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Fu Z, Zeng J, Zhu L, Wang G, Li P, Li W, Song Z, Su Z, Sun X, Tang H, Luo P, Tan L, Gao L, Wang D, Yan S, Zhou L, Tong X, Tang Z, Zhang H, Tan W, Lu J, Zhu S. Clinical factors associated with remission of obese acanthosis nigricans after laparoscopic sleeve gastrectomy: a prospective cohort study. Int J Surg 2023; 109:3944-3953. [PMID: 37678289 PMCID: PMC10720823 DOI: 10.1097/js9.0000000000000693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/07/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Acanthosis nigricans (AN) involves skin hyperpigmentation in body folds and creases. Obesity-associated AN (OB_AN) is the most common type of AN. The skin condition of obese patients with AN can be improved through bariatric surgery, such as laparoscopic sleeve gastrectomy (LSG), after weight loss. However, the contributing factors to the remission of AN after surgery are still not fully determined. The authors aimed to assess the metabolic and pathological factors associated with remission of AN following LSG in obese individuals. METHODS The study included 319 obese patients who underwent LSG at our hospital. The subjects were divided into obesity (OB) only (OB, n =178) or OB with AN (OB_AN, n =141) groups. The basic clinical and metabolic indices and the dermatological features via reflectance confocal microscopy and histology were collected from patients prior to and after LSG. RESULTS OB_AN patients had higher fasting plasma glucose, homeostatic model assessment for insulin resistance, and testosterone levels than OB patients. LSG could significantly improve the biochemical and histopathological features of OB_AN patients. The remissive rate of OB_AN patients was about 86.5% (122 out of 141) after surgery. The remission of OB_AN skin lesions was positively correlated with testosterone levels ( P <0.01). In addition, there was a significant positive correlation between changes in AN scores and epidermal thickness and skin pigmentation scores after surgery ( P <0.01). CONCLUSION The remissive rate of OB_AN after LSG is associated with improved testosterone levels and reduced epidermal thickness and skin pigmentation levels.
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Affiliation(s)
- Zhibing Fu
- Department of General Surgery
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Jinrong Zeng
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | | | | | | | | | | | | | | | | | | | - Lina Tan
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Lihua Gao
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Dan Wang
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Siyu Yan
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Lu Zhou
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Xiaoliao Tong
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Zhen Tang
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Hanyi Zhang
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Wenbin Tan
- Department of Cell Biology and Anatomy, School of Medicine
- Department of Biomedical Engineering, College of Engineering and Computing, University of South Carolina, Columbia, South Carolina, USA
| | - Jianyun Lu
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
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Kang W, Mohamad Sithik MN, Khoo J, Ooi Y, Lim Q, Lim L. Gaps in the management of diabetes in Asia: A need for improved awareness and strategies in men's sexual health. J Diabetes Investig 2022; 13:1945-1957. [PMID: 36151988 PMCID: PMC9720202 DOI: 10.1111/jdi.13903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/22/2022] [Accepted: 08/17/2022] [Indexed: 11/28/2022] Open
Abstract
Sexual dysfunction, which is defined as 'difficulty during any stage of the sexual encounter that prevents or impairs the individual or couple from enjoying sexual activity', is globally prevalent in males with prediabetes and diabetes. It is an early harbinger of cardiovascular diseases and has a profound impact on one's physical, mental, and social health. Among patients with either prediabetes or diabetes, the most common male sexual dysfunctions are hypogonadism, erectile dysfunction, and premature ejaculation. In Asia, although sexual health is an important factor of men's health, it is rarely discussed freely in real-life practice. Addressing sexual health in Asian males has always been challenging with multiple barriers at the levels of patients and health care providers. Therefore, the assessment and management of sexual dysfunction in routine clinical practice should involve a holistic approach with effective patient-provider communication. In this review, we discuss the epidemiology, pathophysiology, and the management of hypogonadism, erectile dysfunction, and premature ejaculation among males with either prediabetes or diabetes (type 1 and type 2), as well as the evidence gaps across Asia.
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Affiliation(s)
- Waye‐Hann Kang
- Department of Medicine, Faculty of Medicine and Health SciencesUniversity Tunku Abdul RahmanSelangorMalaysia
| | | | - Jun‐Kit Khoo
- Department of Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Ying‐Guat Ooi
- Department of Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Quan‐Hziung Lim
- Department of Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Lee‐Ling Lim
- Department of Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
- Department of Medicine and TherapeuticsThe Chinese University of Hong KongHong Kong SARChina
- Asia Diabetes FoundationHong Kong SARChina
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Santos HO, Cadegiani FA, Forbes SC. Nonpharmacological Interventions for the Management of Testosterone and Sperm Parameters: A Scoping Review. Clin Ther 2022; 44:1129-1149. [PMID: 35810031 DOI: 10.1016/j.clinthera.2022.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/23/2022] [Accepted: 06/16/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Testosterone replacement and associated pharmacologic agents are effective strategies to treat male hypogonadism; however, nutraceutical agents and lifestyle modification approaches have gained medical interest. The purpose of this scoping review is to highlight the evidence (or lack thereof) of nutraceuticals and lifestyle modification approaches in the management of testosterone levels and sperm parameters. METHODS A scoping review of nonpharmacologic interventions (supplements, herbal medicines, diets, sleep, and exercise) with the potential to improve male health was undertaken to elucidate changes in testosterone levels and sperm parameters in men with hypogonadism or infertility compared with healthy patients. FINDINGS A multitude of nutraceuticals and functional nutrients are purported to stimulate testosterone production; however, only a select few have had promising results, such as zinc, vitamin D (in case of hypovitaminosis D), l-arginine, mucuna, and ashwagandha, based on well-controlled randomized clinical trials of men with low testosterone levels and related problems. Except for l-arginine, these natural agents, as well as tribulus and ω3 fatty acids, can improve some degree of sperm parameters in infertile men. Before implementing these nutraceutical agents, adequate sleep, exercise, and weight loss in patients with obesity are imperative. The effects of nonpharmacologic interventions on testosterone levels are modest and hence do not directly translate into clinical benefits. Correspondingly, androgen receptor content, but not endogenous androgens, has been regarded as the principal factor in muscle hypertrophy. IMPLICATIONS A limited number of supplements and herbal medicines can be considered as adjunctive approaches in the management of testosterone levels and sperm parameters, primarily in men with low testosterone levels and infertility, whereas most nonpharmacologic supplements appear to lack evidence. Although proper physical exercise, sleep, and diet are indisputable approaches because of the general benefits to health, the use of nutraceuticals, if considered, must be personalized by physicians and/or registered dietitians.
