Lifestyle modification-induced increase in serum testosterone and SHBG decreases arterial stiffness in overweight and obese men

Combined effects of sleep and objectively-measured daily physical activity on arterial stiffness in middle-aged and older adults

Although sleep quality and physical activity (PA) may influence on arterial stiffness, the combined effects of these two factors on arterial stiffness remain unknown. A total of 103 healthy middle-aged and older men and women (aged 50-83 years) with no history of cardiovascular disease and depression were included in this study. Arterial stiffness was measured using carotid-femoral pulse wave velocity (cfPWV), brachial-ankle PWV (baPWV), and femoral-ankle PWV (faPWV). Poor sleepers were defined as those with a Pittsburgh Sleep Quality Index score of >5.5. Using an accelerometer for seven consecutive days, low levels of PA were defined as low moderate-to-vigorous-intensity PA (MVPA) <19.0 min/day and low step counts <7100 steps/day, respectively. Poor sleepers with low PA levels, as determined by MVPA and daily steps, showed higher cfPWV, but not faPWV or baPWV, in middle-aged and older adults. Furthermore, in the analysis of covariance (ANCOVA) analyses adjusted for age, obesity, dyslipidemia, and sedentary behavior, the cfPWV result remained significant. Our study revealed that the coexistence of poor sleep quality and decreased PA (low MVPA or daily steps) might increase central arterial stiffness in middle-aged and older adults. Therefore, adequate sleep (good and sufficient sleep quality) and regular PA, especially at appropriate levels of MVPA (i.e., at least of 7100 steps/day), should be encouraged to decrease central arterial stiffness in middle-aged and older adults.

Regular aerobic exercise improves sexual function assessed by the Aging Males' Symptoms questionnaire in adult men

The leading cause of aging-induced male-specific disorders such as physical, mental and/or sexual symptoms is testosterone deficiency. Although aerobic exercise is suggested to improves circulating testosterone levels, physical fitness, depressive symptoms, and sexual function, the effect of regular aerobic exercise on aging-induced disorders has not yet been clarified. Here we performed cross-sectional and interventional studies to identify the effect of aerobic exercise on aging-induced disorders assessed by the Aging Males' Symptoms questionnaire (AMS). In study 1, the relationship between aerobic exercise capacity (i.e. peak oxygen consumption) and AMS scores were cross-sectionally examined in 169 adult men. In study 2, the effect of a 12-week regular aerobic exercise on AMS scores was longitudinally investigated in 18 adult men. In study 1, the AMS-total, AMS-somatic, AMS-psychological, and AMS-sexual scores were significantly correlated to aerobic exercise capacity even after considering age and testosterone levels. In study 2, 12-week aerobic exercise training significantly improved AMS-sexual and tended to improve AMS-total scores. Additionally, an increase in vigorous physical activity was correlated to improve in the AMS-sexual score. These results suggest that regular aerobic exercise is an effective strategy to improve aging-induced disorders in men.

Role of High Physical Fitness in Deterioration of Male Sexual Function in Japanese Adult Men

Male sexual function is regulated by vascular function and impaired vascular function is closely related with erectile dysfunction (ED). Vascular functions are positively influenced by physical fitness (i.e., aerobic capacity, muscle strength, and flexibility). The detailed associations between physical fitness and male sexual function remain poorly understood. The present study aimed to clarify the influence of physical fitness on male sexual function. In 177 adult men, peak oxygen consumption (VO_{2 peak}), handgrip strength (HGS), and sit and reach were measured as indices of physical fitness. Arterial stiffness and erectile function were assessed by carotid-femoral pulse wave velocity (cfPWV) and the International Index of Erectile Function 5 (IIEF5) questionnaire, respectively. IIEF5 score was significantly correlated with VO_{2 peak} ( r_s = 0.52), HGS ( r_s = 0.37), and cfPWV ( r_s = -0.44); and multivariate linear regression analyses showed that VO_{2 peak}, HGS, and cfPWV were significantly associated with IIEF5 score after considering confounders. The receiver operator characteristic curve analysis suggested that the cutoff values for predicting ED were 29.0 ml/min/kg for VO_{2 peak} and 39.3 kg for HGS. The IIEF5 score was the highest in the subjects with the values of both VO_{2 peak} and HGS were higher than their respective cutoff values, while the IIEF5 score was the lowest in the subjects with the values of both VO_{2 peak} and HGS were lower than their respective cutoff values. These results suggest that the maintenance of high aerobic capacity and muscular strength may offset deterioration of male sexual function.

Sexual Function Is an Indicator of Central Arterial Stiffness and Arterial Stiffness Gradient in Japanese Adult Men

Background

As arterial stiffness increases in the absence of subjective symptoms, a personal indicator that reflects increased risk of cardiovascular disease is necessary. Penile erection is regulated by vascular function, and atherosclerosis affects the penile artery earlier than it affects the coronary and carotid arteries. Therefore, we hypothesized that deterioration of erectile function could be a marker of increased risk for cardiovascular disease. To test our hypothesis, we assessed erectile function and arterial stiffness in a cross‐sectional study.

