1
|
Kim KJ, Lee JH, Kim SJ, Yu BY, Kang JH. Relationship between Serum Total Testosterone Concentration and Metabolic Syndrome in Premenopausal Obese Women. Korean J Fam Med 2024; 45:215-222. [PMID: 38414373 PMCID: PMC11273172 DOI: 10.4082/kjfm.23.0089] [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: 06/21/2023] [Revised: 10/10/2023] [Accepted: 11/03/2023] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Men with low testosterone levels are at an increased risk of developing metabolic syndrome, irrespective of age or obesity. However, the relationship between metabolic syndrome and testosterone levels in women remains unclear. We compared the total testosterone concentrations between premenopausal obese women with and without metabolic syndrome and identified the factors affecting these concentrations. METHODS A single-center retrospective analysis was conducted using the medical records of 580 premenopausal women with obesity. The diagnostic criteria for metabolic syndrome were established using the National Cholesterol Education Program Adult Treatment Panel III guidelines. RESULTS The mean±standard deviation age, weight, and body mass index were 38.8±8.4 years, 78.0±11.8 kg, and 30.0±4.1 kg/m2, respectively. The mean total testosterone concentration was lower in the metabolic syndrome group than in the non-metabolic syndrome group (n=385 vs. n=195; 0.22±0.10 ng/mL vs. 0.24±0.11 ng/mL; P<0.001). In a model adjusted for age, body mass index, skeletal muscle mass, body fat mass, and body fat percentage, the odds ratio for metabolic syndrome with respect to the total testosterone level was 0.128 (P=0.028). Testosterone concentration was negatively correlated with age (r=-0.334), systolic blood pressure (r=-0.084), and triglyceride concentration (r=-0.093) but positively correlated with weight (r=0.144), body mass index (r=0.140), waist circumference (r=0.133), body fat mass (r=0.167), and body fat percentage (r=0.167). Stepwise regression analysis revealed that age (β=-0.004, P<0.001), body mass index (β=0.003, P=0.004), and high-density lipoprotein cholesterol concentration (β=0.001, P=0.019) were independently associated with total testosterone concentration (adjusted R2=12.6%). CONCLUSION Metabolic syndrome and obesity may be independently associated with testosterone levels in premenopausal women with obesity.
Collapse
Affiliation(s)
- Kyu-Jin Kim
- Department of Family Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Jun-Ho Lee
- Department of Family Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Seong-Ju Kim
- Department of Family Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Byung-Yeon Yu
- Department of Family Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Jee-Hyun Kang
- Department of Family Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| |
Collapse
|
2
|
Magdalena P, Olga KJ, Anna P, Robert J. Unfavorably altered lipid profile in women with primary ovarian insufficiency. J Clin Lipidol 2024:S1933-2874(24)00173-9. [PMID: 38908972 DOI: 10.1016/j.jacl.2024.04.125] [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: 05/07/2023] [Revised: 04/02/2024] [Accepted: 04/12/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND Hypoestrogenism related to the cessation of ovarian function increases the risk of metabolic disorders in postmenopausal women. Women with primary ovarian insufficiency (POI) are exposed to longer period of estrogen deficiency together with a subsequently higher risk of long-term comorbidities. OBJECTIVE To compare metabolic along with hormonal status among newly diagnosed women with POI with pre- and postmenopausal women. To investigate the impact of POI etiology on both metabolic and hormonal profiles. METHODS A case-control study with women assigned to one of the groups: 1) POI (n = 216), 2) age-matched premenopausal (n = 216), 3) postmenopausal (n = 227). Lipid profile, fasting glucose and insulin levels together with insulin resistance were determined among all participants. RESULTS POI women exhibited increased both total cholesterol (TC, p = 0.04) and low-density lipoprotein cholesterol (LDL-C, p < 0.01) compared to the premenopausal women and higher triglycerides (TG, p < 0.001) than postmenopausal women. POI group showed higher fasting glucose level (p = 0.04) differently to premenopausal women. The idiopathic POI group showed both lower SHBG (p = 0.02) and DHEA-s (p = 0.04) along with reduced TC (p = 0.03) and TG (p = 0.01) together with increased HDL-C (p = 0.04) levels than non-idiopathic POI women. CONCLUSION Women with newly diagnosed POI exhibited less favorable lipid profile than pre- or postmenopausal women. The association of negatively changed lipid profile in POI women is mostly mediated by women with unknown cause of premature ovarian cessation.
Collapse
Affiliation(s)
- Piróg Magdalena
- Department of Gynecological Endocrinology, Jagiellonian University Medical College, Krakow, Poland (Magdalena, Olga, Anna and Robert).
| | - Kacalska-Janssen Olga
- Department of Gynecological Endocrinology, Jagiellonian University Medical College, Krakow, Poland (Magdalena, Olga, Anna and Robert)
| | - Pulka Anna
- Department of Gynecological Endocrinology, Jagiellonian University Medical College, Krakow, Poland (Magdalena, Olga, Anna and Robert)
| | - Jach Robert
- Department of Gynecological Endocrinology, Jagiellonian University Medical College, Krakow, Poland (Magdalena, Olga, Anna and Robert)
| |
Collapse
|
3
|
Chen Z, Zhang E, Gan L, Jiang G, Duan Q, Huang M, Li H, Huang G. Analysis of the association between testosterone and cardiovascular disease potential risk factor apolipoprotein B in adult males without cancer: national health and nutrition examination survey 2011-2016. Front Endocrinol (Lausanne) 2024; 15:1304344. [PMID: 38435750 PMCID: PMC10905265 DOI: 10.3389/fendo.2024.1304344] [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: 09/29/2023] [Accepted: 01/22/2024] [Indexed: 03/05/2024] Open
Abstract
Background Over the years, there has been extensive exploration of the association between testosterone and lipid profiles, yet the precise mechanisms underlying their interaction remain incompletely elucidated. Similarly, there is a dearth of research on the correlation between serum apolipoprotein B (apoB) and serum total testosterone (TT), particularly within specific populations. Methods We conducted a cross-sectional study to assess the relationship between serum TT concentration and serum apoB concentration. Using the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2016, we employed weighted generalized linear models, weighted univariate, weighted multivariate analysis, and smooth curve fitting to assist in exploring the relationship between serum TT and apoB. Serum apoB concentration served as the independent variable, and serum TT concentration as the dependent variable. ApoB was divided into four quartiles-Q1 (<0.7g/L, N=691), Q2 (≥0.7g/L to <0.9g/L, N=710), Q3 (≥0.9g/L to <1.1g/L, N=696), and Q4 (≥1.1g/L, N=708)-thereby further solidifying the stable association between the two. Additionally, the application of smooth curve fitting will contribute to a more detailed elucidation of the specific relationship between serum TT concentration and serum apoB concentration under different factors (Drinking, Smoke, Diabetes, Hypertension, and High cholesterol level.). Results The results indicate a negative correlation between serum TT concentration and apoB concentration (β=-113.4; 95% CI: -146.6, -80.2; P<0.001). After adjusting for confounding variables, the negative correlation between apoB concentration and TT concentration remains significant (β=-61.0; 95% CI: -116.7, -5.2; P=0.040). When apoB concentration was converted from a continuous variable to a categorical variable (quartiles: Q1<0.7g/L; Q2:≥0.7g/L to<0.9g/L; Q3:≥0.9g/L to <1.1g/L; Q4: ≥1.1g/L), TT level of participants in the highest quartile (≥1.1g/L) was -47.2 pg/mL (95% CI: -91.2, -3.3; P=0.045) lower than that in the lowest quartile (<0.7g/L). The smooth curve fitting diagram revealed differences in the relationship between TT concentration and apoB among individuals with different cardiovascular disease (CVD) risk factors. Conclusions This study elucidates a robust inverse correlation between serum TT concentration and apoB concentration, maintaining statistical significance even upon adjustment for confounding factors. These findings present a promising avenue for addressing the prevention and treatment of low testosterone and CVD.
Collapse
Affiliation(s)
- Zhiyi Chen
- Department of Urology, The Third Affiliated Hospital of Shenzhen University, Shenzhen University School of Medicine, Shenzhen, China
- Department of Urology, The Third Affiliated Hospital of Shenzhen University, Shenzhen Luohu Hospital Group Luohu People's Hospital, Shenzhen, China
| | - Enpu Zhang
- Department of Urology, The Third Affiliated Hospital of Shenzhen University, Shenzhen Luohu Hospital Group Luohu People's Hospital, Shenzhen, China
| | - Lu Gan
- Department of Urology, The Third Affiliated Hospital of Shenzhen University, Shenzhen Luohu Hospital Group Luohu People's Hospital, Shenzhen, China
| | - Ganggang Jiang
- Department of Urology, The Third Affiliated Hospital of Shenzhen University, Shenzhen Luohu Hospital Group Luohu People's Hospital, Shenzhen, China
| | - Qilin Duan
- Department of Urology, The Third Affiliated Hospital of Shenzhen University, Shenzhen Luohu Hospital Group Luohu People's Hospital, Shenzhen, China
| | - Mou Huang
- Department of Urology, The Third Affiliated Hospital of Shenzhen University, Shenzhen Luohu Hospital Group Luohu People's Hospital, Shenzhen, China
| | - Huizhen Li
- Department of Urology, The Third Affiliated Hospital of Shenzhen University, Shenzhen Luohu Hospital Group Luohu People's Hospital, Shenzhen, China
| | - Guixiao Huang
- Department of Urology, The Third Affiliated Hospital of Shenzhen University, Shenzhen University School of Medicine, Shenzhen, China
- Department of Urology, The Third Affiliated Hospital of Shenzhen University, Shenzhen Luohu Hospital Group Luohu People's Hospital, Shenzhen, China
| |
Collapse
|
4
|
Andrade G, Iori I, Hsieh MK, Milani G, Zandoná PCE, Teixeira TA, Drevet JR, Costa EM, Hallak J. Serum lipid profile levels and semen quality: new insights and clinical perspectives for male infertility and men's health. Int Urol Nephrol 2023; 55:2397-2404. [PMID: 37442905 DOI: 10.1007/s11255-023-03688-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023]
Abstract
PURPOSE Several clinical scenarios regulate the final ejaculated semen, which is pivotal to reproductive success. Sperm motility and plasma membrane fusogenic activity primarily rely on the peculiar sperm lipid composition, influenced by the patient's metabolism, genetics, nutritional, environmental status, and concomitant clinical entities such as varicocele. This study aimed to determine the relationship between serum lipid profile and testicular function (semen quality and testosterone levels). METHODS This retrospective study uses medical charts of 278 infertile men who attended andrological care between 2000 and 2019. Seminal analysis data, lipid profile, and total serum testosterone were collected. A multiple linear regression analysis was performed to evaluate the influence of the lipid parameters on the seminal variables. Statistical analyses were carried out with p ≤ 0.05 considered statistically significant. RESULTS Seminal creatine kinase activity (p = 0.024) is negatively related to HDL (p = 0.032) and triglycerides (p = 0.037), while total testosterone (p < 0.0001) and seminal volume (p = 0.046) appeared both to be negatively related to triglycerides (p = 0.030 and p = 0.033, respectively). CONCLUSION Medical advice commonly advocated to prevent endothelial dysfunction and cardiovascular disease and improve HDL-cholesterol and triglyceride levels in dyslipidemic patients should also be given to infertile men. Physicians should give patients a thorough assessment, including the blood lipid profile, hormonal status, and routine seminal examinations. We propose a more comprehensive men´s health check-up for the infertile male population, not limited to a simple evaluation of basic sperm parameters.
