CIs) of hypotestosteronemia in obesity and metabolic syndrome were 3.072 (2.414-3.911) and 3.294 (2.631-4.125), respectively, after adjusting for age, luteinizing hormone, smoking status, and alcohol consumption. Compared to the MHNW group, male subjects in MHO, MUNW, and MUO groups had decreased serum TT levels. Additionally, the MUO group had a lowest concentration of serum TT and a highest proportion of hypotestosteronemia. There was no significant difference of TT levels between the MHO and MUNW groups. CONCLUSION Obesity and metabolic syndrome are independent risk factors of hypotestosteronemia in Chinese male populations. Our study also suggested that individuals with MHO, MUNW, and MUO have a higher risk of developing hypotestosteronemia.
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Affiliation(s)
- Luna Liu
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong250021, People’s Republic of China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong250021, People’s Republic of China
| | - Shuang Liu
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong250021, People’s Republic of China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong250021, People’s Republic of China
| | - Qianmei Song
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong250021, People’s Republic of China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong250021, People’s Republic of China
| | - Dandan Luo
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong250021, People’s Republic of China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong250021, People’s Republic of China
| | - Yu Su
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong250021, People’s Republic of China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong250021, People’s Republic of China
| | - Xiangyu Qi
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong250021, People’s Republic of China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong250021, People’s Republic of China
| | - Qian Wang
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong250021, People’s Republic of China
| | - Jing Ning
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong250021, People’s Republic of China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong250021, People’s Republic of China
| | - Youyuan Lv
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong250021, People’s Republic of China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong250021, People’s Republic of China
| | - Qingbo Guan
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong250021, People’s Republic of China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong250021, People’s Republic of China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong250021, People’s Republic of China
- Correspondence: Qingbo Guan Tel +86-531-68776375Fax +86-531-87068707 Email
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14
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Jiang Y, Ye J, Zhao M, Tan A, Zhang H, Gao Y, Lu Z, Wu C, Hu Y, Wang Q, Yang X, Mo Z. Cross-sectional and longitudinal associations between serum testosterone concentrations and hypertension: Results from the Fangchenggang Area Male Health and Examination Survey in China. Clin Chim Acta 2018; 487:90-95. [PMID: 30138621 DOI: 10.1016/j.cca.2018.08.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 07/09/2018] [Accepted: 08/14/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Low testosterone concentrations have been suggested as a risk factor for hypertension, but their contribution to the development of hypertension is not well studied. We carried out a cohort study based on the results of an earlier cross-sectional investigation. We established the association between testosterone concentrations and hypertension. METHOD Data on 2427 healthy male subjects, aged from 17 to 88 y, were collected for the cross-sectional study. A representative sample of 853 individuals who did not suffer from hypertension at baseline was followed up for 4 y. Differences between the tertiles groups of sex hormones were analyzed, relative risks (RR) were estimated using binary logistic regression model. RESULTS In the cross-sectional analysis, the serum total testosterone (TT), free testosterone (FT), and bioavailable testosterone (BT) concentrations of the hypertensive population were lower than those of the non-hypertensive population. Binary logistic regression analysis showed that TT, BT, and FT were inversely associated with hypertension. Moreover, decreasing odds ratio (OR) was observed from the lowest tertile group to the highest tertile group. After multivariate adjustment, the correlation between FT, BT, and hypertension was attenuated. Statistically significant differences remained only in the middle tertile group of TT and in the highest tertile group of TT, FT, and BT. In the longitudinal analysis, the 4-y incidence of hypertension was higher in participants with lower TT than in those with higher TT. Subjects in the middle and highest tertile groups of TT had an RR of 0.35 (0.22-0.57) and 0.30 (0.18-0.50), respectively (P for trend <0.001). After further adjustments, these associations still remained statistically significant. CONCLUSIONS Serum TT, FT, and BT concentrations were inversely associated with blood pressure in man, and TT independent of age and body mass index (BMI) influences the development of hypertension. Furthermore, TT can be employed as a risk marker for hypertension in the identification of high-risk individuals.
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Affiliation(s)
- Yonghua Jiang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi 530021, China; Guangxi Key Laboratory of Genomic and Personalized Medicine, Nanning, Guangxi 530021, China; Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi 530021, China
| | - Juan Ye
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi 530021, China; Medical Insurance Section, The Second Affiliated Hospital of Guangxi Medical University, China
| | - Mukun Zhao
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Aihua Tan
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi 530021, China; Department of Chemotherapy, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Haiying Zhang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi 530021, China; Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Yong Gao
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi 530021, China; Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Zheng Lu
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi 530021, China; Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Chunlei Wu
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi 530021, China; Department of Urology, First Affiliated Hospital of Xinxiang Medical College, Xinxiang, Henan Province, China
| | - Yanling Hu
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi 530021, China; Guangxi Key Laboratory of Genomic and Personalized Medicine, Nanning, Guangxi 530021, China; Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi 530021, China
| | - Qiuyan Wang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi 530021, China; Guangxi Key Laboratory of Genomic and Personalized Medicine, Nanning, Guangxi 530021, China; Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi 530021, China
| | - Xiaobo Yang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi 530021, China; Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Zengnan Mo
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi 530021, China; Guangxi Key Laboratory of Genomic and Personalized Medicine, Nanning, Guangxi 530021, China; Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi 530021, China; Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China.