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Affiliation(s)
- Heitor O Santos
- School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Flávio A Cadegiani
- Applied Biology Inc, Irvine, California; Department of Endocrinology, Corpometria Institute, Brasilia, Brazil
| | - Scott C Forbes
- Faculty of Education, Department of Physical Education Studies, Brandon University, Brandon, Manitoba, Canada
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Borbélyová V, Šarayová V, Renczés E, Čonka J, Janko J, Šebeková K, Štefíková K, Ostatníková D, Celec P. The effect of long-term hypogonadism on body composition and morphometry of aged male Wistar rats. Physiol Res 2021; 70:S357-S367. [PMID: 35099254 PMCID: PMC8884397 DOI: 10.33549/physiolres.934836] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 11/11/2021] [Indexed: 11/25/2022] Open
Abstract
Clinical studies show that hypogonadism in the aging male is associated with obesity and osteoporosis. Experimental studies are mostly conducted on relatively young adult animals and the induced hypogonadism lasts for a relatively short time. The present study aimed to describe the effect of long-term hypogonadism beginning in puberty on body composition, morphometry, and bone mineral density in aged male rats. Morphometric measurements and dual-energy X-ray absorptiometry were conducted at the age of 30 months on control and gonadectomized males. Long-term hypogonadism did not affect body weight, but led to a higher fat mass (by 26 %), lower lean mass (by 44 %), shorter body length (by 9 %), and anogenital distance (by 26 %), as well as to lower tail circumference (by 15 %) in comparison to control males. Lower bone mineral density (by 13 %) and bone mineral content (by 15 %) were observed in gonadectomized males. Results showing sarcopenic obesity and osteoporosis in this model of long-term hypogonadism might mimic the situation in aging males better than the widely used short-term hypogonadism induced in young animals. The morphometric analysis could potentially be a useful tool to study normal weight obesity without the need for specific equipment.
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Affiliation(s)
- V Borbélyová
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic.
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张 玲, 李 贵, 苏 莉, 杜 磊, 周 东, 程 晓, 林 紫, 曲 伸. [Correlation between total testosterone levels and insulin resistance in patients with acanthosis nigricans and non-acanthosis nigrican]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:1780-1786. [PMID: 35012908 PMCID: PMC8752425 DOI: 10.12122/j.issn.1673-4254.2021.12.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate the correlation of the total testosterone (TT) level with insulin secretion and resistance in patients with acanthosis nigricans (AN) and non-acanthosis nigricans (NAN). METHODS This study was conducted in a total of 639 overweight patients (body mass index ≥24 kg/m2), including 137 female AN patients, 277 female NAN patients, 129 male AN patients, and 146 male NAN patients. Each group was further divided into 4 subgroups according to the quartile of TT level for comparison of insulin secretion and insulin resistance parameters. RESULTS Both female and male patients with AN showed obvious hyperinsulinemia with increased area under the curve for insulin (AUC-INS) (P < 0.05), increased homeostatic model assessment of insulin resistance (HOMA-IR) index (P < 0.05) and decreased whole-body insulin sensitivity index (WBISI) (P < 0.01) as compared with those in NAN groups, but these parameters did not show significant variations with the change of TT levels. In female patients with NAN, insulin secretion level increased progressively as the TT level increased; the AUC-INS increased (P < 0.01) and WBISI decreased significantly (P < 0.05) when the TT levels increased to Q4. In male patients with NAN, insulin secretion level increased progressively as the TT levels decreased, and the AUC-INS increased (P < 0.05) and the WBISI decreased significantly (P < 0.05) when the TT levels decreased to Q1. CONCLUSIONS The TT level has a significant effect on insulin resistance and insulin secretion, but its effect varies between genders and is more significant in NAN patients than in AN patients.