Collapse
Affiliation(s)
- Gustavo Andrade
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
| | - Ivan Iori
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
| | - Mariana K Hsieh
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
- Faculdade Israelita de Ciências da Saúde Albert Einstein School of Medicine, Sao Paulo, Brazil
| | - Giovanna Milani
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
| | - Pedro C E Zandoná
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
- Division of Urology, Department of Surgery, University of Sao Paulo, Sao Paulo, Brazil
| | - Thiago A Teixeira
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
- Men's Health Study Group, Institute for Advanced Studies, Sao Paulo, Brazil
- Division of Urology, Department of Surgery, University of Sao Paulo, Sao Paulo, Brazil
- Division of Urology, Federal University of Amapa, University Hospital, Macapa, Brazil
| | - Joël R Drevet
- Faculty of Medicine, GReD Institute, CNRS-INSERM-Université Clermont Auvergne, CRBC Building, Clermont-Ferrand, France
| | - Elaine Maria Costa
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
- Men's Health Study Group, Institute for Advanced Studies, Sao Paulo, Brazil
- Division of Endocrinology, University of Sao Paulo, Sao Paulo, Brazil
| | - Jorge Hallak
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil.
- Men's Health Study Group, Institute for Advanced Studies, Sao Paulo, Brazil.
- Division of Urology, Department of Surgery, University of Sao Paulo, Sao Paulo, Brazil.
- Reproductive Toxicology Unit, Department of Pathology, University of Sao Paulo, Sao Paulo, Brazil.
| |
Collapse
|
5
|
Fan C, Wei D, Wang L, Liu P, Fan K, Nie L, Liu X, Hou J, Huo W, Li L, Li X, Li W, Wang C, Mao Z. The association of serum testosterone with dyslipidemia is mediated by obesity: the Henan Rural Cohort Study. J Endocrinol Invest 2023; 46:679-686. [PMID: 36219315 DOI: 10.1007/s40618-022-01911-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/24/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND AIMS This study aimed to evaluate the relationships of serum testosterone with dyslipidemia and blood lipid levels and test whether obesity mediated these associations by gender in Chinese rural population. METHODS AND RESULTS A total of 6150 subjects were finally analyzed in this study. Serum testosterone for each subject was detected by liquid chromatography equipped with tandem mass spectrometry. Logistic regression and linear regression were employed to evaluate the associations of serum testosterone with the prevalence of dyslipidemia and blood lipid levels. Mediation analysis was conducted to identify the mediation effects of obesity on the relationship between serum testosterone and dyslipidemia. After adjusting for multiple confounders, per unit change in serum ln-testosterone levels was associated with a decreased prevalent dyslipidemia in men (odds ratio (OR): 0.785, 95% confidence interval (CI) (0.708, 0.871)). Males with the levels of serum testosterone in the third or fourth quartiles had a 49.4% (OR: 0.506, 95% CI 0.398, 0.644) or 67.1% (OR: 0.329, 95% CI 0.253, 0.428) significantly lower odds of prevalence of dyslipidemia. In addition, a onefold increase in ln-testosterone was related to a 0.043 mmol/L (95% CI 0.028, 0.059) increase in high-density lipoprotein cholesterol (HDL-C) in men. Results of the mediation analysis suggested that obesity played a partial role in the association of testosterone with dyslipidemia in men. CONCLUSIONS These findings suggested that serum testosterone levels were negatively associated with lipid levels and prevalent dyslipidemia, and obesity mediated the effects of serum testosterone on dyslipidemia in men, implying that obesity prevention should be highlighted to decrease the prevalence of dyslipidemia related to changes in testosterone levels.
Collapse
Affiliation(s)
- C Fan
- Department of Hypertension, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, People's Republic of China
| | - D Wei
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - L Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - P Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - K Fan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - L Nie
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - X Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - J Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - W Huo
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - L Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - X Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - W Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - C Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Z Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China.
| |
Collapse
|
6
|
Age-related decrease in serum dihydrotestosterone concentration is accompanied by impaired vascular status. Exp Gerontol 2023; 173:112104. [PMID: 36693531 DOI: 10.1016/j.exger.2023.112104] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 12/03/2022] [Accepted: 01/20/2023] [Indexed: 01/22/2023]
Abstract
INTRODUCTION The effect of androgens on the cardiovascular system in humans is ambiguous. Moreover, still little is known about the effects of the most potent androgen, dihydrotestosterone, on arterial stiffness and endothelial function. The aim of this study was to evaluate whether age-dependent alterations in serum concentration of dihydrotestosterone and its circulating metabolite are accompanied by changes in endothelial function and arterial stiffness. METHODS In 12 young and 11 older men, basal serum concentrations of testosterone, dehydroepiandrosterone sulfate (DHAE-S), androstenedione (AE), dihydrotestosterone (DHT) and androstanediol glucuronide (ADG) were analyzed in relation to vascular status including cIMT - carotid intima media thickness, cAI - central augmentation index, crPWV - carotid radial pulse wave velocity, SI - stiffness index, endothelial and inflammatory markers. RESULTS Although concentration of testosterone was not different between young and older group, it was demonstrated that DHT, DHEA-S, AE and ADG were significantly lower in older men in comparison to young men (p < 0.01). Interestingly the most surprising difference was found for DHT concentration, that was as much as 61 % lower in aged men that displayed significantly higher values of cIMT, AI, crPWV and SI (p < 10-4), suggestive of arterial stiffness. Furthermore, DHT was negatively correlated to all arterial wall parameters (cAI, crPWV, SI and cIMT), c-reactive protein (CRP) and hyaluronic acid (HA) concentration, as well as positively correlated to markers of endothelial function (MNA and 6-keto-PGF1α) in all studied individuals (n = 23). CONCLUSIONS We have shown that ageing leads to a significant decrease in DHT concentration that is accompanied by impaired arterial wall characteristics and worsened endothelial function. Therefore more attention should be paid to the DHT, DHEA-S and ADG concentrations as a biomarkers for vascular dysfunction in ageing men.
Collapse
|
7
|
Chernova MO, Esaulenko DI, Rozhivanova ER, Rozhivanov RV, Mel’nichenko GA, Shestakova MV, Mokrysheva NG. Clinical and epidemiological characteristics of male hypogonadism in type 2 diabetes in Russia: combined analysis of study data for the period 2005–2022. DIABETES MELLITUS 2023. [DOI: 10.14341/dm12978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Background: Male hypogonadism is associated with type 2 diabetes mellitus (T2DM), therefore, it is of interest to study its clinical and epidemiological characteristics. These data are published, but their fragmentation and small sample sizes are a problem. A summary assessment of the combined primary data of the conducted studies will provide sufficient representativeness and will allow to extrapolate the results to the general Russian population with T2DM.Aim: Assessment of the clinical and epidemiological characteristics and aggravating factors of male hypogonadism in T2DM in Russia.Materials and methods: A Combining primary data (anamnesis, anthropometric indicators, laboratory tests) of full-design, cross-sectional, screening studies of hypogonadism in men with T2DM conducted on the territory of the Russian Federation in the period from 2005 to 2022. The groups were compared using the Mann-Whitney U-test for quantitative indicators and χ² with Yates’ correction for qualitative ones. Differences were considered statistically significant with p <0,05. The groups were compared using the Mann-Whitney U-test and χ² with Yates correction. Differences were considered statistically significant at p<0.05.Results: Hypogonadism was detected in 893 of 1576 men (56,7%) with T2DM. Patients with hypogonadism were statistically significantly older, had higher body mass index (BMI), worse glycemic control than eugonadal men. There was statistically significantly higher prevalence of macroangiopathies and polyneuropathy in hypogonadal patients.Conclusion: The prevalence of male hypogonadism in T2DM 56,7%. Its development is due to age, obesity, worse glycemic control. Hypogonadism syndrome is associated with the development of diabetic macroangiopathy and polyneuropathy. Severe violation of glycemic control (glycated hemoglobin (HbA1c) 10% or more) significantly reduces testosterone production and increases the prevalence of hypogonadism.
Collapse
|
8
|
Tsirka A. Gender Differences in Cardiovascular Health: Hormonal Effects on Cardiovascular Risk and Management. Handb Exp Pharmacol 2023; 282:201-218. [PMID: 37468722 DOI: 10.1007/164_2023_668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Cardiovascular disease is the number one cause of death worldwide both in men and women. Significant differences however exist in the age of onset, type of cardiovascular disease (CVD), and treatment response among the genders. These differences are due to both gender societal effects and biological differences from the influence of the hormonal and metabolic milieu in the two sexes.Estrogens are the main female hormone. They impact signaling in almost every body organ and thus affect cardiovascular risk factors. These result in differential expression of CVD. The differential effect of treatment modalities is only recently being evaluated.Research is ongoing regarding the pathophysiology of these differences. Our current level of knowledge is described in this chapter.
Collapse
Affiliation(s)
- Anna Tsirka
- University of Connecticut School of Medicine, Farmington, CT, USA.
- Connecticut Children's Medical Center, Hartford, CT, USA.
- St Christopher's Children's Hospital, Drexel University Medical School, Philadelphia, PA, USA.
| |
Collapse
|
9
|
Rozhivanov RV, Chernova MO, Mel’nichenko GA, Shestakova MV, Mokrysheva NG. The incidence and aggravating factors of male hypogonadism in type 2 diabetes. DIABETES MELLITUS 2022. [DOI: 10.14341/dm12913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND: Male hypogonadism is associated with type 2 diabetes mellitus (T2DM), therefore, it is of interest to study its frequency. The clinical symptoms of hypogonadism are not specific, and laboratory diagnostics is the basis for its detection. The optimal method for this diagnostics is isotope dilution liquid chromatography/tandem mass spectrometry, which was used in our study. AIMS: Assessment of the incidence and aggravating factors of male hypogonadism in type 2 diabetesMATERIALS AND METHODS: A full-design, cross-sectional, screening, single-center, non-interventional study included men with T2DM, who were he was treated in Endocrinology Research Centre, Moscow. The study was conducted from October 2021 to January 2022. Medical history assessment, physical examination with determination of body mass index (BMI), measurement estimation of total testosterone by isotope dilution liquid chromatography/tandem mass spectrometry, glycated hemoglobin (HbA1c) and lipid profiles were performed. The groups were compared using the Mann-Whitney U-test for quantitative indicators and χ² with Yates’ correction for qualitative ones. Differences were considered statistically significant with p0,05.RESULTS: Hypogonadism was detected in 355 (70.3%) men with T2DM. Patients with hypogonadism had statistically significantly higher BMI, worse glycemic control, lower HDL levels, and higher triglycerides than eugonadal men. An additional comparative analysis among non-obese individuals showed the presence of statistically significant differences in the level of HbA1c (higher in hypogonadal men) and HDL (lower in hypogonadal men). An analysis of hypogonadal patients depending on the presence of obesity showed statistically significant differences between groups in the level of total testosterone (lower in obese men) and triglycerides (higher in obese men).CONCLUSIONS: The prevalence of male hypogonadism in type 2 diabetes was 70,3%. Its development was associated with obesity and poor glycemic control.