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15
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Karakas SE, Surampudi P. New Biomarkers to Evaluate Hyperandrogenemic Women and Hypogonadal Men. Adv Clin Chem 2018; 86:71-125. [PMID: 30144842 DOI: 10.1016/bs.acc.2018.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Androgens can have variable effects on men and women. Women may be evaluated for androgen excess for several reasons. Typically, young premenopausal women present with clinical symptoms of hirsutism, alopecia, irregular menses, and/or infertility. The most common cause of these symptoms is polycystic ovary syndrome. After menopause, even though ovaries stop producing estrogen, they continue to produce androgen, and women can have new onset of hirsutism and alopecia. Laboratory evaluation involves measurement of the major ovarian and adrenal androgens. In women, age, phase of the menstrual cycle, menopausal status, obesity, metabolic health, and sex hormone-binding proteins significantly affect total-androgen levels and complicate interpretation. This review will summarize the clinically relevant evaluation of hyperandrogenemia at different life stages in women and highlight pitfalls associated with interpretation of commonly used hormone measurements. Hypogonadism in men is a clinical syndrome characterized by low testosterone and/or low sperm count. Symptoms of hypogonadism include decreased libido, erectile dysfunction, decreased vitality, decreased muscle mass, increased adiposity, depressed mood, osteopenia, and osteoporosis. Hypogonadism is a common disorder in aging men. Hypogonadism is observed rarely in young boys and adolescent men. Based on the defects in testes, hypothalamus, and/or pituitary glands, hypogonadism can be broadly classified as primary, secondary, and mixed hypogonadism. Diagnosis of hypogonadism in men is based on symptoms and laboratory measurement. Biomarkers in use/development for hypogonadism are classified as hormonal, Leydig and Sertoli cell function, semen, genetic/RNA, metabolic, microbiome, and muscle mass-related. These biomarkers are useful for diagnosis of hypogonadism, determination of the type of hypogonadism, identification of the underlying causes, and therapeutic assessment. Measurement of serum testosterone is usually the most important single diagnostic test for male hypogonadism. Patients with primary hypogonadism have low testosterone and increased luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Patients with secondary hypogonadism have low testosterone and low or inappropriately normal LH and FSH. This review provides an overview of hypogonadism in men and a detailed discussion of biomarkers currently in use and in development for diagnosis thereof.
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Affiliation(s)
- Sidika E Karakas
- Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, The University of California at Davis, Davis, CA, United States
| | - Prasanth Surampudi
- Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, The University of California at Davis, Davis, CA, United States
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16
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Traish AM, Johansen V. Impact of Testosterone Deficiency and Testosterone Therapy on Lower Urinary Tract Symptoms in Men with Metabolic Syndrome. World J Mens Health 2018; 36:199-222. [PMID: 30079638 PMCID: PMC6119850 DOI: 10.5534/wjmh.180032] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 05/10/2018] [Indexed: 12/11/2022] Open
Abstract
Lower urinary tract function is modulated by neural, vascular and urethral and bladder structural elements. The pathophysiological mechanisms of lower urinary tract symptoms (LUTS) encompass prostate enlargement, alterations in urethra histological structure bladder fibrosis and alterations in pelvic neuronal and vascular networks, The complex pathophysiological relationship between testosterone (T) deficiency (TD) and the constellations LUTS, and metabolic dysfunction manifested in the metabolic syndrome (Met S) remains poorly understood. TD has emerged as one the potential targets by which Met S may contribute to the onset and development as well as worsening of LUTS. Because it has been recognized that treatment of men with Met S with T therapy ameliorates Met S components, it is postulated that T therapy may represent a therapeutic target in improving LUTS. Furthermore, the effect of TD on the prostate remains unclear, and often debatable. It is believed that T exclusively promotes prostate growth, however recent evidence has strongly contradicted this belief. The true relationship between benign prostatic hyperplasia, TD, and LUTS remains elusive and further research will be required to clarify the role of T in both benign prostatic hypertrophy (BPH) and LUTS as a whole. Although there is conflicting evidence about the benefits of T therapy in men with BPH and LUTS, the current body of literature supports the safety of using this therapy in men with enlarged prostate. As the population afflicted with obesity epidemic continues to age, the number of men suffering from Met S and LUTS together is expected to increase.
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Affiliation(s)
- Abdulmaged M Traish
- Department of Urology, Boston University School of Medicine, Boston, MA, USA.
| | - Vanessa Johansen
- Department of Urology, Boston University School of Medicine, Boston, MA, USA
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17
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Protective Effect of Sex Hormone-Binding Globulin against Metabolic Syndrome: In Vitro Evidence Showing Anti-Inflammatory and Lipolytic Effects on Adipocytes and Macrophages. Mediators Inflamm 2018; 2018:3062319. [PMID: 30046278 PMCID: PMC6036814 DOI: 10.1155/2018/3062319] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 02/06/2023] Open
Abstract
Sex hormone-binding globulin (SHBG) is a serum protein released mainly by the liver, and a low serum level correlates with a risk for metabolic syndrome including diabetes, obesity, and cardiovascular events. However, the underlying molecular mechanism(s) linking SHBG and metabolic syndrome remains unknown. In this study, using adipocytes and macrophages, we focused on the in vitro effects of SHBG on inflammation as well as lipid metabolism. Incubation with 20 nM SHBG markedly suppressed lipopolysaccharide- (LPS-) induced inflammatory cytokines, such as MCP-1, TNFα, and IL-6 in adipocytes and macrophages, along with phosphorylations of JNK and ERK. Anti-inflammatory effects were also observed in 3T3-L1 adipocytes cocultured with LPS-stimulated macrophages. In addition, SHBG treatment for 18 hrs or longer significantly induced the lipid degradation of differentiated 3T3-L1 cells, with alterations in its corresponding gene and protein levels. Notably, these effects of SHBG were not altered by coaddition of large amounts of testosterone or estradiol. In conclusion, SHBG suppresses inflammation and lipid accumulation in macrophages and adipocytes, which might be among the mechanisms underlying the protective effect of SHBG, that is, its actions which reduce the incidence of metabolic syndrome.