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Affiliation(s)
- 玲 张
- 南京医科大学附属上海十院临床医学院内分泌与代谢病科,上海 200072Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital of Nanjing Medical University, Shanghai 200072, China
- 苏州大学附属常州肿瘤医院内分泌科,江苏 常州 213000Department of Endocrinology, Changzhou Cancer Hospital of Soochow University, Changzhou 213000, China
| | - 贵芳 李
- 同济大学附属第十人民医院内分泌代谢中心,同济大学附属第十人民医院减重糖尿病代谢外科,国家标准化代谢性疾病管理中心(上海市第十人民医院),同济大学医学院肥胖症研究所,上海 200072Endocrinology and Metabolism Center, Department of Metabolic Surgery for Obesity and Diabetes, Tenth People's Hospital of Tongji University; National Metabolic Management Center (Shanghai Tenth People's Hospital), Research Institute of Obesity, Tongji University School of Medicine, Shanghai 200072, China
| | - 莉莉 苏
- 同济大学附属第十人民医院内分泌代谢中心,同济大学附属第十人民医院减重糖尿病代谢外科,国家标准化代谢性疾病管理中心(上海市第十人民医院),同济大学医学院肥胖症研究所,上海 200072Endocrinology and Metabolism Center, Department of Metabolic Surgery for Obesity and Diabetes, Tenth People's Hospital of Tongji University; National Metabolic Management Center (Shanghai Tenth People's Hospital), Research Institute of Obesity, Tongji University School of Medicine, Shanghai 200072, China
| | - 磊 杜
- 同济大学附属第十人民医院内分泌代谢中心,同济大学附属第十人民医院减重糖尿病代谢外科,国家标准化代谢性疾病管理中心(上海市第十人民医院),同济大学医学院肥胖症研究所,上海 200072Endocrinology and Metabolism Center, Department of Metabolic Surgery for Obesity and Diabetes, Tenth People's Hospital of Tongji University; National Metabolic Management Center (Shanghai Tenth People's Hospital), Research Institute of Obesity, Tongji University School of Medicine, Shanghai 200072, China
| | - 东雷 周
- 同济大学附属第十人民医院内分泌代谢中心,同济大学附属第十人民医院减重糖尿病代谢外科,国家标准化代谢性疾病管理中心(上海市第十人民医院),同济大学医学院肥胖症研究所,上海 200072Endocrinology and Metabolism Center, Department of Metabolic Surgery for Obesity and Diabetes, Tenth People's Hospital of Tongji University; National Metabolic Management Center (Shanghai Tenth People's Hospital), Research Institute of Obesity, Tongji University School of Medicine, Shanghai 200072, China
| | - 晓芸 程
- 同济大学附属第十人民医院内分泌代谢中心,同济大学附属第十人民医院减重糖尿病代谢外科,国家标准化代谢性疾病管理中心(上海市第十人民医院),同济大学医学院肥胖症研究所,上海 200072Endocrinology and Metabolism Center, Department of Metabolic Surgery for Obesity and Diabetes, Tenth People's Hospital of Tongji University; National Metabolic Management Center (Shanghai Tenth People's Hospital), Research Institute of Obesity, Tongji University School of Medicine, Shanghai 200072, China
| | - 紫薇 林
- 同济大学附属第十人民医院内分泌代谢中心,同济大学附属第十人民医院减重糖尿病代谢外科,国家标准化代谢性疾病管理中心(上海市第十人民医院),同济大学医学院肥胖症研究所,上海 200072Endocrinology and Metabolism Center, Department of Metabolic Surgery for Obesity and Diabetes, Tenth People's Hospital of Tongji University; National Metabolic Management Center (Shanghai Tenth People's Hospital), Research Institute of Obesity, Tongji University School of Medicine, Shanghai 200072, China
| | - 伸 曲
- 南京医科大学附属上海十院临床医学院内分泌与代谢病科,上海 200072Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital of Nanjing Medical University, Shanghai 200072, China
- 同济大学附属第十人民医院内分泌代谢中心,同济大学附属第十人民医院减重糖尿病代谢外科,国家标准化代谢性疾病管理中心(上海市第十人民医院),同济大学医学院肥胖症研究所,上海 200072Endocrinology and Metabolism Center, Department of Metabolic Surgery for Obesity and Diabetes, Tenth People's Hospital of Tongji University; National Metabolic Management Center (Shanghai Tenth People's Hospital), Research Institute of Obesity, Tongji University School of Medicine, Shanghai 200072, China
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Piani F, Melena I, Tommerdahl KL, Nokoff N, Nelson RG, Pavkov ME, van Raalte DH, Cherney DZ, Johnson RJ, Nadeau KJ, Bjornstad P. Sex-related differences in diabetic kidney disease: A review on the mechanisms and potential therapeutic implications. J Diabetes Complications 2021; 35:107841. [PMID: 33423908 PMCID: PMC8007279 DOI: 10.1016/j.jdiacomp.2020.107841] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/02/2020] [Accepted: 12/02/2020] [Indexed: 02/08/2023]
Abstract
Sexual dimorphism may play a key role in the pathogenesis of diabetic kidney disease (DKD) and explain differences observed in disease phenotypes, responses to interventions, and disease progression between men and women with diabetes. Therefore, omitting the consideration of sex as a biological factor may result in delayed diagnoses and suboptimal therapies. This review will summarize the effects of sexual dimorphism on putative metabolic and molecular mechanisms underlying DKD, and the potential implications of these differences on therapeutic interventions. To successfully implement precision medicine, we require a better understanding of sexual dimorphism in the pathophysiologic progression of DKD. Such insights can unveil sex-specific therapeutic targets that have the potential to maximize efficacy while minimizing adverse events.
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Affiliation(s)
- Federica Piani
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA; Department of Medicine and Surgery Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy; Department of Medicine, Division of Nephrology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Isabella Melena
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Kalie L Tommerdahl
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA; Department of Medicine, Division of Nephrology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Natalie Nokoff
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Robert G Nelson
- Chronic Kidney Disease Section, Phoenix Epidemiology and Clinical Research Branch, NIDDK, Phoenix, AZ, USA
| | - Meda E Pavkov
- Division of Diabetes Translation, Center for Disease Control and Prevention, Atlanta, GA, USA
| | - Daniël H van Raalte
- Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands
| | - David Z Cherney
- Department of Medicine, Division of Nephrology, University of Toronto School of Medicine, Toronto, Ontario, Canada
| | - Richard J Johnson
- Department of Medicine, Division of Nephrology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Kristen J Nadeau
- Department of Medicine, Division of Nephrology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Petter Bjornstad
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA; Department of Medicine, Division of Nephrology, University of Colorado School of Medicine, Aurora, CO, USA.