Collapse
|
10
|
Joury A, Alshehri M, Li LZ, Rezan T. Androgenic steroids dysregulation and the risk of coronary artery disease. Expert Rev Cardiovasc Ther 2022; 20:343-349. [PMID: 35583488 DOI: 10.1080/14779072.2022.2077193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Endogenous testosterone deficiency or excess anabolic-androgenic steroids (AAS) have been linked to alter the physiology of different organs in the body, more specifically, the vasculature of coronary arteries. Despite the health-related concerns of using synthetic testosterone derivatives, such as AAS, there has been a tremendous increase in the use of AAS among athletes and bodybuilders. AREAS COVERED We have highlighted the three main mechanisms that AAS increase the risk of coronary artery disease (CAD): altering the homeostasis of lipid metabolism which results in dyslipidemia and subsequently atherosclerosis, disturbing the function of platelet which results in platelet aggregation and subsequent thrombosis, and increasing the risk of coronary vasospasm by affecting the physiological function of vascular bed. EXPERT OPINION Despite the restriction of AAS in specific clinical conditions such as testosterone deficiency and cancer therapy, many amateurs' athletes misuse the AAS. Although there has been a strong association between the AAS misuse and risk of developing CAD, the more valued approach would be a randomized clinical double-blind trial. The suggested primary endpoint would be an occurrence of adverse cardiovascular events, such as myocardial infarction, cerebrovascular accidents, and death. Increasing awareness of the risk of missing AAS among high-risk groups is imperative.
Collapse
Affiliation(s)
- Abdulaziz Joury
- Department of Cardiology, Ochsner Health System, New Orleans, LA, US.,King Salman Heart Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mona Alshehri
- Department of Ophthalmology and Vision Sciences, McGill University, Montreal, Quebec, Canada.,Department of Ophthalmology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Luke Z Li
- The University of Queensland, Saint Lucia, Australia
| | - Tameem Rezan
- Department of Internal Medicine, Ochsner Health System, New Orleans, LA, US
| |
Collapse
|
11
|
Jayasena CN, Ho CLT, Bhasin S. The Effects of Testosterone Treatment on Cardiovascular Health. Endocrinol Metab Clin North Am 2022; 51:109-122. [PMID: 35216710 DOI: 10.1016/j.ecl.2021.11.006] [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] [Indexed: 11/03/2022]
Abstract
Current evidence suggests that testosterone therapy has numerous benefits and risks on cardiovascular health. Examples of this include published data that support improvements in insulin sensitivity and body composition which may reduce the risk of diabetes. On the other hand, testosterone therapy may offset such benefits by mild impairments in lipid parameters. Consequently, controversy on the effects of testosterone therapy on cardiovascular health remains. Studies are underway to clarify this important question for the benefit of men with hypogonadism.
Collapse
Affiliation(s)
- Channa N Jayasena
- Section of Endocrinology and Investigative Medicine, Imperial College London, W12 0HS, UK.
| | - Carmen Lok Tung Ho
- Section of Endocrinology and Investigative Medicine, Imperial College London, W12 0HS, UK
| | - Shalender Bhasin
- Boston Claude D. Pepper Older Americans Independence Center, Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA
| |
Collapse
|
12
|
Kato Y, Shigehara K, Inaba T, Sakamoto J, Iijima M, Kawaguchi S, Izumi K, Kadono Y, Namiki M, Mizokami A. Low free testosterone level as a predictor of cardiovascular events in Japanese men with coronary risk factors. Aging Male 2021; 24:8-14. [PMID: 34000968 DOI: 10.1080/13685538.2021.1920912] [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] [Indexed: 10/21/2022] Open
Abstract
Aim: We investigated whether low plasma free testosterone (FT) levels could predict cardiovascular events (CVE) in Japanese men with coronary risk factors.Methods: Male patients with classical coronary risk factors who had undergone serum FT testing were enrolled. New incidences of CVE were retrospectively investigated among all eligible participants based on their medical records.Results: Overall, 466 male outpatients with coronary risk factors without a previous history of CVE were identified. Throughout the follow-up period (median = 92 months), 126 CVE occurred. The Kaplan-Meier survival analysis according to the tertiles of plasma FT levels revealed that patients with the lowest FT tertile (<6.5 pg/mL) had a higher likelihood of developing CVE than those with the highest tertile (>9.3 pg/mL) (p<.01). Multivariate analysis showed that increased frequency of CVE was observed with lower FT tertiles, independent of other coronary risk factors, with hazard ratios of 0.617 (95% CI, 0.389-0.976; p=.030) and 0.524 (95% CI, 0.309-0.887; p=.016) for the second and highest tertile relative to the lowest FT tertile, respectively.Conclusion: Among Japanese men with coronary risk factors, a lower FT level was a predictor for the development of cardiovascular diseases independent of other coronary risk factors and age.
Collapse
Affiliation(s)
- Yuki Kato
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Kazuyoshi Shigehara
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Takahiro Inaba
- Department of Urology, National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - Jiro Sakamoto
- Department of Urology, Hokuriku Hospital, KKR Kanazawa, Kanazawa, Japan
| | - Masashi Iijima
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Shohei Kawaguchi
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Kouji Izumi
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Yoshifumi Kadono
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Mikio Namiki
- Department of Urology, Hasegawa Hospital, Toyama, Japan
| | - Atsushi Mizokami
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| |
Collapse
|
13
|
Grandys M, Majerczak J, Zapart-Bukowska J, Duda K, Kulpa JK, Zoladz JA. Lowered Serum Testosterone Concentration Is Associated With Enhanced Inflammation and Worsened Lipid Profile in Men. Front Endocrinol (Lausanne) 2021; 12:735638. [PMID: 34566895 PMCID: PMC8459752 DOI: 10.3389/fendo.2021.735638] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 08/16/2021] [Indexed: 11/13/2022] Open
Abstract
The negative relationship between testosterone and inflammatory cytokines has been reported for decades, although the exact mechanisms of their interactions are still not clear. At the same time, little is known about the relation between androgens and acute phase proteins. Therefore, in this investigation, we aimed to study the relationship between androgen status and inflammatory acute phase reactants in a group of men using multi-linear regression analysis. Venous blood samples were taken from 149 men ranging in age from 18 to 77 years. Gonadal androgens [testosterone (T) and free testosterone (fT)], acute phase reactants [C-reactive protein (CRP), ferritin (FER), alpha-1-acid glycoprotein (AAG), and interleukin-6 (IL-6)], cortisol (C), and lipid profile concentrations were determined. It was demonstrated that the markers of T and fT were negatively correlated with all acute phase proteins (CRP, FER, and AAG; p < 0.02) and the blood lipid profile [total cholesterol (TC), low-density lipoprotein (LDL), and triglycerides (TG); p < 0.03]. Multivariate analysis showed that T, fT, and the fT/C ratio were inversely correlated with the CRP, AAG, and FER concentrations independently of age and blood lipids. When adjustment for BMI was made, T, fT, and the fT/C ratio were negatively correlated with the AAG concentrations only. In addition, it was demonstrated that gonadal androgens were positively correlated with physical activity level (p < 0.01). We have concluded that a lowered serum T concentration may promote inflammatory processes independently of adipose tissue and age through a reduced inhibition of inflammatory cytokine synthesis, which leads to enhanced acute phase protein production. Therefore, a low serum T concentration appears to be an independent risk factor in the development of atherosclerosis and cardiovascular diseases. Moreover, the positive correlation between testosterone and physical activity level suggests that exercise training attenuates the age-related decrease in gonadal androgens and, in this way, may reduce the enhancement of systemic low-grade inflammation in aging men.
Collapse
Affiliation(s)
- Marcin Grandys
- Department of Muscle Physiology, Institute of Basic Sciences, Faculty of Rehabilitation, University School of Physical Education, Krakow, Poland
- Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
- *Correspondence: Marcin Grandys, ; Jerzy A. Zoladz,
| | - Joanna Majerczak
- Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
- Department of Neurobiology, Poznan University of Physical Education, Poznań, Poland
| | - Justyna Zapart-Bukowska
- Department of Muscle Physiology, Institute of Basic Sciences, Faculty of Rehabilitation, University School of Physical Education, Krakow, Poland
| | - Krzysztof Duda
- Department of Nursing, Institute of Health Protection, The State Higher School of Vocational Education, Tarnow, Poland
| | - Jan K. Kulpa
- Department of Clinical Biochemistry, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Cracow Branch, Krakow, Poland
| | - Jerzy A. Zoladz
- Department of Muscle Physiology, Institute of Basic Sciences, Faculty of Rehabilitation, University School of Physical Education, Krakow, Poland
- Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
- *Correspondence: Marcin Grandys, ; Jerzy A. Zoladz,
| |
Collapse
|
14
|
Letkiewicz S, Pilis K, Ślęzak A, Pilis A, Pilis W, Żychowska M, Langfort J. Eight Days of Water-Only Fasting Promotes Favorable Changes in the Functioning of the Urogenital System of Middle-Aged Healthy Men. Nutrients 2020; 13:nu13010113. [PMID: 33396948 PMCID: PMC7824351 DOI: 10.3390/nu13010113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/16/2020] [Accepted: 12/29/2020] [Indexed: 12/03/2022] Open
Abstract
The aim of this study was to determine whether, after 8 days of water-only fasting, there are changes in the efficiency of the lower urinary tract, the concentration of sex hormones, and the symptoms of prostate diseases in a group of middle-aged men (n = 14). For this purpose, before and after 8 days of water-only fasting (subjects drank ad libitum moderately mineralized water), and the following somatic and blood concentration measurements were made: total prostate specific antigen (PSA-T), free prostate specific antigen (PSA-F), follicle stimulating hormone (FSH), luteotropic hormone (LH), prolactin (Pr), total testosterone (T-T), free testosterone (T-F), dehydroepiandrosterone (DHEA), sex hormone globulin binding (SHGB), total cholesterol (Ch-T), β-hydroxybutyrate (β-HB). In addition, prostate volume (PV), volume of each testis (TV), total volume of both testes (TTV), maximal urinary flow rate (Qmax), and International Prostate Symptom Score (IPSS) values were determined. The results showed that after 8 days of water-only fasting, Qmax and IPSS improved but PV and TTV decreased significantly. There was also a decrease in blood levels of PSA-T, FSH, P, T-T, T-F, and DHEA, but SHGB concentration increased significantly. These results indicate that 8 days of water-only fasting improved lower urinary tract functions without negative health effects.