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18
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Yao QM, Wang B, An XF, Zhang JA, Ding L. Testosterone level and risk of type 2 diabetes in men: a systematic review and meta-analysis. Endocr Connect 2018; 7:220-231. [PMID: 29233816 PMCID: PMC5793809 DOI: 10.1530/ec-17-0253] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 12/12/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Type 2 diabetes is a risk factor for testosterone deficiency and impaired sex steroid status. Some studies also investigated the association of testosterone level with diabetes risk in men, but reported controversial findings. To clarify this issue, we conducted a systematic review and meta-analysis. METHODS PubMed, EMBASE and Web of Science were searched for eligible cohort or nested case-control studies published up to August 15, 2017. Meta-analysis was used to calculate the pooled relative risk (RR) of type 2 diabetes associated with higher testosterone level. RESULTS Thirteen cohort or nested case-control studies with 16,709 participants were included. Meta-analysis showed that higher total testosterone level could significantly decrease the risk of type 2 diabetes in men (RR = 0.65; 95% CI 0.50-0.84; P = 0.001), and higher free testosterone level could also decrease the risk of type 2 diabetes in men (RR = 0.94; 95% CI 0.90-0.99; P = 0.014). After excluding two studies that did not calculate RRs by quartiles of testosterone levels, both higher total testosterone and free testosterone levels could decrease the risk of type 2 diabetes in men, and the pooled RRs were 0.62 (95% CI 0.51-0.76; P < 0.001) and 0.77 (95% CI 0.61-0.98; P = 0.03), respectively. CONCLUSION This meta-analysis suggests that higher testosterone level can significantly decrease the risk of type 2 diabetes in men. Therefore, combined with previous researches, the findings above suggest a reverse-causality scenario in the relation between testosterone deficiency and risk of type 2 diabetes in men.
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Affiliation(s)
- Qiu-Ming Yao
- Department of EndocrinologyJinshan Hospital of Fudan University, Shanghai, China
| | - Bin Wang
- Department of EndocrinologyJinshan Hospital of Fudan University, Shanghai, China
| | - Xiao-Fei An
- Department of EndocrinologyJinshan Hospital of Fudan University, Shanghai, China
| | - Jin-An Zhang
- Department of EndocrinologyShanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Liumei Ding
- Department of Clinical LaboratoryJinshan Hospital of Fudan University, Shanghai, China
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19
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The Utility of Sex Hormone-Binding Globulin in Hypogonadism and Infertile Males. J Urol 2017; 197:1326-1331. [PMID: 28087298 DOI: 10.1016/j.juro.2017.01.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE We sought to determine the role of sex hormone-binding globulin in patients with male infertility. MATERIALS AND METHODS We retrospectively reviewed the records of 168 males seen at a fertility clinic from 2012 to 2014 to investigate the accuracy of total testosterone in the biochemical diagnosis of hypogonadism using calculated bioavailable testosterone as the reference value. We used multivariable analysis to assess sex hormone-binding globulin as an independent predictor of infertility. RESULTS Computations using calculated bioavailable testosterone as a standard in the measurement of definitive biochemical hypogonadism (less than 156 ng/dl) revealed 81% sensitivity, 83% specificity, 81% positive predictive value and 82% negative predictive value for diagnosing hypogonadism with total testosterone alone. Of the 90 men with total testosterone greater than 300 ng/dl, 20% had low bioavailable testosterone less than 156 ng/dl, 52% had borderline low bioavailable testosterone less than 210 ng/dl and only 48% could be considered biochemically eugonadal according to calculated bioavailable testosterone. Of the 80 patients with total testosterone less than 300 ng/dl, 19% had free testosterone levels greater than 6.5 ng/dl and, thus, could be considered to be eugonadal. By a magnitude similar to that of follicle-stimulating hormone, sex hormone-binding globulin independently predicted decreased sperm concentration (p = 0.0027) and motility (p = 0.0447). After excluding men with azoospermia, only sex hormone-binding globulin levels differed significantly in classically hypogonadal men (group 1-total testosterone less than 300 ng/dl) and those missed but hypogonadal (group 2-calculated bioavailable testosterone less than 210 ng/dl) (p = 0.0001). At a more stringent cutoff of calculated bioavailable testosterone less than 156 ng/dl, sperm motility was significantly different for groups 1 and 2 (p = 0.014). CONCLUSIONS Adding sex hormone-binding globulin to total testosterone serum testing facilitates more accurate diagnosis with free testosterone and calculated bioavailable testosterone, and clinical implications of decreased semen parameters to a magnitude similar to that of follicle-stimulating hormone. This warrants further study of the role of sex hormone-binding globulin in male infertility.