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Improvement of testosterone deficiency by fermented Momordica charantia extracts in aging male rats. Food Sci Biotechnol 2021; 30:443-454. [PMID: 33868755 DOI: 10.1007/s10068-020-00872-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 12/08/2020] [Accepted: 12/29/2020] [Indexed: 10/22/2022] Open
Abstract
This study evaluated the efficacy of Momordica charantia (MC; bitter melon) extracts against andropause symptoms. We fermented MC with Lactobacillus plantarum and verified the ability of the fermented MC extracts (FMEs) to control testosterone deficiency by using aging male rats as an animal model of andropause. FME administration considerably increased total and free testosterone levels, muscle mass, forced swimming time, and total and motile sperm counts in aging male rats. In contrast, sex hormone-binding globulin, retroperitoneal fat, serum cholesterol, and triglyceride levels were significantly reduced in the treated groups compared to the non-treated control aging male rats. Furthermore, we observed that FME enhanced the expression of testosterone biosynthesis-related genes but reduced the expression of testosterone degradation-related genes in a mouse Leydig cell line. These results suggest that FME has effective pharmacological activities that increase and restore free testosterone levels and that FME may be employed as a promising natural product for alleviating testosterone deficiency syndrome. Supplementary Information The online version contains supplementary material available at 10.1007/s10068-020-00872-x.
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Comparative Study of the Steroidogenic Effects of Human Chorionic Gonadotropin and Thieno[2,3-D]pyrimidine-Based Allosteric Agonist of Luteinizing Hormone Receptor in Young Adult, Aging and Diabetic Male Rats. Int J Mol Sci 2020; 21:ijms21207493. [PMID: 33050653 PMCID: PMC7590010 DOI: 10.3390/ijms21207493] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 12/16/2022] Open
Abstract
Low-molecular-weight agonists of luteinizing hormone (LH)/human chorionic gonadotropin (hCG) receptor (LHCGR), which interact with LHCGR transmembrane allosteric site and, in comparison with gonadotropins, more selectively activate intracellular effectors, are currently being developed. Meanwhile, their effects on testicular steroidogenesis have not been studied. The purpose of this work is to perform a comparative study of the effects of 5-amino-N-tert-butyl-4-(3-(1-methylpyrazole-4-carboxamido)phenyl)-2-(methylthio)thieno[2,3-d] pyrimidine-6-carboxamide (TP4/2), a LHCGR allosteric agonist developed by us, and hCG on adenylyl cyclase activity in rat testicular membranes, testosterone levels, testicular steroidogenesis and spermatogenesis in young (four-month-old), aging (18-month-old) and diabetic male Wistar rats. Type 1 diabetes was caused by a single streptozotocin (50 mg/kg) injection. TP4/2 (20 mg/kg/day) and hCG (20 IU/rat/day) were administered for 5 days. TP4/2 was less effective in adenylyl cyclase stimulation and ability to activate steroidogenesis when administered once into rats. On the 3rd–5th day, TP4/2 and hCG steroidogenic effects in young adult, aging and diabetic rats were comparable. Unlike hCG, TP4/2 did not inhibit LHCGR gene expression and did not hyperstimulate the testicular steroidogenesis system, moderately increasing steroidogenic proteins gene expression and testosterone production. In aging and diabetic testes, TP4/2 improved spermatogenesis. Thus, during five-day administration, TP4/2 steadily stimulates testicular steroidogenesis, and can be used to prevent androgen deficiency in aging and diabetes.
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Hassanabad MF, Fatehi M. Androgen Therapy in Male Patients Suffering from Type 2 Diabetes: A Review of Benefits and Risks. Curr Diabetes Rev 2020; 16:189-199. [PMID: 30073928 DOI: 10.2174/1573399814666180731125724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/23/2018] [Accepted: 07/29/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND The current estimated numbers of patients with Type 2 Diabetes (T2D) is believed to be close to 10% of the whole populations of many geographical regions, causing serious concerns over the resulting elevated morbidity and mortality as well as the impact on health care systems around the world. In addition to negatively affecting the quality of life, diabetes is associated with cardiovascular and cerebrovascular complications, indicating that appropriate drug therapy should not only deal with metabolic dysfunction but also protect the vascular system, kidney function and skeletal muscle mass from the effects of the epigenetic changes induced by hyperglycaemia. OBJECTIVE To provide an insight into the management of hypogonadism associated with T2D, this review focuses on clinical observations related to androgen therapy in qualified diabetic patients, and discusses the lines of evidence for its benefits and risks. The potential interactions of testosterone with medicines used by patients with T2D will also be discussed. CONCLUSION From recent clinical findings, it became evident that a considerable percentage of patients suffering from T2D manifested low serum testosterone and experienced diminished sexual activity, as well as reduced skeletal muscle mass and lower bone density. Although there are some controversies, Testosterone Replacement Therapy (TRT) for this particular population of patients appears to be beneficial overall only if it is implemented carefully and monitored regularly.