Collapse
Affiliation(s)
- Sławomir Letkiewicz
- Department of Health Sciences, Jan Długosz University in Częstochowa, 42-200 Częstochowa, Poland; (S.L.); (A.Ś.); (A.P.); (W.P.)
- Urological and Andrological Clinic “Urogen”, 42-600 Tarnowskie Góry, Poland
| | - Karol Pilis
- Department of Health Sciences, Jan Długosz University in Częstochowa, 42-200 Częstochowa, Poland; (S.L.); (A.Ś.); (A.P.); (W.P.)
- Correspondence: ; Tel.: +48-34-365-5983 or +48-508-204-403
| | - Andrzej Ślęzak
- Department of Health Sciences, Jan Długosz University in Częstochowa, 42-200 Częstochowa, Poland; (S.L.); (A.Ś.); (A.P.); (W.P.)
| | - Anna Pilis
- Department of Health Sciences, Jan Długosz University in Częstochowa, 42-200 Częstochowa, Poland; (S.L.); (A.Ś.); (A.P.); (W.P.)
| | - Wiesław Pilis
- Department of Health Sciences, Jan Długosz University in Częstochowa, 42-200 Częstochowa, Poland; (S.L.); (A.Ś.); (A.P.); (W.P.)
| | - Małgorzata Żychowska
- Faculty of Physical Education, Department of Sport, Kazimierz Wielki University in Bydgoszcz, 85-091 Bydgoszcz, Poland;
| | - Józef Langfort
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland;
| |
Collapse
|
15
|
Ko DH, Kim SE, Lee JY. Prevalence of Low Testosterone According to Health Behavior in Older Adults Men. Healthcare (Basel) 2020; 9:healthcare9010015. [PMID: 33374470 PMCID: PMC7824172 DOI: 10.3390/healthcare9010015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 11/16/2022] Open
Abstract
Testosterone is a representative sex hormone for men, and low testosterone causes erectile dysfunction and cardiovascular disease. The purpose of this study was to investigate the association between low testosterone (LTT) and health behaviors, such as alcohol, smoking, and exercise habits. We included 2980 men aged 65 to 80. Total serum testosterone and body composition were measured. A testosterone level less than 300 ng/dL was defined as low testosterone. A questionnaire on smoking, alcohol, and exercise was included. The odds ratio (OR) of LTT was calculated through logistic regression. Model 1 only used age as the adjustment variable, whereas Model 2 adjusted for age, waist circumference, and smoking. The prevalence of LTT was 626 (21.0%). The prevalence of LTT was significant in fat mass (Model 1: OR, 2.133) and muscle mass (Model 1: medium OR, 2.130 and low OR, 3.022; Model 2: medium OR, 1.638 and low OR, 1.740). The prevalence of LTT was also different based on smoking (Model 1: OR, 1.590; Model 2: OR, 1.629) and strength exercise (Model 1: OR, 0.849; Model 2: OR, 0.923). In conclusion, high frequency strength exercise and smoking cessation lower the prevalence of low testosterone, and obesity and low muscle mass increase the prevalence of low testosterone.
Collapse
Affiliation(s)
- Duk Han Ko
- Department of Sports Science Convergence, Dongguk University, Seoul 04620, Korea;
| | - Seong Eon Kim
- Department of Physical Education, Sejong University, Seoul 05006, Korea
- Correspondence: (S.E.K.); (J.Y.L.); Tel.: +82-2-6140-5844 (S.E.K.); +82-33-640-2556 (J.Y.L.); Fax: +050-4042-9315 (S.E.K.); +82-33-641-3659 (J.Y.L.)
| | - Ji Young Lee
- Department of Physical Education, Gangneung-Wonju National University, Gangneung 25457, Korea
- Correspondence: (S.E.K.); (J.Y.L.); Tel.: +82-2-6140-5844 (S.E.K.); +82-33-640-2556 (J.Y.L.); Fax: +050-4042-9315 (S.E.K.); +82-33-641-3659 (J.Y.L.)
| |
Collapse
|
16
|
Kharaba ZJ, Buabeid MA, Ibrahim NA, Jirjees FJ, Obaidi HJA, Kaddaha A, Khajehkarimoddini L, Alfoteih Y. Testosterone therapy in hypogonadal patients and the associated risks of cardiovascular events. Biomed Pharmacother 2020; 129:110423. [PMID: 32570122 DOI: 10.1016/j.biopha.2020.110423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/06/2020] [Accepted: 06/13/2020] [Indexed: 10/24/2022] Open
Abstract
Since the male secondary sex characters, libido and fertility are attributed to their major androgen hormone testosterone, the sub-optimum levels of testosterone in young adults may cause infertility and irregularities in their sexual behaviour. Such deficiency is often secondary to maladies involving testes, pituitary or hypothalamus that could be treated with an administration of exogenous testosterone. In the last few decades, the number of testosterone prescriptions has markedly increased to treat sub-optimal serum levels even though its administration in such conditions is not yet approved. On account of its associated cardiovascular hazards, the food and drug authority in the United States has issued safety alerts on testosterone replacement therapy (TRT). Owing to a great degree of conflict among their findings, the published clinical trials seem struggling in presenting a decisive opinion on the matter. Hence, the clinicians remain uncertain about the possible cardiovascular adversities while prescribing TRT in hypogonadal men. The uncertainty escalates even further while prescribing such therapy in older men with a previous history of cardiovascular ailments. In the current review, we analysed the pre-clinical and clinical studies to evaluate the physiological impact of testosterone on cardiovascular and related parameters. We have enlisted studies on the association of cardiovascular health and endogenous testosterone levels with a comprehensive analysis of epidemiological studies, clinical trials, and meta-analyses on the cardiovascular risk of TRT. The review is aimed to assist clinicians in making smart decisions regarding TRT in their patients.
Collapse
Affiliation(s)
- Zelal Jaber Kharaba
- Department of Clinical Sciences, College of Pharmacy, Al-Ain University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Manal Ali Buabeid
- Department of Clinical Sciences, Ajman University, Ajman, 346, United Arab Emirates
| | - Nihal A Ibrahim
- Department of Clinical Sciences, Ajman University, Ajman, 346, United Arab Emirates
| | | | | | | | | | - Yassen Alfoteih
- City University College of Ajman, Ajman, 18484, United Arab Emirates.
| |
Collapse
|
17
|
Abou-Khalil NS, Ali MF, Ali MM, Ibrahim A. Surgical castration versus chemical castration in donkeys: response of stress, lipid profile and redox potential biomarkers. BMC Vet Res 2020; 16:310. [PMID: 32847551 PMCID: PMC7448993 DOI: 10.1186/s12917-020-02530-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 08/19/2020] [Indexed: 01/17/2023] Open
Abstract
Background Castration is a husbandry practice raising important questions on the welfare and physiological status of farm animals. Searching for effective castration methods that minimally compromise the body physiology is worthy of attention. Therefore, this study aimed to evaluate the differential response of biological systems in donkeys to surgical castration versus the chemical one by CaCl2 with special emphasis on stress, lipid profile, and oxidative stress biomarkers. Donkeys were divided randomly and equally into two groups; the chemical (Ch) and surgical (S) groups (n = 6). The Ch group was chemically castrated by intratesticular injection of 20% CaCl2 dissolved in absolute ethanol. Blood samples were collected prior to castration and at 15, 30, 45, and 60 days after the beginning of experiment. Results Surprisingly, the Ch group at the end of the experiment was characterized by significantly higher cortisol level compared to the S group. TC and LDL-C levels in the S group significantly decreased at day 45, while TG levels significantly increased at days 45 and 60 in comparison with day 0. HDL-C levels at days 30 and 60 in the Ch group significantly increased in comparison with day 0. At day 30 post-castration, HDL-C was significantly higher and LDL-C was significantly lower in the Ch group than the S group. A significant elevation in TC and LDL-C was observed at day 45 and in HDL-C at the end of experimental duration in the Ch group when compared with the S group. TPX level was significantly lower and TAC was significantly higher in the Ch group at day 45 than the S group. Conclusion Surgical castration evoked less stress and minor changes in lipid profile and oxidant/antioxidant balance relative to chemical castration by intratesticular 20% CaCl2 dissolved in absolute ethanol.
Collapse
Affiliation(s)
- Nasser S Abou-Khalil
- Department of Medical Physiology, Faculty of Medicine, Assiut University, Assiut, 71526, Egypt
| | - Marwa F Ali
- Department of Veterinary Pathology and Clinical Pathology, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt
| | - Magda M Ali
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt
| | - Ahmed Ibrahim
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt.
| |
Collapse
|
18
|
Kharaba ZJ, Buabeid MA, Alfoteih YA. Effectiveness of testosterone therapy in hypogonadal patients and its controversial adverse impact on the cardiovascular system. Crit Rev Toxicol 2020; 50:491-512. [PMID: 32689855 DOI: 10.1080/10408444.2020.1789944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Testosterone is the major male hormone produced by testicles which are directly associated with man's appearance and secondary sexual developments. Androgen deficiency starts when the male hormonal level falls from its normal range though, in youngsters, the deficiency occurs due to disruption of the normal functioning of pituitary, hypothalamus glands, and testes. Thus, testosterone replacement therapy was already known for the treatment of androgen deficiency with lesser risks of producing cardiovascular problems. Since from previous years, the treatment threshold in the form of testosterone replacement therapy has effectively increased to that extent that it was prescribed for those conditions which it was considered as inappropriate. However, there are some research studies and clinical trials available that proposed the higher risk of inducing cardiovascular disease with the use of testosterone replacement therapy. Thus under the light of these results, the FDA has published the report of the increased risk of cardiovascular disease with the increased use of testosterone replacement therapy. Nevertheless, there is not a single trial available or designed that could evaluate the risk of cardiovascular events with the use of testosterone replacement therapy. As a result, the use of testosterone still questioned the cardiovascular safety of this replacement therapy. Thus, this literature outlines the distribution pattern of disease by investigating the data and link between serum testosterone level and the cardiovascular disease, also the prescription data of testosterone replacement therapy patients and their tendency of inducing cardiovascular disease, meta-analysis and the trials regarding testosterone replacement therapy and its connection with the risks of causing cardiovascular disease and lastly, the possible effects of testosterone replacement therapy on the cardiovascular system. This study aims to evaluate the available evidence regarding the use of testosterone replacement therapy when choosing it as a treatment plan for their patients.