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Yang YH, Zhao MJ, Zhou SJ, Lu WH, Liang XW, Xiong CL, Wan CC, Shang XJ, Gu YQ. Is serum sex hormone-binding globulin a dominant risk factor for metabolic syndrome? Asian J Androl 2016; 17:991-5. [PMID: 25851658 PMCID: PMC4814971 DOI: 10.4103/1008-682x.150845] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
This multi-center, cross-sectional study investigated the association between serum testosterone (T) levels, serum sex hormone-binding globulin (SHBG) levels, and the risk of metabolic syndrome (MS) in 3332 adult Chinese men. The prevalence of MS was 34.7%, and men with MS had lower serum levels of total T (TT) and SHBG than those without MS (P < 0.001). There was no significant difference in serum free T (FT) levels between subjects with and without MS (P = 0.627). In logistic regression analysis, the association between MS and serum SHBG levels persisted after adjusting for age, body mass index (BMI), smoking and drinking status, and serum TT (odds ratio [OR] 0.962, 95% confidence interval [95% CI] 0.954-0.969, P< 0.01). However, the association between serum TT level and the risk of MS was weak after adjusting for age, BMI, SHBG level, and smoking and drinking status (OR 0.981, 95% CI 0.960-1.007). Our study reveals that both serum TT and SHBG levels, but not serum FT, are inversely associated with the prevalence of MS and that serum SHBG is an independent and dominant risk factor for MS.
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Affiliation(s)
| | | | | | | | | | | | | | - Xue-Jun Shang
- Department of Andrology, Nanjing General Hospital of Nanjing Command, PLA, Nanjing 210002, China
| | - Yi-Qun Gu
- Graduate School of Peking Union Medical College, Beijing 100730; National Health and Family Planning Key Laboratory of Male Reproductive Health, Department of Male Clinical Research, National Research Institute for Family Planning, Beijing 100081, China
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Ring JD, Lwin AA, Köhler TS. Current medical management of endocrine-related male infertility. Asian J Androl 2016; 18:357-63. [PMID: 27098657 PMCID: PMC4854080 DOI: 10.4103/1008-682x.179252] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 03/18/2016] [Accepted: 03/21/2016] [Indexed: 01/16/2023] Open
Abstract
Male factor contributes to 50%-60% of overall infertility but is solely responsible in only 20% of couples. Although most male factor infertility is ascertained from an abnormal semen analysis, other male factors can be contributory especially if the sample returns normal. Male infertility can be due to identifiable hormonal or anatomical etiologies that may be reversible or irreversible. This manuscript will highlight existing guidelines and our recommendations for hormone evaluation for male infertility and empiric therapies including multivitamins, estrogen receptor modulators (clomiphene), estrogen conversion blockers (anastrozole), and hormone replacement.
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Affiliation(s)
- Joshua D Ring
- Division of Urology, Department of Surgery, Southern Illinois University, Springfield, IL 62794, USA
| | - Aye A Lwin
- Division of Urology, Department of Surgery, Southern Illinois University, Springfield, IL 62794, USA
| | - Tobias S Köhler
- Division of Urology, Department of Surgery, Southern Illinois University, Springfield, IL 62794, USA
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Abstract
Controversies surround the usefulness of identifying patients with the metabolic syndrome (MetS). Many of the components are accepted risk factors for cardiovascular disease (CVD). Although the MetS as defined includes many men with insulin resistance, insulin resistance is not universal. The low total testosterone (TT) and sex hormone binding globulin (SHBG) levels in these men are best explained by the hyperinsulinism and increased inflammatory cytokines that accompany obesity and increased waist circumference. It is informative that low SHBG levels predict future development of the MetS. Evidence is strong relating low TT levels to CVD in men with and without the MetS; however, the relationship may not be causal. The recommendations of the International Diabetes Federation for managing the MetS include cardiovascular risk assessment, lifestyle changes in diet, exercise, weight reduction and treatment of individual components of the MetS. Unfortunately, it is uncommon to see patients with the MetS lose and maintain a 10% weight loss. Recent reports showing testosterone treatment induced dramatic changes in weight, waist circumference, insulin sensitivity, hemoglobin A1c levels and improvements in each of the components of the MetS are intriguing. While some observational studies have reported that testosterone replacement therapy increases cardiovascular events, the Food and Drug Administration in the United States has reviewed these reports and found them to be seriously flawed. Large, randomized, placebo-controlled trials are needed to provide more definitive data regarding the efficacy and safety of this treatment in middle and older men with the MetS and low TT levels.