Methods and Results

Carotid‐femoral pulse wave velocity (PWV), brachial‐ankle PWV, femoral‐ankle PWV, and arterial stiffness gradient (PWV ratio: carotid‐femoral PWV/femoral‐ankle PWV) were measured as indexes of central, systemic, and peripheral arterial stiffness and peripheral organ damage, respectively, in 317 adult men. In addition, erectile function was assessed by using the questionnaire International Index of Erectile Function 5 (a descending score indicates worsening of erectile function). The scores of male sexual function were inversely correlated with carotid‐femoral PWV (r_s=−0.41), brachial‐ankle PWV (r_s=−0.35), femoral‐ankle PWV (r_s=−0.19), and PWV ratio (r_s=−0.33). Furthermore, multivariate linear regression analyses revealed that International Index of Erectile Function 5 scores were significantly associated with carotid‐femoral PWV (β=−0.22) and PWV ratio (β=−0.25), but not with brachial‐ankle PWV and femoral‐ankle PWV.

Conclusions

Our results indicated that erectile function is independently associated with central arterial stiffness and peripheral organ damage. These findings suggest that male sexual function could be an easily identifiable and independent marker of increased central arterial stiffness and peripheral organ damage.

Which cytokine is the most related to weight loss-induced decrease in arterial stiffness in overweight and obese men?

Obesity and increased arterial stiffness are risk factors for cardiovascular disease. A well-known characteristic of obesity is the chronic low-grade inflammatory state, and it causes elevation of arterial stiffness. Weight-loss reduces arterial stiffness and inflammatory level in obese individuals. However, it is unclear which inflammatory factor is most related to weight loss-induce decreases in arterial stiffness in overweight and obese men. Thus, the aim of this study was to determine which circulating cytokine level has the most effect on decreasing arterial stiffness after lifestyle modification. Twenty overweight and obese men completed a 12-week period of lifestyle modifications (combination of aerobic exercise training and dietary modification). We measured brachial-ankle pulse wave velocity (baPWV) as an index of arterial stiffness, and circulating cytokine levels using comprehensive analysis. After the 12-week lifestyle modifications, body mass was markedly decreased. Also, baPWV and the levels of several circulating cytokines significantly decreased after the lifestyle modifications. We observed a positive correlation between changes in baPWV and circulating interleukin-6 (IL-6) levels. Furthermore, multiple liner regression analysis revealed that change in baPWV was significantly associated with that in IL-6 levels after consideration of changes in systolic blood pressure and body mass index. These results suggest that for overweight and obese men, a 12-week period of lifestyle modifications-induced a decrease in circulating cytokine levels (especially IL-6 levels), leads to decreased baPWV.

Increased physical activity has a greater effect than reduced energy intake on lifestyle modification-induced increases in testosterone

Obesity has reached epidemic proportions worldwide. Obesity results in reduced serum testosterone levels, which causes many disorders in men. Lifestyle modifications (increased physical activity and calorie restriction) can increase serum testosterone levels. However, it is unknown whether increased physical activity or calorie restriction during lifestyle modifications has a greater effects on serum testosterone levels. Forty-one overweight and obese men completed a 12-week lifestyle modification program (aerobic exercise training and calorie restriction). We measured serum testosterone levels, the number of steps, and the total energy intake. We divided participants into two groups based on the median change in the number of steps (high or low physical activities) or that in calorie restriction (high or low calorie restrictions). After the program, serum testosterone levels were significantly increased. Serum testosterone levels in the high physical activity group were significantly higher than those in the low activity group. This effect was not observed between the groups based on calorie restriction levels. We found a significant positive correlation between the changes in serum testosterone levels and the number of steps. Our results suggested that an increase in physical activity greatly affected the increased serum testosterone levels in overweight and obese men during lifestyle modification.

Lifestyle modification increases serum testosterone level and decrease central blood pressure in overweight and obese men

Obesity has reached global epidemic proportions and is associated with multiple comorbidities, including cardiovascular disease. A novel predictor of cardiovascular disease is elevated central systolic blood pressure. In fact, lifestyle modifications have been shown to decrease the central systolic blood pressure in overweight and obese men. The mechanism underlying these changes has yet to be fully elucidated. Interestingly, testosterone has been found to have cardioprotective effects. Moreover, serum testosterone levels are lower in obese men than in normal weight men. However, it is still unclear whether testosterone participates in the decrease of central blood pressure in overweight and obese men following lifestyle modifications. So, the purpose of the present study was to investigate the effect of testosterone on central systolic blood pressure in overweight and obese men before and after the 12-week lifestyle modification program. Forty-four overweight and obese men completed a 12-week lifestyle modification program (aerobic exercise training and dietary modifications). For all participants, central systolic blood pressure and serum testosterone levels were measured before and after the program. After the program, central systolic blood pressure was significantly decreased while serum total testosterone levels were significantly increased in overweight and obese men. Moreover, we also found a significant negative relationship between the change in serum testosterone levels and that in central systolic blood pressure. The present study suggests that increased serum testosterone levels likely contribute to a decrease in central blood pressure in overweight and obese men.