Collapse
Affiliation(s)
- Zelal Jaber Kharaba
- Department of Clinical Sciences, College of Pharmacy, Al-Ain University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Manal Ali Buabeid
- Department of Clinical Sciences, Ajman University, Ajman, United Arab Emirates
| | | |
Collapse
|
19
|
Abstract
Testosterone is the main male sex hormone and is essential for the maintenance of male secondary sexual characteristics and fertility. Androgen deficiency in young men owing to organic disease of the hypothalamus, pituitary gland or testes has been treated with testosterone replacement for decades without reports of increased cardiovascular events. In the past decade, the number of testosterone prescriptions issued for middle-aged or older men with either age-related or obesity-related decline in serum testosterone levels has increased exponentially even though these conditions are not approved indications for testosterone therapy. Some retrospective studies and randomized trials have suggested that testosterone replacement therapy increases the risk of cardiovascular disease, which has led the FDA to release a warning statement about the potential cardiovascular risks of testosterone replacement therapy. However, no trials of testosterone replacement therapy published to date were designed or adequately powered to assess cardiovascular events; therefore, the cardiovascular safety of this therapy remains unclear. In this Review, we provide an overview of epidemiological data on the association between serum levels of endogenous testosterone and cardiovascular disease, prescription database studies on the risk of cardiovascular disease in men receiving testosterone therapy, randomized trials and meta-analyses evaluating testosterone replacement therapy and its association with cardiovascular events and mechanistic studies on the effects of testosterone on the cardiovascular system. Our aim is to help clinicians to make informed decisions when considering testosterone replacement therapy in their patients.
Collapse
|
20
|
The association of metabolic syndrome and its components with serum prostate-specific antigen levels. Eur J Cancer Prev 2020; 29:36-41. [DOI: 10.1097/cej.0000000000000508] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
21
|
Lorigo M, Mariana M, Oliveira N, Lemos MC, Cairrao E. Vascular Pathways of Testosterone: Clinical Implications. J Cardiovasc Transl Res 2019; 13:55-72. [DOI: 10.1007/s12265-019-09939-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 11/15/2019] [Indexed: 12/17/2022]
|
22
|
Rezanezhad B, Borgquist R, Willenheimer R, Elzanaty S. The Association between Serum Testosterone and Risk Factors for Atherosclerosis. Curr Urol 2019; 13:101-106. [PMID: 31768177 DOI: 10.1159/000499285] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 01/15/2019] [Indexed: 12/17/2022] Open
Abstract
Objective To study the associations between serum testosterone and risk factors for atherosclerosis in 119 men from general population. Methods Systolic pressure, body mass index (BMI), testosterone, fasting glucose, glucose tolerance test, apolipoprotein A-1 (ApoA-1), apolipoprotein B (ApoB), and ApoB/ApoA-1 ratio were assessed. Subjects classified into hypogonadal (testosterone ≤ 12 nmol/l), and eugonadal men (testosterone > 12 nmol/l). Results BMI (28 vs. 26 kg/ m<sup>2</sup>, p = 0.01), systolic pressure (129 vs. 123 mmHg, p = 0.03), fasting glucose (5.9 vs. 5.5 mmol/l, p = 0.03), ApoB (1.1 vs. 1.0 g/l, p = 0.03), and ApoB/ApoA-1 ratio (0.8 vs. 0.7, p = 0.03) were higher in hypogonadal compared to eugonadal men, respectively. In adjusted multivariate regression analysis model, testosterone showed negative associations with BMI (β = -1.832, p = 0.030, 95% CI = -3.485--0.180), fasting glucose (β = -0.394, p = 0.011, 95% CI = -0.696--0.091), glucose tolerance test (β = -0.957, p = 0.045, 95% CI = -1.892--0.022), ApoB (β = -0.157, p = 0.017, 95% CI = -0.286--0.029), and ApoB/ApoA-1 ratio (β = -0.118, p = 0.046, 95% CI = -0.234--0.002). Conclusions These results suggest an inverse association between testosterone levels and risk factors for atherosclerosis.
Collapse
Affiliation(s)
| | | | - Ronnie Willenheimer
- Department of Translational Medicine, Skåne University Hospital, Lund University, Lund, Sweden
| | | |
Collapse
|
23
|
Kralik M, Cvecka J, Buzgo G, Putala M, Ukropcova B, Ukropec J, Killinger Z, Payer J, Kollarik B, Bujdak P, Raastad T, Sedliak M. Strength training as a supplemental therapy for androgen deficiency of the aging male (ADAM): study protocol for a three-arm clinical trial. BMJ Open 2019; 9:e025991. [PMID: 31492775 PMCID: PMC6731925 DOI: 10.1136/bmjopen-2018-025991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Androgen deficiency of the ageing male is a clinical syndrome resulting from the low production of androgens (testosterone levels <6.9 nmol/L) with symptoms including decline in lean mass, muscle strength, increases in body mass and overall fat mass. The aim of the study is to examine the effect of a 12 week strength training intervention on body composition, physical function, muscle cellular and molecular and selected biochemical markers of metabolic health in hypogonadal patients. METHODS AND ANALYSIS The study is three-group controlled 12-week experiment to assess the effect of strength training on hypogonadal patients with testosterone replacement therapy and newly diagnosed males without testosterone replacement therapy. Age matched healthy eugonadal males are also engaged in strength training. Lean mass is used to determine sample size indicating, that 22 subjects per group will be sufficient to detect intervention related changes at the power of 0.90. All outcomes are collected before the intervention (pre-intervention assessments) and after the intervention (post-intervention assessments). Clinical outcomes are body composition (lean mass, fat mass and total body mass) measured by dual-energy X-ray absorptiometry, physical functioning assessed by physical tests and psychosocial functioning. The most important haematological and biochemical parameters included are glucose, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, testosterone, luteinizing hormone, follicle-stimulating hormone, sexhormone-binding globulin, insulin and prostate-specific antigen. Muscle cellular and molecular outcomes are muscle fibre size and regulators of muscle fibre size. Muscle cellular outcomes are measured from muscle biopsies obtained from musculus vastus lateralis. ETHICS AND DISSEMINATION This trial is approved by Ethics Committee of the University Hospital in Bratislava, Slovakia, (ref. trial number: 127/2017) and all subjects will be fully informed on the rationale, risks and benefits of the study and sign the written informed consent prior to entering the study. Results will be published in peer-reviewed journals and presented in scientific conferences. TRIAL REGISTRATION NUMBER NCT03282682.
Collapse
Affiliation(s)
- Michal Kralik
- Deparment of Biological and Medical Sciences, Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava, Slovakia
| | - Jan Cvecka
- Deparment of Biological and Medical Sciences, Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava, Slovakia
| | - Gabriel Buzgo
- Deparment of Biological and Medical Sciences, Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava, Slovakia
| | - Matus Putala
- Deparment of Biological and Medical Sciences, Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava, Slovakia
| | - Barbara Ukropcova
- Deparment of Biological and Medical Sciences, Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava, Slovakia
- Obesity Section, Laboratory of Diabetes and Metabolic Disease, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia
- Institute of Pathophysiology, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia
| | - Jozef Ukropec
- Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Zdenko Killinger
- 5th Department of Internal Medicine, Faculty of Medicine, Comenius University in Bratislava, University Hospital, Bratislava, Slovakia
| | - Juraj Payer
- 5th Department of Internal Medicine, Faculty of Medicine, Comenius University in Bratislava, University Hospital, Bratislava, Slovakia
| | - Boris Kollarik
- Department of Urology, University Hospital - Petrzalka, Bratislava, Slovakia
| | - Peter Bujdak
- Department of Urology, Slovak Medical University Bratislava, Bratislava, Slovakia
| | - Truls Raastad
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Milan Sedliak
- Deparment of Biological and Medical Sciences, Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava, Slovakia
| |
Collapse
|
24
|
Kobayashi M, Mizuno T, Yuki H, Kambara T, Betsunoh H, Nukui A, Abe H, Fukabori Y, Yashi M, Kamai T. Association between serum prostate-specific antigen level and diabetes, obesity, hypertension, and the laboratory parameters related to glucose tolerance, hepatic function, and lipid profile: implications for modification of prostate-specific antigen threshold. Int J Clin Oncol 2019; 25:472-478. [PMID: 31440861 DOI: 10.1007/s10147-019-01527-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 08/06/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Previous studies indicated inverse relationships between body mass index (BMI), diabetes and prostate-specific antigen (PSA) concentration besides an established positive relationship between age and PSA. Other causal relationships between clinical parameters including hypertension, hepatic function, tests, lipid profile and PSA were also suggested. Thus, we incorporated these parameters all together into the analysis to identify possible determinants of PSA concentration to improve the accuracy of PSA tests. METHODS Associations between PSA and the above-mentioned clinical parameters were examined among 14,486 men who visited our hospital for a routine health checkup, using linear regression analyses. RESULTS Total of 1403 (9.7%) and 784 (5.4%) men were classified as diabetes and obesity, respectively. After adjusting age, significant PSA reductions were found in diabetic men, especially for men taking antidiabetics. Such association was seen when the diabetic status was represented by hemoglobin A1c (HbA1c) and fasting blood sugar (FBS) levels. That is, PSA levels were significantly reduced in men with higher HbA1c and FBS levels. Obesity was also associated with a reduction in PSA levels. Moreover, PSA levels were significantly decreased with increased ALT levels. CONCLUSIONS PSA test results should be carefully interpreted especially for men with diabetes and obesity, in whom a substantial reduction in PSA concentration is likely to occur.
Collapse
Affiliation(s)
- Minoru Kobayashi
- Department of Urology, Utsunomiya Memorial Hospital, 1-3-16, Ohdori, Utsunomiya City, Tochigi, 320-0811, Japan.
| | - Tomoya Mizuno
- Department of Urology, Nasu Red Cross Hospital, Tochigi, Japan
| | - Hideo Yuki
- Department of Urology, Dokkyo Medical University, Tochigi, Japan
| | | | | | - Akinori Nukui
- Department of Urology, Dokkyo Medical University, Tochigi, Japan
| | - Hideyuki Abe
- Department of Urology, Dokkyo Medical University, Tochigi, Japan
| | | | - Masahiro Yashi
- Department of Urology, Dokkyo Medical University, Tochigi, Japan
| | - Takao Kamai
- Department of Urology, Dokkyo Medical University, Tochigi, Japan
| |
Collapse
|
25
|
Effect of treatment with testosterone on endothelial function in hypogonadal men: a systematic review and meta-analysis. Int J Impot Res 2019; 32:379-386. [DOI: 10.1038/s41443-019-0163-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/09/2019] [Accepted: 05/16/2019] [Indexed: 12/15/2022]
|
26
|
Bowel preparation for colonoscopy may decrease the levels of testosterone in Korean men. Sci Rep 2019; 9:7080. [PMID: 31068639 PMCID: PMC6506588 DOI: 10.1038/s41598-019-43598-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 04/26/2019] [Indexed: 12/27/2022] Open
Abstract
Although colonoscopy is commonly conducted for medical check-ups in Korea, investigations for the influence of bowel preparation on various health conditions are insufficient. This cross-sectional study investigated whether bowel preparation has an influence on serum levels of testosterone. A total of 1114 men were divided into the bowel preparation group and control groups. The median total and free testosterone levels were significantly lower in the bowel preparation group (14.89 and 0.26 nmol/L, respectively) than in the control groups (15.72 and 0.28 nmol/L, respectively). The level of total testosterone significantly increased with age in the bowel preparation group (r = 0.103). The differences in the levels of total and free testosterone between the 2 groups were more prominent in younger men than in older men. In multivariate regression models, bowel preparation was independently associated with the levels of total and free testosterone. In these models, the interaction between age and bowel preparation was significant for the levels of total and free testosterone. In conclusion, bowel preparation may independently decrease the serum levels of total and free testosterone. The decline in testosterone was more evident in younger men than in older men.