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Affiliation(s)
- Glenn R Cunningham
- Departments of Medicine and Molecular and Cellular Biology, Baylor College of Medicine, Baylor St. Luke's Medical Center, 6624 Fannin, Suite 1180, Houston, TX 77030, USA
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Cooper LA, Page ST, Amory JK, Anawalt BD, Matsumoto AM. The association of obesity with sex hormone-binding globulin is stronger than the association with ageing--implications for the interpretation of total testosterone measurements. Clin Endocrinol (Oxf) 2015; 83:828-33. [PMID: 25777143 PMCID: PMC4782930 DOI: 10.1111/cen.12768] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 01/18/2015] [Accepted: 03/05/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Total testosterone concentrations are influenced by sex hormone-binding globulin (SHBG) concentrations, which are decreased by obesity and increased with ageing. Therefore, we sought to understand and compare the associations of ageing and obesity with SHBG. DESIGN We performed a retrospective, cross-sectional analysis of the associations of obesity and age on SHBG and testosterone measurements in men being evaluated for hypogonadism. PATIENTS, MEASUREMENTS AND ANALYSIS A total of 3671 men who underwent laboratory testing for testosterone deficiency from the Veterans Administration Puget Sound Health Care System from 1997 through 2007 was included. Univariate and multivariate linear regression modelling of the associations between age and body mass index (BMI) and SHBG was performed. RESULTS Obesity was associated with a significantly lower SHBG [β = -1·26 (95% CI -1·14, -1·38) nmol/l] per unit increase in BMI. In contrast, ageing was associated with a significantly increased SHBG [β = 0·46 (95% CI 0·39, 0·53) nmol/l per year] (P < 0·001 for both effects). The association of obesity with lower SHBG was two to three times larger than the association of ageing with increased SHBG in both univariate and multivariate modelling. On average, obese men (BMI >30 kg/m(2)) had significantly lower SHBG and total testosterone concentrations than nonobese men [(mean ± SD) SHBG: 36 ± 22 vs 50 ± 27 nmol/l and total testosterone: 10·5 ± 5·4 nmol/l vs 14·1 ± 7·4 nmol/l; (P < 0·001 for both comparisons)], but calculated free testosterone concentrations did not differ between obese and nonobese men. CONCLUSIONS We found that the association between obesity and lowered SHBG is greater than the association of ageing with increased SHBG. These competing effects may impact total testosterone measurements for the diagnosis of low testosterone, particularly in obese men.
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Affiliation(s)
- Lori A Cooper
- Center for Research in Reproduction and Contraception, University of Washington, Seattle, WA, USA
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Stephanie T Page
- Center for Research in Reproduction and Contraception, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - John K Amory
- Center for Research in Reproduction and Contraception, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Bradley D Anawalt
- Center for Research in Reproduction and Contraception, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Alvin M Matsumoto
- Center for Research in Reproduction and Contraception, University of Washington, Seattle, WA, USA
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
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24
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Mather KJ, Kim C, Christophi CA, Aroda VR, Knowler WC, Edelstein SE, Florez JC, Labrie F, Kahn SE, Goldberg RB, Barrett-Connor E. Steroid Sex Hormones, Sex Hormone-Binding Globulin, and Diabetes Incidence in the Diabetes Prevention Program. J Clin Endocrinol Metab 2015; 100. [PMID: 26200237 PMCID: PMC4596040 DOI: 10.1210/jc.2015-2328] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Steroid sex hormones and SHBG may modify metabolism and diabetes risk, with implications for sex-specific diabetes risk and effects of prevention interventions. OBJECTIVE This study aimed to evaluate the relationships of steroid sex hormones, SHBG and SHBG single-nucleotide polymorphisms (SNPs) with diabetes risk factors and with progression to diabetes in the Diabetes Prevention Program (DPP). DESIGN AND SETTING This was a secondary analysis of a multicenter randomized clinical trial involving 27 U.S. academic institutions. PARTICIPANTS The study included 2898 DPP participants: 969 men, 948 premenopausal women not taking exogenous sex hormones, 550 postmenopausal women not taking exogenous sex hormones, and 431 postmenopausal women taking exogenous sex hormones. INTERVENTIONS Participants were randomized to receive intensive lifestyle intervention, metformin, or placebo. MAIN OUTCOMES Associations of steroid sex hormones, SHBG, and SHBG SNPs with glycemia and diabetes risk factors, and with incident diabetes over median 3.0 years (maximum, 5.0 y). RESULTS T and DHT were inversely associated with fasting glucose in men, and estrone sulfate was directly associated with 2-hour post-challenge glucose in men and premenopausal women. SHBG was associated with fasting glucose in premenopausal women not taking exogenous sex hormones, and in postmenopausal women taking exogenous sex hormones, but not in the other groups. Diabetes incidence was directly associated with estrone and estradiol and inversely with T in men; the association with T was lost after adjustment for waist circumference. Sex steroids were not associated with diabetes outcomes in women. SHBG and SHBG SNPs did not predict incident diabetes in the DPP population. CONCLUSIONS Estrogens and T predicted diabetes risk in men but not in women. SHBG and its polymorphisms did not predict risk in men or women. Diabetes risk is more potently determined by obesity and glycemia than by sex hormones.