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Affiliation(s)
- Mortaza F Hassanabad
- Alberta Institute of Diabetes and Department of Pharmacology, Faculty of Sciences, University of Alberta, Edmonton, Canada
| | - Mohammad Fatehi
- Alberta Institute of Diabetes and Department of Pharmacology, Faculty of Medicine, University of Alberta, Edmonton, Canada
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Jansen A, Berg JP, Klungsøyr O, Müller MHB, Lyche JL, Aaseth JO. The Influence of Persistent Organic Pollutants on Thyroidal, Reproductive and Adrenal Hormones After Bariatric Surgery. Obes Surg 2019; 30:1368-1378. [DOI: 10.1007/s11695-019-04273-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Pham NH, Bena J, Bhatt DL, Kennedy L, Schauer PR, Kashyap SR. Increased Free Testosterone Levels in Men with Uncontrolled Type 2 Diabetes Five Years After Randomization to Bariatric Surgery. Obes Surg 2018; 28:277-280. [PMID: 29143290 DOI: 10.1007/s11695-017-2881-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Hypogonadism frequently occurs in male patients with type 2 diabetes (T2DM) and is linked to insulin resistance and inflammation. Testosterone levels rise acutely in obese patients following bariatric surgery, though long-term changes have not been investigated in a randomized controlled trial. This study evaluated obese men with T2DM randomized to either bariatric surgery or medical therapy. Testosterone, gonadotropins, body composition, insulin sensitivity, and inflammatory markers were evaluated in 32 patients at baseline and at 5 years. Surgical patients had 47.4% increase in free testosterone compared to medical therapy patients who had 2.2% decrease (P = 0.013). Increase in free testosterone correlated with reduction in body weight, high-sensitivity C-reactive protein (hsCRP), and leptin levels. Prolonged improvements in testosterone levels after bariatric surgery in T2DM are found to be related to reduction in body weight and adipogenic inflammation.
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Affiliation(s)
- Nathan H Pham
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve, Cleveland, OH, USA
| | - James Bena
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve, Endocrinology and Metabolism Institute, 9500 Euclid Ave, Cleveland, OH, 44195, USA
| | - Deepak L Bhatt
- Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Laurence Kennedy
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve, Cleveland, OH, USA
| | - Philip R Schauer
- Cleveland Clinic, Bariatric and Metabolic Institute, Cleveland, OH, USA
| | - Sangeeta R Kashyap
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve, Cleveland, OH, USA.
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve, Endocrinology and Metabolism Institute, 9500 Euclid Ave, Cleveland, OH, 44195, USA.
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13
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Wang L, Niu YM, Wu SS, Zhang C, Zhou L, Zuo HX, Wang P. A Study on the Association Between Polymorphisms in the Cytochrome P450 Family 17 Subfamily A Member 1 Gene Region and Type 2 Diabetes Mellitus in Han Chinese. Front Endocrinol (Lausanne) 2018; 9:323. [PMID: 29942286 PMCID: PMC6004380 DOI: 10.3389/fendo.2018.00323] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 05/28/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Cytochrome P450 family 17 subfamily A member 1 (CYP17A1) gene encodes a key enzyme in the synthesis and metabolism of steroid hormones and has been associated with various factors, such as hypertension, insulin resistance, and polycystic ovary syndrome. However, whether the gene was associated with type 2 diabetes mellitus (T2DM) has not been reported yet. Therefore, we sought to investigate whether CYP17A1 was associated with T2DM and related traits among Han Chinese. METHODS Three tagging single nucleotide polymorphisms (rs1004467, rs17115149, and rs12413409), in the CYP17A1 gene region were selected and genotyped in a case-control study that included 440 diabetes and 1,320 control subjects. Effects of genetic loci were studied using univariate unconditional logistic regression and multivariate logistic regression analysis adjusted for age, sex, family history, body mass index, smoking, and drinking. Bioinformatics analysis was also conducted using the GEO DataSets and PROMO database to gain hints of possible mechanism. RESULTS Rs17115149 and rs12413409 polymorphisms were significantly associated with the risk of T2DM, even after adjusting for age, sex, family history, body mass index, smoking, and drinking. In stratified analyses, rs1004467 and rs12413409 showed significant association with T2DM in the older age group (≥65 years) and, in the case of rs12413409, the risk of T2DM was significant in men but not in women. Rs17115149 had significant association with T2DM in the hypertension subgroup, and rs12413409 in the non-hypertension subgroup. Moreover, rs12413409 showed significant association with plasma glucose levels in the recessive model (P = 0.020) among subjects not taking hypoglycemic measures. Bioinformatics analysis revealed significantly higher CYP17A1 gene expression in T2DM patients compared to healthy controls. Finally, the mutant T allele of the rs17115149 polymorphism allowed binding to the RBP-Jkappa transcription factor. CONCLUSION This is the first report to identify that variants rs1004467, rs17115149, and rs12413409 of CYP17A1, are related to plasma glucose levels and T2DM among Han Chinese. Our results suggest that CYP17A1 might constitute a risk gene for progression to T2DM.
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Affiliation(s)
- Long Wang
- Department of Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Yu-Ming Niu
- Department of Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China
- *Correspondence: Yu-Ming Niu, ; Shi-Shi Wu,
| | - Shi-Shi Wu
- Department of Histology and Embryology, School of Basic Medical Sciences, Hubei University of Medicine, Shiyan, China
- *Correspondence: Yu-Ming Niu, ; Shi-Shi Wu,
| | - Chao Zhang
- Department of Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Li Zhou
- Research Center for Medicine and Social Development, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Hong-Xia Zuo
- Department of Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Peng Wang
- Department of Clinical Laboratory, Taihe Hospital, Hubei University of Medicine, Shiyan, China
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14
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Sakkiah S, Wang T, Zou W, Wang Y, Pan B, Tong W, Hong H. Endocrine Disrupting Chemicals Mediated through Binding Androgen Receptor Are Associated with Diabetes Mellitus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 15:ijerph15010025. [PMID: 29295509 PMCID: PMC5800125 DOI: 10.3390/ijerph15010025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 12/13/2017] [Accepted: 12/20/2017] [Indexed: 02/06/2023]
Abstract
Endocrine disrupting chemicals (EDCs) can mimic natural hormone to interact with receptors in the endocrine system and thus disrupt the functions of the endocrine system, raising concerns on the public health. In addition to disruption of the endocrine system, some EDCs have been found associated with many diseases such as breast cancer, prostate cancer, infertility, asthma, stroke, Alzheimer’s disease, obesity, and diabetes mellitus. EDCs that binding androgen receptor have been reported associated with diabetes mellitus in in vitro, animal, and clinical studies. In this review, we summarize the structural basis and interactions between androgen receptor and EDCs as well as the associations of various types of diabetes mellitus with the EDCs mediated through androgen receptor binding. We also discuss the perspective research for further understanding the impact and mechanisms of EDCs on the risk of diabetes mellitus.