Collapse
|
27
|
Robeva R, Elenkova A, Zacharieva S. Causes and Metabolic Consequences of Gynecomastia in Adult Patients. Int J Endocrinol 2019; 2019:6718761. [PMID: 31687020 PMCID: PMC6794958 DOI: 10.1155/2019/6718761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/21/2019] [Accepted: 09/06/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Gynecomastia (GM) is a benign enlargement of male breast due to glandular tissue proliferation. GM is a symptom of systemic or local hormonal disturbances, which could be associated with functional changes or pathological conditions. However, the long-lasting steroid imbalance in men with GM might exert negative influence on their metabolic health. METHODS A total of 110 adult men with symptomatic GM were included in the present retrospective cross-sectional study. Anthropometric, metabolic, and hormonal data of the patients were collected. RESULTS In almost 64% of GM patients, the underlying pathological condition was identified. Moreover, the development of GM was among the primary symptoms leading to the proper diagnosis in more than 40% of hypogonadal patients. The prevalence of metabolic syndrome (MS) was 53%; the highest prevalence of MS was found in patients with medication-induced GM and in the hypogonadal patients, whereas the lowest prevalence was observed in men with idiopathic postpubertal GM despite the similar degree of obesity. The lower testosterone levels were associated with more unfavorable lipid profile in the GM patients. CONCLUSION The development of GM in adults might be an important symptom of an underlying gonadal disease. Moreover, it could be associated with an increased risk of metabolic disturbances. Our results support the need of detailed laboratory and hormonal investigations in patients with GM including targeted screening for metabolic disturbances. Further longitudinal studies are needed to evaluate the long-term consequences of sex hormones imbalance on cardiovascular morbidity and mortality in adults with GM.
Collapse
Affiliation(s)
- Ralitsa Robeva
- USHATE “Acad. Iv. Penchev”, Department of Endocrinology, Faculty of Medicine, Medical University-Sofia, Sofia, Bulgaria
| | - Atanaska Elenkova
- USHATE “Acad. Iv. Penchev”, Department of Endocrinology, Faculty of Medicine, Medical University-Sofia, Sofia, Bulgaria
| | - Sabina Zacharieva
- USHATE “Acad. Iv. Penchev”, Department of Endocrinology, Faculty of Medicine, Medical University-Sofia, Sofia, Bulgaria
| |
Collapse
|
28
|
Shigehara K, Konaka H, Nohara T, Izumi K, Kitagawa Y, Kadono Y, Iwamoto T, Koh E, Mizokami A, Namiki M. Effects of testosterone replacement therapy on metabolic syndrome among Japanese hypogonadal men: A subanalysis of a prospective randomised controlled trial (EARTH study). Andrologia 2017; 50. [PMID: 28497534 DOI: 10.1111/and.12815] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2017] [Indexed: 11/27/2022] Open
Abstract
We investigated the effects of testosterone replacement therapy (TRT) on metabolic factors among hypogonadal men with a metabolic syndrome. From the study population of the EARTH study, which was a randomised controlled study in Japan, 65 hypogonadal patients with a metabolic syndrome, comprising the TRT group (n = 32) and controls (n = 33), were included in this study analysis. The TRT group was administered 250 mg of testosterone enanthate as an intramuscular injection every 4 weeks for 12 months. Waist circumference, body mass index, body fat volume and blood pressure were measured in all patients at baseline and at 12 months. In addition, blood biochemical data, including total cholesterol, triglyceride (TG), HDL cholesterol, fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) levels, were also evaluated. Changes in these categories from baseline to 12 months were compared between the TRT and control groups, with significant differences observed in waist circumference, body fat percentage, FPG, TG and HbA1c levels. No significant differences were observed in other parameters. TRT for 1 year was associated with improvements in some metabolic factors among Japanese men with hypogonadism and metabolic syndrome.
Collapse
Affiliation(s)
- K Shigehara
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan
| | - H Konaka
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan
| | - T Nohara
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan
| | - K Izumi
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan
| | - Y Kitagawa
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan
| | - Y Kadono
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan
| | - T Iwamoto
- Division of Male Infertility, Center for Infertility and IVF, International University of Health and Welfare, Nasushiobara, Tochigi, Japan
| | - E Koh
- Komagane Urological Clinic, Komagane, Nagano, Japan
| | - A Mizokami
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan
| | - M Namiki
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan.,Department of Urology, Hasegawa Hospital, Toyama, Japan
| |
Collapse
|
29
|
Li X, Meng Z, Tan J, Liu M, Jia Q, Zhang G, He Y, Zhang Q, Liu L, Song K, He Q, Zhu M, Wang S, Zhang J, Zheng W, Wang R, Hu T, Liu N, Upadhyaya A. Gender impact on the correlation between thyroid function and serum lipids in patients with differentiated thyroid cancer. Exp Ther Med 2016; 12:2873-2880. [PMID: 27882089 PMCID: PMC5103717 DOI: 10.3892/etm.2016.3701] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 09/01/2016] [Indexed: 12/21/2022] Open
Abstract
The present study aimed to explore the association between thyroid stimulating hormone (TSH) and serum lipids in patients with differentiated thyroid cancer (DTC), with a focus on the risk of hyperlipidemia between different genders. The study included 352 DTC patients who were ready to receive I-131 therapy as well as 352 matched normal controls. In the DTC group, 157 patients were monitored for TSH and lipid parameters prior to and after 1 month of thyroxine therapy. Results were analyzed using t-tests, Pearson bivariate correlation and binary logistic regression analyses. All participants were divided into 3 subgroups according to TSH levels: Subgroup 1 (normal TSH level), subgroup 2 (TSH between 5 and 30 µIU/ml), and subgroup 3 (TSH >30 µIU/ml). Serum total cholesterol (TC), triglycerides (TG), and low-density lipoprotein-cholesterol (LDL-C) levels were significantly higher in the DTC group than in the control group. The levels of these parameters decreased after thyroxine therapy and significant positive correlations were observed between TSH and TC, and TG and LDL-C in both genders. Binary logistic regression demonstrated that female DTC patients had higher risks of developing hyperlipidemia than male patients, and these risks increased when TSH increased. For example, the odds ratios (ORs) of high TC in subgroup 2 were 3.30 in males and 4.60 in females, respectively. However, in subgroup 3, the ORs were 9.40 in males and 13.12 in females, respectively. The results of the present study showed that after thyroidectomy, the risk of dyslipidemia markedly increased in DTC patients. More importantly, female patients had a higher risk than male patients.
Collapse
Affiliation(s)
- Xue Li
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Zhaowei Meng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Jian Tan
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Ming Liu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China; Division of Metabolism, Endocrinology and Diabetes, University of Michigan Medical Center, Ann Arbor, MI 48109, USA
| | - Qiang Jia
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Guizhi Zhang
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Yajing He
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Qing Zhang
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Li Liu
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Kun Song
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Qing He
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Mei Zhu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Shen Wang
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Jianping Zhang
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Wei Zheng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Renfei Wang
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Tianpeng Hu
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Na Liu
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Arun Upadhyaya
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| |
Collapse
|
30
|
|
31
|
|
32
|
Siahmansur TJ, Schofield JD, Azmi S, Liu Y, Durrington PN, Soran H. Unintended positive and negative effects of drugs on lipoproteins. Curr Opin Lipidol 2015; 26:325-37. [PMID: 26103613 DOI: 10.1097/mol.0000000000000198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Dyslipidaemia is an important cardiovascular disease risk factor. Many drugs affect lipid profile and lipoprotein metabolism. We reviewed unintended effects of nonlipid modifying, commonly used medications on lipid profile and lipoprotein metabolism. RECENT FINDING Several detrimental effects of many drug classes such as diuretics, antidepressant, anticonvulsant and antiretroviral drugs have been reported, whereas other drug classes such as antiobesity, alpha 1-blockers, oestrogens and thyroid replacement therapy were associated with positive effects. SUMMARY Dyslipidaemia is a common side-effect of many medications. This should be taken into consideration, especially in patients at high risk of cardiovascular disease. Other drugs demonstrated positive effects on circulating lipids and lipoproteins. The impact of these unintended effects on atherosclerotic disease risk and progression is unclear.
Collapse
Affiliation(s)
- Tarza J Siahmansur
- aCardiovascular Research Group, School of Medicine, Core Technology Facility (3rd Floor), University of Manchester bCardiovascular Trials Unit, Central Manchester and Manchester Children University Hospital NHS Foundation Trust, Manchester, UK
| | | | | | | | | | | |
Collapse
|
33
|
Thirumalai A, Rubinow KB, Page ST. An update on testosterone, HDL and cardiovascular risk in men. ACTA ACUST UNITED AC 2015; 10:251-258. [PMID: 26257830 DOI: 10.2217/clp.15.10] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Testosterone prescriptions have risen steadily and sharply in the USA despite a lack of clear understanding of the relationship between androgens and cardiovascular disease. In men with increasing age, testosterone levels decline and cardiovascular disease risk goes up. Ties between hypogonadism and cardiovascular disease are suggested by observational data, yet therapy with testosterone replacement has not been shown to mitigate that risk. To the contrary, recent literature has raised concern for increased cardiovascular disease in certain groups of men receiving testosterone therapy. In this article, we review current literature in an attempt to better understand what it suggests is the true relationship between testosterone and cardiovascular disease. We also take a closer look at effects of testosterone on lipids and HDL in particular, to see if this explains the cardiovascular effects seen in clinical studies.