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Affiliation(s)
- K J Mather
- Department of Medicine (K.J.M.), Indiana University, Indianapolis, Indiana 46202; Departments of Medicine and Obstetrics & Gynecology (C.K.), University of Michigan, Ann Arbor, Michigan 48109; Biostatistics Center (C.A.C., S.E.E.), George Washington University, Rockville, Maryland 20850; Medstar Health Research Institute (V.R.A.), Hyattsville, Maryland 20782; National Institute of Diabetes and Digestive and Kidney Diseases (W.C.K.), Phoenix, Arizona 85014; Diabetes Research Center (Diabetes Unit) and Center for Human Genetics Research (J.C.F.), Massachusetts General Hospital, Boston, Massachusetts 02114; Program in Medical and Population Genetics (J.C.F.), Broad Institute, Cambridge, Massachusetts 02142; Department of Medicine (J.C.F.), Harvard Medical School, Boston, Massachusetts 02115; Endoceutics Inc. (F.L.), Québec City, G1W 2J5, Canada; VA Puget Sound Health Care System and University of Washington (S.E.K.), Seattle, Washington 98108; University of Miami (R.B.G.), Miami, Florida 33124; and University of California, San Diego (E.B.-C.), San Diego, California 92093
| | - C Kim
- Department of Medicine (K.J.M.), Indiana University, Indianapolis, Indiana 46202; Departments of Medicine and Obstetrics & Gynecology (C.K.), University of Michigan, Ann Arbor, Michigan 48109; Biostatistics Center (C.A.C., S.E.E.), George Washington University, Rockville, Maryland 20850; Medstar Health Research Institute (V.R.A.), Hyattsville, Maryland 20782; National Institute of Diabetes and Digestive and Kidney Diseases (W.C.K.), Phoenix, Arizona 85014; Diabetes Research Center (Diabetes Unit) and Center for Human Genetics Research (J.C.F.), Massachusetts General Hospital, Boston, Massachusetts 02114; Program in Medical and Population Genetics (J.C.F.), Broad Institute, Cambridge, Massachusetts 02142; Department of Medicine (J.C.F.), Harvard Medical School, Boston, Massachusetts 02115; Endoceutics Inc. (F.L.), Québec City, G1W 2J5, Canada; VA Puget Sound Health Care System and University of Washington (S.E.K.), Seattle, Washington 98108; University of Miami (R.B.G.), Miami, Florida 33124; and University of California, San Diego (E.B.-C.), San Diego, California 92093
| | - C A Christophi
- Department of Medicine (K.J.M.), Indiana University, Indianapolis, Indiana 46202; Departments of Medicine and Obstetrics & Gynecology (C.K.), University of Michigan, Ann Arbor, Michigan 48109; Biostatistics Center (C.A.C., S.E.E.), George Washington University, Rockville, Maryland 20850; Medstar Health Research Institute (V.R.A.), Hyattsville, Maryland 20782; National Institute of Diabetes and Digestive and Kidney Diseases (W.C.K.), Phoenix, Arizona 85014; Diabetes Research Center (Diabetes Unit) and Center for Human Genetics Research (J.C.F.), Massachusetts General Hospital, Boston, Massachusetts 02114; Program in Medical and Population Genetics (J.C.F.), Broad Institute, Cambridge, Massachusetts 02142; Department of Medicine (J.C.F.), Harvard Medical School, Boston, Massachusetts 02115; Endoceutics Inc. (F.L.), Québec City, G1W 2J5, Canada; VA Puget Sound Health Care System and University of Washington (S.E.K.), Seattle, Washington 98108; University of Miami (R.B.G.), Miami, Florida 33124; and University of California, San Diego (E.B.-C.), San Diego, California 92093
| | - V R Aroda
- Department of Medicine (K.J.M.), Indiana University, Indianapolis, Indiana 46202; Departments of Medicine and Obstetrics & Gynecology (C.K.), University of Michigan, Ann Arbor, Michigan 48109; Biostatistics Center (C.A.C., S.E.E.), George Washington University, Rockville, Maryland 20850; Medstar Health Research Institute (V.R.A.), Hyattsville, Maryland 20782; National Institute of Diabetes and Digestive and Kidney Diseases (W.C.K.), Phoenix, Arizona 85014; Diabetes Research Center (Diabetes Unit) and Center for Human Genetics Research (J.C.F.), Massachusetts General Hospital, Boston, Massachusetts 02114; Program in Medical and Population Genetics (J.C.F.), Broad Institute, Cambridge, Massachusetts 02142; Department of Medicine (J.C.F.), Harvard Medical School, Boston, Massachusetts 02115; Endoceutics Inc. (F.L.), Québec City, G1W 2J5, Canada; VA Puget Sound Health Care System and University of Washington (S.E.K.), Seattle, Washington 98108; University of Miami (R.B.G.), Miami, Florida 33124; and University of California, San Diego (E.B.-C.), San Diego, California 92093
| | - W C Knowler
- Department of Medicine (K.J.M.), Indiana University, Indianapolis, Indiana 46202; Departments of Medicine and Obstetrics & Gynecology (C.K.), University of Michigan, Ann Arbor, Michigan 48109; Biostatistics Center (C.A.C., S.E.E.), George Washington University, Rockville, Maryland 20850; Medstar Health Research Institute (V.R.A.), Hyattsville, Maryland 20782; National Institute of Diabetes and Digestive and Kidney Diseases (W.C.K.), Phoenix, Arizona 85014; Diabetes Research Center (Diabetes Unit) and Center for Human Genetics Research (J.C.F.), Massachusetts General Hospital, Boston, Massachusetts 02114; Program in Medical and Population Genetics (J.C.F.), Broad Institute, Cambridge, Massachusetts 02142; Department of Medicine (J.C.F.), Harvard Medical School, Boston, Massachusetts 02115; Endoceutics Inc. (F.L.), Québec City, G1W 2J5, Canada; VA Puget Sound Health Care System and University of Washington (S.E.K.), Seattle, Washington 98108; University of Miami (R.B.G.), Miami, Florida 33124; and University of California, San Diego (E.B.-C.), San Diego, California 92093