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Affiliation(s)
- Sugunadevi Sakkiah
- National Center for Toxicological Research, Food and Drug Administration, Jefferson, AR 72079, USA.
| | - Tony Wang
- Department of Biology, Arkansas University, Fayetteville, AR 72701, USA.
| | - Wen Zou
- National Center for Toxicological Research, Food and Drug Administration, Jefferson, AR 72079, USA.
| | - Yuping Wang
- National Center for Toxicological Research, Food and Drug Administration, Jefferson, AR 72079, USA.
| | - Bohu Pan
- National Center for Toxicological Research, Food and Drug Administration, Jefferson, AR 72079, USA.
| | - Weida Tong
- National Center for Toxicological Research, Food and Drug Administration, Jefferson, AR 72079, USA.
| | - Huixiao Hong
- National Center for Toxicological Research, Food and Drug Administration, Jefferson, AR 72079, USA.
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15
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Balamir I, Ates I, Topcuoglu C, Turhan T. Association of Endocan, Ischemia-Modified Albumin, and hsCRP Levels With Endothelial Dysfunction in Type 2 Diabetes Mellitus. Angiology 2017; 69:609-616. [DOI: 10.1177/0003319717740781] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
We investigated the relationship of ischemia-modified albumin (IMA) and high-sensitivity C-reactive protein (hsCRP) levels with direct (endocan) and indirect (carotid intima–media thickness [cIMT] and 24 hours urine protein excretion) endothelial dysfunction indicators in type 2 diabetes mellitus (T2DM). Patients with T2DM (n = 88) and 88 healthy individuals were included in the study. The median endocan (475.15 vs 216.37 pg/mL; P < .001, respectively) and hsCRP (10.74 vs 3.11 mg/L; P < .001, respectively) and the mean IMA (0.64 ± 0.12 vs 0.51 ± 0.12 absorbance units; P < .001, respectively) levels were higher in participants with endothelial dysfunction compared to those without endothelial dysfunction in T2DM. The 24-hour urine protein excretion and cIMT levels had a positive correlation with hsCRP ( r = .357; P = .001 and r = .592; P < .001, respectively), IMA ( r = .519; P < .001 and r = .495; P < .001, respectively) and endocan ( r = .347; P = .001 and r = .583; P < .001, respectively) levels in the T2DM group. Stepwise multivariable logistic regression analysis, which included laboratory findings found to be associated with endothelial dysfunction, showed that endocan (odds ratio [OR] = 1.456; P = .004), hsCRP (OR = 1.298; P = .008), and IMA (OR = 2.270, P = .003) were independent risk factors. It was found that none of these markers were superior in terms of diagnostic discrimination for endothelial dysfunction. Endocan, IMA, and hsCRP levels were found to be associated with endothelial dysfunction in patients with T2DM.
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Affiliation(s)
- Ilhan Balamir
- Department of Biochemistry, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Ihsan Ates
- Department of Internal Medicine, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Canan Topcuoglu
- Department of Biochemistry, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Turan Turhan
- Department of Biochemistry, Ankara Numune Training and Research Hospital, Ankara, Turkey
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16
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Zhang KS, Zhao MJ, An Q, Jia YF, Fu LL, Xu JF, Gu YQ. Effects of testosterone supplementation therapy on lipid metabolism in hypogonadal men with T2DM: a meta-analysis of randomized controlled trials. Andrology 2017; 6:37-46. [PMID: 28950433 DOI: 10.1111/andr.12425] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 08/04/2017] [Accepted: 08/09/2017] [Indexed: 12/21/2022]
Abstract
Testosterone supplementation may be effective for the treatment of hypogonadism in men with type 2 diabetes mellitus (T2DM), but the evidence from randomized controlled trials (RCTs) is inconclusive. We aimed to systematically summarize results from intervention studies and assess the effects of testosterone supplementation therapy (TST) on lipid metabolism in RCTs of hypogonadal men with T2DM by meta-analysis. PubMed, Embase, and Cochrane Library databases were searched for studies reporting the effect of TST on lipid metabolism in hypogonadal men with T2DM until December 31, 2016. Seven RCTs from 252 trials, enrolling a total of 612 patients in the experimental and control groups with a mean age of 58.5 years, were included in this study. The pooled results of the meta-analysis demonstrated that TST significantly decreased TC and TG levels in hypogonadal men with T2DM compared with the control group, with mean differences (MDs) of -6.44 (95% CI: -11.82 to -1.06; I2 = 28%; p = 0.02) and -27.94 (95% CI: -52.33 to -3.54; I2 = 76%; p = 0.02). Subgroup analyses revealed that the heterogeneity (I2 = 76%) of TG originated from different economic regions, in which economic development, genetic and environmental factors, and dietary habits affect lipid metabolism of human, with a decrease (I2 = 45%) in developed countries. Additionally, subgroup analyses showed that TST increased HDL-C level in developing countries compared with the control group (MD = 2.79; 95% CI: 0.73 to 4.86; I2 = 0%; p = 0.008), but there was no improvement in developed countries (MD = 1.02; 95% CI: -4.55 to 6.60; I2 = 91%; p = 0.72). However, LDL-C levels were not improved consistently. Because the relationship between lipid metabolism and atherosclerosis is unequivocal, TST, which ameliorates lipid metabolism, may decrease the morbidity and mortality of cardiovascular disease in hypogonadal men with T2DM by preventing atherogenesis.