Collapse
Affiliation(s)
- Arthi Thirumalai
- University of Washington, Division of Metabolism, Endocrinology & Nutrition, 1959 NE Pacific Street, Box 356426, Seattle, WA 98195, USA
| | - Katya B Rubinow
- University of Washington, Division of Metabolism, Endocrinology & Nutrition, South Lake Union Campus, 850 Republican Street, Box 358055, Seattle, WA 98109, USA
| | - Stephanie T Page
- University of Washington, Division of Metabolism, Endocrinology & Nutrition, 1959 NE Pacific Street, Box 357138, Seattle, WA 98195, USA
| |
Collapse
|
34
|
Cai Z, Xi H, Pan Y, Jiang X, Chen L, Cai Y, Zhu K, Chen C, Xu X, Chen M. Effect of testosterone deficiency on cholesterol metabolism in pigs fed a high-fat and high-cholesterol diet. Lipids Health Dis 2015; 14:18. [PMID: 25889601 PMCID: PMC4357180 DOI: 10.1186/s12944-015-0014-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 02/20/2015] [Indexed: 12/31/2022] Open
Abstract
Background Testosterone deficiency is associated with increased serum cholesterol levels. However, how testosterone deficiency precisely affects cholesterol metabolism remains unclear. Therefore, in the current study, we examined the effect of testosterone deficiency on cholesterol metabolism and liver gene expression in pigs fed a high-fat and high-cholesterol (HFC) diet. Methods Sexually mature male miniature pigs (6–7 months old) were randomly divided into 3 groups as follows: intact male pigs fed an HFC diet (IM + HFC), castrated male pigs fed an HFC diet (CM + HFC), and castrated pigs with testosterone replacement fed an HFC diet (CM + HFC + T). Serum testosterone levels and lipid profiles were measured, and gene expression levels associated with hepatic cholesterol metabolism were determined. Furthermore, total hepatic cholesterol contents and the activities of enzymes mediating hepatic cholesterol metabolism were measured. Results Serum testosterone levels were significantly decreased in CM + HFC pigs, and testosterone replacement attenuated castration-induced testosterone deficiency. Castration significantly increased the serum levels of total cholesterol, low-density lipoprotein cholesterol and triglycerides, as well as hepatic lipid contents in pigs fed an HFC diet. Compared with IM + HFC and CM + HFC + T pigs, low-density lipoprotein receptor (LDLR) mRNA expression and protein levels were significantly decreased in the livers of CM + HFC pigs. In contrast, we found that compared with IM + HFC pigs, hepatic proprotein convertase subtilisin/kexin type 9 (PCSK9) mRNA and serum PCSK9 protein levels were significantly increased in CM + HFC pigs. Moreover, testosterone treatment reversed the increase in PCSK9 expression in CM + HFC pigs. However, neither castration nor testosterone replacement affected the expression of the other hepatic genes that were tested. Conclusions This study demonstrated that castration-induced testosterone deficiency caused severe hypercholesterolemia in pigs fed an HFC diet; furthermore, these effects could be reversed by testosterone replacement therapy. Altered hepatic PCSK9 and LDLR expression, resulting in reduced LDL-cholesterol clearance, may contribute to the increased serum cholesterol levels induced by testosterone deficiency and an HFC diet. These results deepen our understanding of the underlying molecular mechanisms that mediate the effects of testosterone deficiency on cholesterol metabolism.
Collapse
Affiliation(s)
- Zhaowei Cai
- Laboratory Animal Research Center, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
| | - Haitao Xi
- Reproduction Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027, China.
| | - Yongming Pan
- Laboratory Animal Research Center, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
| | - Xiaoling Jiang
- College of Animal Science, Zhejiang University, Hangzhou, 310025, China.
| | - Liang Chen
- Laboratory Animal Research Center, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
| | - Yueqin Cai
- Laboratory Animal Research Center, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
| | - Keyan Zhu
- Laboratory Animal Research Center, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
| | - Cheng Chen
- Laboratory Animal Research Center, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
| | - Xiaoping Xu
- Laboratory Animal Research Center, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
| | - Minli Chen
- Laboratory Animal Research Center, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
| |
Collapse
|
35
|
Doğan BA, Karakılıç E, Tuna MM, Arduç A, Berker D, Güler S. Effect of androgen replacement therapy on atherosclerotic risk markers in young-to-middle-aged men with idiopathic hypogonadotropic hypogonadism. Clin Endocrinol (Oxf) 2015; 82:422-8. [PMID: 25280063 DOI: 10.1111/cen.12617] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 08/17/2014] [Accepted: 08/28/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Idiopathic hypogonadotropic hypogonadism is a rare disorder. This study evaluated the effect of androgen replacement therapy on atherosclerotic risk markers in young-to-middle-aged men with this disorder. DESIGN AND METHODS Forty-three male patients aged 30 (range: 24-39 years) who were newly diagnosed with idiopathic hypogonadotropic hypogonadism and 20 age-, sex- and weight-matched controls (range: 26-39 years) were included in the study. Androgen replacement therapy was given according to the Algorithm of Testosterone Therapy in Adult Men with Androgen Deficiency Syndromes (2010; Journal of Clinical Endocrinology and Metabolism, 95, 2536). The patients were assessed at a pretreatment visit and 3 and 6 months after the treatment. Inflammatory markers and lipid parameters were evaluated. Endothelial function was assessed with brachial flow-mediated dilation of a brachial artery and high-resolution ultrasonography of the carotid intima-media thickness. RESULTS The carotid intima-media thickness (P < 0·001) was higher and the brachial flow-mediated diameter (P = 0·002) was lower in patients with idiopathic hypogonadotropic hypogonadism compared to the control subjects at the pretreatment visit. There was a negative correlation between the total testosterone level and carotid intima-media thickness (r = -0·556, P = <0·001). The carotid intima-media thickness and per cent flow-mediated diameter were significantly improved in the patient group 6 months after the androgen replacement therapy (P = 0·002 and 0·026, respectively). CONCLUSIONS This study indicated that low total testosterone levels can be considered a significant marker of atherosclerosis in patients with idiopathic hypogonadotropic hypogonadism and that androgen replacement therapy significantly reduces atherosclerotic risk markers in these patients after 6 months.
Collapse
Affiliation(s)
- Berçem Ayçiçek Doğan
- Department of Endocrinology and Metabolism Disease, Darica Farabi State Hospital, Darica, Kocaeli, Turkey
| | | | | | | | | | | |
Collapse
|
36
|
The Role of Testosterone Therapy in Cardiovascular Mortality: Culprit or Innocent Bystander? Curr Atheroscler Rep 2015; 17:490. [DOI: 10.1007/s11883-015-0490-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
37
|
Chen Q, Fu Z, Wu X, Jin L, Li J, Wang Y, Li X. Association of serum androgen concentrations with cardiovascular risk factors in elderly male patients with chronic systolic heart failure in China. Aging Male 2014; 17:155-60. [PMID: 24805790 DOI: 10.3109/13685538.2014.896893] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To survey the serum androgen concentrations and investigate the relationship between androgen levels and cardiovascular risk factors in elderly male patients with chronic systolic heart failure (HF) in China. METHODS 106 consecutive male patients hospitalized for chronic systolic HF aged from 60 to 87 were enrolled. About 400 healthy age-matched men were compared as a control group. Total testosterone (TT), free testosterone (FT), dehydroepiandrosterone sulfate (DHEAS) and sex hormone binding globulin (SHBG) were measured. Differences of androgen levels between HF patients and healthy men were determined by t-test and associations of androgen with cardiovascular risk factors were evaluated by partial correlations analyses. RESULTS Compared with healthy men, TT, FT and DHEAS levels in patients with HF decreased, whereas SHBG level increased significantly (both p < 0.01). TT was negatively correlated with TC, TG and DBP (p < 0.05), FT was negatively correlated with TC, LDL-C and DBP (p < 0.05). SHBG correlated with BMI and smoking history positively (p < 0.05). CONCLUSIONS Level of bio-available testosterone decreased with advancing age, especially in men with HF. Men with low levels of bio-available testosterone had worse profiles of cardiovascular risk factors. Treatment of HF is still challenging and testosterone supplementation therapy may be an effective therapeutic option.
Collapse
|
38
|
Zhang N, Zhang H, Zhang X, Zhang B, Wang F, Wang C, Zhao M, Yu C, Gao L, Zhao J, Guan Q. The relationship between endogenous testosterone and lipid profile in middle-aged and elderly Chinese men. Eur J Endocrinol 2014; 170:487-94. [PMID: 24394726 DOI: 10.1530/eje-13-0802] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To evaluate the relationship between serum total testosterone (TT) level and lipid profile after adjusting for some traditional confounding factors, free thyroid hormones and TSH in Chinese men. METHODS This was a retrospective study based on an epidemiological investigation including 11 000 subjects. Bivariate and partial correlation analysis, multiple linear regression analysis, and a general linear model were used to assess the influence of TT on the lipid profile. Additionally, the odds ratios (ORs) (95% CIs) for hypertriglyceridemia and low HDL-C in relation to TT categories were calculated using logistic regression analysis. RESULTS A total of 4114 subjects whose mean age was 56.04±8.75 years were finally analyzed. There was a significant linear trend toward lower total cholesterol (TC), lower triglycerides (TG), and higher HDL-C with increasing serum TT, which remained significant after adjusting for age, BMI, fasting blood glucose, systolic blood pressure, free triiodothyronine, free thyroxine, and TSH. Compared with the bottom quartile of TT, the adjusted OR (95% CI) for hypertriglyceridemia and low HDL-C was 0.082 (0.048-0.138, P=0.000) and 0.669 (0.503-0.891, P=0.006) respectively in the top quartile of TT. CONCLUSIONS TT was correlated negatively and linearly with TC, TG, and LDL-C and positively and linearly with HDL-C. Low TT might have adverse effects on the lipid profile and thus represent a risk factor for hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C, suggesting the importance of maintaining an appropriate TT level in men.
Collapse
Affiliation(s)
- Nan Zhang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan 250021 Shandong, China
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Traish AM, Haider A, Doros G, Saad F. Long-term testosterone therapy in hypogonadal men ameliorates elements of the metabolic syndrome: an observational, long-term registry study. Int J Clin Pract 2014; 68:314-29. [PMID: 24127736 PMCID: PMC4282282 DOI: 10.1111/ijcp.12319] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
AIM The goal of this study was to determine if long-term testosterone (T) therapy in men with hypogonadism, henceforth referred to as testosterone deficiency (TD), ameliorates or improves metabolic syndrome (MetS) components. METHODS We performed a cumulative registry study of 255 men, aged between 33 and 69 years (mean 58.02 ± 6.30) with subnormal plasma total T levels (mean: 9.93 ± 1.38; range: 5.89-12.13 nmol/l) as well as at least mild symptoms of TD assessed by the Aging Males' symptoms scale. All men received treatment with parenteral T undecanoate 1000 mg (Nebido(®) , Bayer Pharma, Berlin, Germany), administered at baseline and 6 weeks and thereafter every 12 weeks for up to 60 months. Lipids, glucose, liver enzymes and haemoglobin A1c analyses were carried out in a commercial laboratory. Anthropometric measurements were also made throughout the study period. RESULTS Testosterone therapy restored physiological T levels and resulted in reductions in total cholesterol (TC) [7.29 ± 1.03 to 4.87 ± 0.29 mmol/l (281.58 ± 39.8 to 188.12 ± 11.31 mg/dl)], low-density lipoprotein cholesterol [4.24 ± 1.07 to 2.84 ± 0.92 mmol/l (163.79 ± 41.44 to 109.84 ± 35.41 mg/dl)], triglycerides [3.14 ± 0.58 to 2.16 ± 0.13 mmol/l (276.16 ± 51.32 to 189.78 ± 11.33 mg/dl)] and increased high-density lipoprotein levels [1.45 ± 0.46 to 1.52 ± 0.45 mmol/l (56.17 ± 17.79 to 58.85 ± 17.51 mg/dl)] (p < 0.0001 for all). There were marked reductions in systolic and diastolic blood pressure, blood glucose, haemoglobin A1c , C-reactive protein (6.29 ± 7.96 to 1.03 ± 1.87 U/l), alanine aminotransferase and aspartate aminotransferase (p < 0.0001 for all). CONCLUSIONS Long-term T therapy, at physiological levels, ameliorates MetS components. These findings strongly suggest that T therapy in hypogonadal men may prove useful in reducing the risk of cardiometabolic diseases.