| | - S E Edelstein
- Department of Medicine (K.J.M.), Indiana University, Indianapolis, Indiana 46202; Departments of Medicine and Obstetrics & Gynecology (C.K.), University of Michigan, Ann Arbor, Michigan 48109; Biostatistics Center (C.A.C., S.E.E.), George Washington University, Rockville, Maryland 20850; Medstar Health Research Institute (V.R.A.), Hyattsville, Maryland 20782; National Institute of Diabetes and Digestive and Kidney Diseases (W.C.K.), Phoenix, Arizona 85014; Diabetes Research Center (Diabetes Unit) and Center for Human Genetics Research (J.C.F.), Massachusetts General Hospital, Boston, Massachusetts 02114; Program in Medical and Population Genetics (J.C.F.), Broad Institute, Cambridge, Massachusetts 02142; Department of Medicine (J.C.F.), Harvard Medical School, Boston, Massachusetts 02115; Endoceutics Inc. (F.L.), Québec City, G1W 2J5, Canada; VA Puget Sound Health Care System and University of Washington (S.E.K.), Seattle, Washington 98108; University of Miami (R.B.G.), Miami, Florida 33124; and University of California, San Diego (E.B.-C.), San Diego, California 92093
| | - J C Florez
- Department of Medicine (K.J.M.), Indiana University, Indianapolis, Indiana 46202; Departments of Medicine and Obstetrics & Gynecology (C.K.), University of Michigan, Ann Arbor, Michigan 48109; Biostatistics Center (C.A.C., S.E.E.), George Washington University, Rockville, Maryland 20850; Medstar Health Research Institute (V.R.A.), Hyattsville, Maryland 20782; National Institute of Diabetes and Digestive and Kidney Diseases (W.C.K.), Phoenix, Arizona 85014; Diabetes Research Center (Diabetes Unit) and Center for Human Genetics Research (J.C.F.), Massachusetts General Hospital, Boston, Massachusetts 02114; Program in Medical and Population Genetics (J.C.F.), Broad Institute, Cambridge, Massachusetts 02142; Department of Medicine (J.C.F.), Harvard Medical School, Boston, Massachusetts 02115; Endoceutics Inc. (F.L.), Québec City, G1W 2J5, Canada; VA Puget Sound Health Care System and University of Washington (S.E.K.), Seattle, Washington 98108; University of Miami (R.B.G.), Miami, Florida 33124; and University of California, San Diego (E.B.-C.), San Diego, California 92093
| | - F Labrie
- Department of Medicine (K.J.M.), Indiana University, Indianapolis, Indiana 46202; Departments of Medicine and Obstetrics & Gynecology (C.K.), University of Michigan, Ann Arbor, Michigan 48109; Biostatistics Center (C.A.C., S.E.E.), George Washington University, Rockville, Maryland 20850; Medstar Health Research Institute (V.R.A.), Hyattsville, Maryland 20782; National Institute of Diabetes and Digestive and Kidney Diseases (W.C.K.), Phoenix, Arizona 85014; Diabetes Research Center (Diabetes Unit) and Center for Human Genetics Research (J.C.F.), Massachusetts General Hospital, Boston, Massachusetts 02114; Program in Medical and Population Genetics (J.C.F.), Broad Institute, Cambridge, Massachusetts 02142; Department of Medicine (J.C.F.), Harvard Medical School, Boston, Massachusetts 02115; Endoceutics Inc. (F.L.), Québec City, G1W 2J5, Canada; VA Puget Sound Health Care System and University of Washington (S.E.K.), Seattle, Washington 98108; University of Miami (R.B.G.), Miami, Florida 33124; and University of California, San Diego (E.B.-C.), San Diego, California 92093
| | - S E Kahn
- Department of Medicine (K.J.M.), Indiana University, Indianapolis, Indiana 46202; Departments of Medicine and Obstetrics & Gynecology (C.K.), University of Michigan, Ann Arbor, Michigan 48109; Biostatistics Center (C.A.C., S.E.E.), George Washington University, Rockville, Maryland 20850; Medstar Health Research Institute (V.R.A.), Hyattsville, Maryland 20782; National Institute of Diabetes and Digestive and Kidney Diseases (W.C.K.), Phoenix, Arizona 85014; Diabetes Research Center (Diabetes Unit) and Center for Human Genetics Research (J.C.F.), Massachusetts General Hospital, Boston, Massachusetts 02114; Program in Medical and Population Genetics (J.C.F.), Broad Institute, Cambridge, Massachusetts 02142; Department of Medicine (J.C.F.), Harvard Medical School, Boston, Massachusetts 02115; Endoceutics Inc. (F.L.), Québec City, G1W 2J5, Canada; VA Puget Sound Health Care System and University of Washington (S.E.K.), Seattle, Washington 98108; University of Miami (R.B.G.), Miami, Florida 33124; and University of California, San Diego (E.B.-C.), San Diego, California 92093
| | - R B Goldberg
- Department of Medicine (K.J.M.), Indiana University, Indianapolis, Indiana 46202; Departments of Medicine and Obstetrics & Gynecology (C.K.), University of Michigan, Ann Arbor, Michigan 48109; Biostatistics Center (C.A.C., S.E.E.), George Washington University, Rockville, Maryland 20850; Medstar Health Research Institute (V.R.A.), Hyattsville, Maryland 20782; National Institute of Diabetes and Digestive and Kidney Diseases (W.C.K.), Phoenix, Arizona 85014; Diabetes Research Center (Diabetes Unit) and Center for Human Genetics Research (J.C.F.), Massachusetts General Hospital, Boston, Massachusetts 02114; Program in Medical and Population Genetics (J.C.F.), Broad Institute, Cambridge, Massachusetts 02142; Department of Medicine (J.C.F.), Harvard Medical School, Boston, Massachusetts 02115; Endoceutics Inc. (F.L.), Québec City, G1W 2J5, Canada; VA Puget Sound Health Care System and University of Washington (S.E.K.), Seattle, Washington 98108; University of Miami (R.B.G.), Miami, Florida 33124; and University of California, San Diego (E.B.-C.), San Diego, California 92093