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Affiliation(s)
- K-S Zhang
- Chinese Academy of Medical Sciences, Graduate School of Peking Union Medical College, Beijing, China.,National Health and Family Planning Key Laboratory of Male Reproductive Health, Department of Male Clinical Research, National Research Institute for Family Planning & WHO Collaborating Center for Research in Human Reproduction, Beijing, China
| | - M-J Zhao
- Department of Reproduction and Genetics, Maternity and Child Health Care Hospital, Tangshan, China
| | - Q An
- Chinese Academy of Medical Sciences, Graduate School of Peking Union Medical College, Beijing, China.,National Health and Family Planning Key Laboratory of Male Reproductive Health, Department of Male Clinical Research, National Research Institute for Family Planning & WHO Collaborating Center for Research in Human Reproduction, Beijing, China
| | - Y-F Jia
- Chinese Academy of Medical Sciences, Graduate School of Peking Union Medical College, Beijing, China.,National Health and Family Planning Key Laboratory of Male Reproductive Health, Department of Male Clinical Research, National Research Institute for Family Planning & WHO Collaborating Center for Research in Human Reproduction, Beijing, China
| | - L-L Fu
- Chinese Academy of Medical Sciences, Graduate School of Peking Union Medical College, Beijing, China.,National Health and Family Planning Key Laboratory of Male Reproductive Health, Department of Male Clinical Research, National Research Institute for Family Planning & WHO Collaborating Center for Research in Human Reproduction, Beijing, China
| | - J-F Xu
- National Health and Family Planning Key Laboratory of Male Reproductive Health, Department of Male Clinical Research, National Research Institute for Family Planning & WHO Collaborating Center for Research in Human Reproduction, Beijing, China
| | - Y-Q Gu
- Chinese Academy of Medical Sciences, Graduate School of Peking Union Medical College, Beijing, China.,National Health and Family Planning Key Laboratory of Male Reproductive Health, Department of Male Clinical Research, National Research Institute for Family Planning & WHO Collaborating Center for Research in Human Reproduction, Beijing, China
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17
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Zhao Y, Li HX, Wang K, Yan BY, Li W. Regulation of testicular steroidogenesis by Foxa3 via transcriptional modulation of ERα signaling in type 2 diabetes mellitus (T2DM). Biochem Biophys Res Commun 2017. [DOI: 10.1016/j.bbrc.2017.06.118] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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18
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Zhou P, Meng Z, Liu M, Ren X, Zhu M, He Q, Zhang Q, Liu L, Song K, Jia Q, Tan J, Li X, Liu N, Hu T, Upadhyaya A. The associations between leukocyte, erythrocyte or platelet, and metabolic syndrome in different genders of Chinese. Medicine (Baltimore) 2016; 95:e5189. [PMID: 27858856 PMCID: PMC5591104 DOI: 10.1097/md.0000000000005189] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Leukocyte, erythrocyte or platelet and metabolic syndrome (MS) are closely correlated, and there exist gender differences. We aimed to explore the associations between the hematological parameters and MS in different genders of Chinese. This cross-sectional study included 32,900 participants (20,733 males, 12,167 females) who were enrolled in a health examination. Clinical data including anthropometric measurements and serum parameters were collected. The associations between hematological parameters and MS of both genders were analyzed separately. Odds ratio (OR) of MS was calculated by binary logistic regression models. All hematological parameters were related to MS. With leukocyte and erythrocyte counts rising, the risks of developing MS increased in both genders, which was more obvious in women. For instance, in model 3, the ORs of MS in leukocyte quartiles in females were from 1.333 to 2.045 (P < 0.01), while in males, from 1.238 to 1.675 (P < 0.01). Platelet seemed as a protective factor in males. Model 1 and model 3 in quartile 2 demonstrated ORs of 0.922 (P < 0.05) and 0.912 (P < 0.05). However, platelet acted as risk factor in female. For instance, the ORs were 1.253 (P < 0.01), 1.461 (P < 0.01), and 1.322 (P < 0.01) in platelet quartile 4 of all 3 models in female. Gender has influences on the associations between leukocyte, erythrocyte or platelet, and MS. In both genders, higher levels of leukocyte and erythrocyte increased risks of MS. For men, platelet was a protective factor, but for women, platelet seemed as a risk factor.