| | - E Barrett-Connor
- Department of Medicine (K.J.M.), Indiana University, Indianapolis, Indiana 46202; Departments of Medicine and Obstetrics & Gynecology (C.K.), University of Michigan, Ann Arbor, Michigan 48109; Biostatistics Center (C.A.C., S.E.E.), George Washington University, Rockville, Maryland 20850; Medstar Health Research Institute (V.R.A.), Hyattsville, Maryland 20782; National Institute of Diabetes and Digestive and Kidney Diseases (W.C.K.), Phoenix, Arizona 85014; Diabetes Research Center (Diabetes Unit) and Center for Human Genetics Research (J.C.F.), Massachusetts General Hospital, Boston, Massachusetts 02114; Program in Medical and Population Genetics (J.C.F.), Broad Institute, Cambridge, Massachusetts 02142; Department of Medicine (J.C.F.), Harvard Medical School, Boston, Massachusetts 02115; Endoceutics Inc. (F.L.), Québec City, G1W 2J5, Canada; VA Puget Sound Health Care System and University of Washington (S.E.K.), Seattle, Washington 98108; University of Miami (R.B.G.), Miami, Florida 33124; and University of California, San Diego (E.B.-C.), San Diego, California 92093
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Pintana H, Chattipakorn N, Chattipakorn S. Testosterone deficiency, insulin-resistant obesity and cognitive function. Metab Brain Dis 2015; 30:853-76. [PMID: 25703239 DOI: 10.1007/s11011-015-9655-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 02/03/2015] [Indexed: 12/29/2022]
Abstract
Testosterone is an androgenic steroid hormone, which plays an important role in the regulation of male reproduction and behaviors, as well as in the maintenance of insulin sensitivity. Several studies showed that testosterone exerted beneficial effects in brain function, including preventing neuronal cell death, balancing brain oxidative stress and antioxidant activity, improving synaptic plasticity and involving cognitive formation. Although previous studies showed that testosterone deficiency is positively correlated with cognitive impairment and insulin-resistant obesity, several studies demonstrated contradictory findings. Thus, this review comprehensively summarizes the current evidence from in vitro, in vivo and clinical studies of the relationship between testosterone deficiency and insulin-resistant obesity as well as the correlation between either insulin-resistant obesity or testosterone deficiency and cognitive impairment. Controversial reports and the mechanistic insights regarding the roles of testosterone in insulin-resistant obesity and cognitive function are also presented and discussed.
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Affiliation(s)
- Hiranya Pintana
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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26
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Liao M, Guo X, Yu X, Pang G, Zhang S, Li J, Tan A, Gao Y, Yang X, Zhang H, Qin X, Mo L, Lu Z, Wu C, Mo Z. Role of metabolic factors in the association between osteocalcin and testosterone in Chinese men. J Clin Endocrinol Metab 2013; 98:3463-9. [PMID: 23824426 DOI: 10.1210/jc.2013-1805] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Osteocalcin can regulate energy metabolism and increase testosterone production. Although previous studies have shown the positive association between osteocalcin and testosterone, the effect of metabolic factors in the association is unclear. DESIGN AND SETTING Osteocalcin, testosterone, and metabolic factors were accessed in 2400 men aged 20 to 69 years, who participated in the population-based Fangchenggang Area Male Health and Examination Survey in Guangxi province of China from September 2009 to December 2009. MAIN OUTCOME MEASURES Metabolic syndrome was defined based on the updated report of National Cholesterol Education Program Adult Treatment Panel III criteria. Serum total osteocalcin, total testosterone (TT), and sex hormone binding globulin (SHBG) were measured, whereas free testosterone (FT) and bioavailable testosterone (BT) were calculated based on Vermeulen's formula. The multivariable linear regression analysis was used. RESULTS Osteocalcin was positively associated with TT, FT, and BT in the unadjusted model (all P < .001). After adjusting for age, the positive association between osteocalcin and TT remained statistically significant (β = .17, 95% confidence interval = 0.14-0.20) and was not attenuated in each MetS subgroup including hypertriglyceridemia, hyperglycemia, elevated blood pressure, and low high-density lipoprotein cholesterol, while in the group of central obesity (waist circumstance ≥90 cm), the association appeared significantly stronger (β = 0.21, 95% confidence interval = 0.12-0.30). After further adjusting for SHBG, osteocalcin was positively associated with TT, FT, and BT in men with central obesity or men with any two MetS components (all P < .05). CONCLUSIONS Serum total osteocalcin is positively associated with testosterone, which is probably modified by SHBG and central obesity.
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Affiliation(s)
- Ming Liao
- Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, People's Republic of China
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