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Affiliation(s)
| | - Zhaowei Meng
- Department of Nuclear Medicine
- Correspondence: Zhaowei Meng, Department of Nuclear Medicine, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, Peoples Republic of China (e-mail: )
| | - Ming Liu
- Department of Endocrinology and Metabolism
| | | | - Mei Zhu
- Department of Endocrinology and Metabolism
| | - Qing He
- Department of Endocrinology and Metabolism
| | - Qing Zhang
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, Peoples Republic of China
| | - Li Liu
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, Peoples Republic of China
| | - Kun Song
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, Peoples Republic of China
| | | | | | - Xue Li
- Department of Nuclear Medicine
| | - Na Liu
- Department of Nuclear Medicine
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19
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Verma N, Usman K, Patel N, Jain A, Dhakre S, Swaroop A, Bagchi M, Kumar P, Preuss HG, Bagchi D. A multicenter clinical study to determine the efficacy of a novel fenugreek seed ( Trigonella foenum-graecum) extract (Fenfuro™) in patients with type 2 diabetes. Food Nutr Res 2016; 60:32382. [PMID: 27733237 PMCID: PMC5061863 DOI: 10.3402/fnr.v60.32382] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 09/08/2016] [Accepted: 09/09/2016] [Indexed: 01/30/2023] Open
Abstract
Background Trigonella foenum-graecum (fenugreek) seeds are known to exhibit potent antioxidant, hypoglycemic, and nephroprotective activities, as well as serve as excellent membrane stabilizers especially because of their content of novel furostanolic saponins. Our previous studies exhibited the broad spectrum safety and efficacy of Fenfuro, a novel T. foenum-graecum seed extract enriched in furostanolic saponins, in type 2 diabetes (T2D) in rats. Design This multicenter, randomized, placebo-controlled, double-blind, add-on clinical study evaluated over a period of 90 consecutive days the efficacy of Fenfuro (daily dosage: 500 mg bid) in 154 subjects (male: 108; female: 46; age: 25–60 years) with T2D. Methods This study examined the body weight, blood pressure, and pulse rate, as well as the efficacy of Fenfuro on fasting and post-prandial plasma sugar (mg/dL), glycosylated hemoglobin (HbA1c), and fasting and post-prandial C-peptide levels. Results Fenfuro caused significant reduction in both fasting plasma and post-prandial blood sugar levels. Approximately 83% of the subjects reported decreases in fasting plasma sugar levels in the Fenfuro-treated group as compared to 62% in the placebo group, while 89% of the subjects demonstrated reduction in post-prandial plasma sugar levels in the Fenfuro-treated group as compared to 72% in the placebo group. HbA1c levels were reduced in both placebo and treatment groups. The decrease in HbA1c levels was significant in both groups as compared to respective baseline values. A significant increase in fasting and post-prandial C-peptide levels compared to the respective baseline values was observed, while no significant changes in fasting and post-prandial C-peptide levels were observed between the two groups. No significant adverse effects were observed by blood chemistry analyses. Furthermore, 48.8% of the subjects reported reduced dosage of anti-diabetic therapy in the Fenfuro-treated group, whereas 18.05% reported reduced dosage of anti-diabetic therapy in the placebo group. Conclusion In summary, Fenfuro proved safe and efficacious in ameliorating the symptoms of T2D in humans.
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Affiliation(s)
- Narsingh Verma
- Department of Physiology, King George's Medical University, Lucknow, India.,Department of Medicine, King George's Medical University, Lucknow, India
| | - Kauser Usman
- Department of Physiology, King George's Medical University, Lucknow, India.,Department of Medicine, King George's Medical University, Lucknow, India
| | - Naresh Patel
- Department of Physiology, King George's Medical University, Lucknow, India.,Department of Medicine, King George's Medical University, Lucknow, India
| | - Arvind Jain
- Department of Physiology, King George's Medical University, Lucknow, India.,Department of Medicine, King George's Medical University, Lucknow, India
| | - Sudhir Dhakre
- Department of Physiology, King George's Medical University, Lucknow, India.,Department of Medicine, King George's Medical University, Lucknow, India
| | | | | | - Pawan Kumar
- Research & Development, Chemical Resources, Panchkula, Haryana, India
| | - Harry G Preuss
- Department of Biochemistry, Georgetown University Medical Center, Washington, DC, USA.,Department of Medicine, Georgetown University Medical Center, Washington, DC, USA.,Department of Pathology, Georgetown University Medical Center, Washington, DC, USA
| | - Debasis Bagchi
- Cepham Research Center, Piscataway, NJ, USA.,Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, University of Houston, Houston, TX, USA;
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20
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Chen MJ, Ho HN. Hepatic manifestations of women with polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol 2016; 37:119-128. [PMID: 27107966 DOI: 10.1016/j.bpobgyn.2016.03.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 03/05/2016] [Indexed: 12/11/2022]
Abstract
Women with polycystic ovary syndrome (PCOS) have a higher prevalence of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) than the general population. The link between NAFLD/NASH and PCOS is not just a coincidence. Indeed, both of these disorders comprise common risk factors, including central obesity, insulin resistance, chronic low-grade inflammation, and hyperandrogenemia. The characteristics of hyperandrogenemia in women with PCOS include elevated total and free testosterone levels and low sex hormone-binding globulin levels and are reported to be associated with NAFLD and elevated liver enzymes; however, not all elevated androgen levels in women with PCOS have the same adverse effects on the liver. With the exception of weight loss and encouraging exercise in obese women, few evidence-based effective treatments target NAFLD/NASH in women with PCOS. Selective antiandrogens and insulin sensitizers might be beneficial in treating NAFLD/NASH in women with PCOS, but further elucidation is needed.
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Affiliation(s)
- Mei-Jou Chen
- Departments of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan; College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hong-Nerng Ho
- Departments of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan; College of Medicine, National Taiwan University, Taipei, Taiwan.
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21
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Clotet S, Riera M, Pascual J, Soler MJ. RAS and sex differences in diabetic nephropathy. Am J Physiol Renal Physiol 2016; 310:F945-F957. [PMID: 26962103 DOI: 10.1152/ajprenal.00292.2015] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The incidence and progression of kidney diseases are influenced by sex. The renin-angiotensin system (RAS) is an important regulator of cardiovascular and renal function. Sex differences in the renal response to RAS blockade have been demonstrated. Circulating and renal RAS has been shown to be altered in type 1 and type 2 diabetes; this enzymatic cascade plays a critical role in the development of diabetic nephropathy (DN). Angiotensin converting enzyme (ACE) and ACE2 are differentially regulated depending on its localization within the diabetic kidney. Furthermore, clinical and experimental studies have shown that circulating levels of sex hormones are clearly modulated in the context of diabetes, suggesting that sex-dependent RAS regulation may be also be affected in these individuals. The effect of sex hormones on circulating and renal RAS may be involved in the sex differences observed in DN progression. In this paper we will review the influence of sex hormones on RAS expression and its relation to diabetic kidney disease. A better understanding of the sex dimorphism on RAS might provide a new approach for diabetic kidney disease treatment.
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