Collapse
Affiliation(s)
- A M Traish
- Departments of Biochemistry and Urology, Boston University School of Medicine, Boston, MA, USA
| | | | | | | |
Collapse
|
40
|
Roberts CK, Chen BH, Pruthi S, Lee ML. Effects of varying doses of testosterone on atherogenic markers in healthy younger and older men. Am J Physiol Regul Integr Comp Physiol 2014; 306:R118-23. [DOI: 10.1152/ajpregu.00372.2013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Whether exogenous testosterone is proatherogenic remains controversial. We assessed the effects of graded doses of testosterone on serum markers of oxidative stress, chemotaxis, adhesion, and inflammation in healthy younger and older men. In a double-blind, randomized trial, 121 eugonadal men ( n = 61, 18–35 years of age and n = 60, 60–75 years of age) were randomized to one of five groups to receive weekly injections of 25, 50, 125, 300, or 600 mg of testosterone enanthate for 20 wk, respectively, along with a long-acting gonadotropin-releasing hormone (GnRH) agonist. Energy and protein intakes were standardized and no resistance training was allowed. We measured plasma levels of the atherogenic biomarkers monocyte chemotactic protein-1 (MCP-1), soluble intracellular adhesion molecule-1 (sICAM-1), 8-isoprostane-PGF2α (8-iso-PGF2α), and high-sensitivity C-reactive protein (hs-CRP) before and after the intervention. Administration of increasing doses of testosterone led to reduction in total 8-iso-PGF2α in the younger (p-trendYounger = 0.01), but not older (p-trendOlder = 0.79) men. No significant linear associations were observed between testosterone dose and MCP-1, sICAM-1, or hs-CRP (all p-trend >0.20). In apparently healthy men, over a wide dose range, testosterone did not adversely affect atherogenic biomarkers. Long-term studies with larger sample sizes are warranted to determine whether testosterone supplementation affects atherosclerosis progression and cardiovascular risk.
Collapse
Affiliation(s)
- Christian K. Roberts
- Exercise and Metabolic Disease Research Laboratory, Translational Sciences Section, School of Nursing, University of California, Los Angeles, California; and
| | - Brian H. Chen
- Exercise and Metabolic Disease Research Laboratory, Translational Sciences Section, School of Nursing, University of California, Los Angeles, California; and
| | - Sandeep Pruthi
- Exercise and Metabolic Disease Research Laboratory, Translational Sciences Section, School of Nursing, University of California, Los Angeles, California; and
| | - Martin L. Lee
- Department of Biostatistics, School of Public Health, University of California, Los Angeles, California
| |
Collapse
|
41
|
Abstract
Obesity, type 2 diabetes mellitus and the metabolic syndrome are major risk factors for cardiovascular disease. Studies have demonstrated an association between low levels of testosterone and the above insulin-resistant states, with a prevalence of hypogonadism of up to 50% in men with type 2 diabetes mellitus. Low levels of testosterone are also associated with an increased risk of all-cause and cardiovascular mortality. Hypogonadism and obesity share a bidirectional relationship as a result of the complex interplay between adipocytokines, proinflammatory cytokines and hypothalamic hormones that control the pituitary-testicular axis. Interventional studies have shown beneficial effects of testosterone on components of the metabolic syndrome, type 2 diabetes mellitus and other cardiovascular risk factors, including insulin resistance and high levels of cholesterol. Biochemical evidence indicates that testosterone is involved in promoting glucose utilization by stimulating glucose uptake, glycolysis and mitochondrial oxidative phosphorylation. Testosterone is also involved in lipid homeostasis in major insulin-responsive target tissues, such as liver, adipose tissue and skeletal muscle.
Collapse
Affiliation(s)
- Preethi M Rao
- Academic Unit of Diabetes, Endocrinology and Metabolism, School of Medicine and Biomedical Sciences, University of Sheffield, UK
| | | | | |
Collapse
|
42
|
Abstract
PURPOSE OF REVIEW To review recent data concerning the relationship between endogenous testosterone and lipids as well as testosterone replacement therapy and lipids. To describe the effects of sex hormones on cardiovascular disease (CVD) that may act via serum lipids. RECENT FINDINGS Low endogenous testosterone is associated with high low-density lipoprotein and low high-density lipoprotein in both cross-sectional and prospective observational studies. Exogenous testosterone administration is associated with decreased high-density lipoprotein coupled with beneficial decreases in low-density lipoprotein and total cholesterol. The overall impact of testosterone administration on CVD is still unclear, with mixed safety results from recent randomized controlled trials. SUMMARY There may be CVD risk reduction benefits, including an improved lipid profile, from testosterone administration in hypogonadal men. The overall effect of testosterone on CVD risk has not been definitively determined.
Collapse
Affiliation(s)
- Anne K Monroe
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Maryland, USA
| | | |
Collapse
|
43
|
Vodo S, Bechi N, Petroni A, Muscoli C, Aloisi AM. Testosterone-induced effects on lipids and inflammation. Mediators Inflamm 2013; 2013:183041. [PMID: 23606790 PMCID: PMC3628213 DOI: 10.1155/2013/183041] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 03/08/2013] [Indexed: 12/14/2022] Open
Abstract
Chronic pain has to be considered in all respects a debilitating disease and 10-20% of the world's adult population is affected by this disease. In the most general terms, pain is symptomatic of some form of dysfunction and (often) the resulting inflammatory processes in the body. In the study of pain, great attention has been paid to the possible involvement of gonadal hormones, especially in recent years. In particular, testosterone, the main androgen, is thought to play a beneficial, protective role in the body. Other important elements to be related to pain, inflammation, and hormones are lipids, heterogenic molecules whose altered metabolism is often accompanied by the release of interleukins, and lipid-derived proinflammatory mediators. Here we report data on interactions often not considered in chronic pain mechanisms.
Collapse
Affiliation(s)
- Stella Vodo
- Department of Medicine, Surgery and Neuroscience, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy
| | - Nicoletta Bechi
- Department of Medicine, Surgery and Neuroscience, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy
| | - Anna Petroni
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy
| | - Carolina Muscoli
- Department of Health Science, University of “Magna Graecia” Catanzaro and Drug Center, IRCCS San Raffaele Pisana, Via di Val Cannuta 247, 00163 Roma, Italy
| | - Anna Maria Aloisi
- Department of Medicine, Surgery and Neuroscience, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy
| |
Collapse
|
44
|
Nagarajan P, Arindkar S, Singh S, Majumdar SS. Effect of long-term castration on serum biochemistry in rhesus monkeys. J Med Primatol 2013; 42:132-6. [PMID: 23551040 DOI: 10.1111/jmp.12046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Testicular failure has an effect on normal physiology. To address this issue, an experimental non-human primate model of long-term castrated rhesus monkey was chosen for this study to evaluate the influence of castration on various biochemical parameters. METHODS Nine castrated rhesus monkeys were evaluated for changes in body weight, serum testosterone, and serum biochemical parameters as compared to those in non-castrated macaques. RESULTS Castration caused statistically significant changes in body weight, biochemical analytes, and testosterone levels. Body weight and testosterone levels were decreased, and there were increase in alanine aminotransferase, cholesterol, serum bilirubin, phosphorous, alkaline phosphatase, urea and a decrease in serum protein, uric acid, creatinine, and triglycerides. CONCLUSIONS This study provided essential baseline information on biochemical variables due to the effect of castration associated with declining levels of testosterone, as data are not readily accessible from the existing body of scientific literature on non-human primates.
Collapse
Affiliation(s)
- P Nagarajan
- Primate Research Center, National Institute of Immunology, New Delhi, India
| | | | | | | |
Collapse
|
45
|
Occurrence of erectile dysfunction, testosterone deficiency syndrome and metabolic syndrome in patients with abdominal obesity. Where is a sufficient level of testosterone? Int Urol Nephrol 2012; 44:1113-20. [PMID: 22315154 DOI: 10.1007/s11255-012-0132-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Accepted: 01/19/2012] [Indexed: 02/07/2023]
Abstract
AIM The aim of this study was to determine the prevalence of erectile dysfunction (ED), testosterone deficiency syndrome (TDS), and metabolic syndrome in patients with abdominal obesity (AO) and the prevalence of morbidity at different levels of testosterone (TST). BACKGROUND Male sex hormones play an important role in ED and variety of TDS and may have influence on the development of metabolic syndrome. The number of men with AO which constitutes a serious health risk is continuously growing. Currently, there are different views that TST levels are already insufficient, and the patient should benefit from treatment. OBJECTIVES This study examined the association between ED, testosterone level and metabolic syndrome in men with AO. DESIGN, SETTING, AND PARTICIPANTS The study was carried out in an outpatient urology center of Urology Clinic and Obesity Center of the Clinic of Internal Medicine. There were 167 participants—men with AO which were examined as part of preventive examination. METHODS Hormonal, a complete urological and internal evaluation was carried out in every patient. RESULTS AND LIMITATIONS We found some degree of ED in 73% (122/167) in men with AO. The TST levels below 14 nmol/l had of these 122 patients 84 patients (68.9%) and 49 patients (40.2%) below 10 nmol/l. In this group of patients, we found 103/167 patients (61.7%) with metabolic syndrome. When we compared TST level and morbidity, we found significantly more patients with diabetes mellitus (DM), hypertension and dyslipidemia in group with TST below 10 nmol/l. We also found difference in the levels of HDL cholesterol and triglycerides in the group of patients with TST 10–14 and over 14 nmol/l. CONCLUSION Patients over 40 years of age with AO and ED should also be examined for TDS and metabolic syndrome. In this group of patients we found that 113/167 patients (67.6%) had total TST below 14 nmol/l, and sufficient level of TST seems to be above this level.
Collapse
|
46
|
Endogenous androgen deficiency enhances diet-induced hypercholesterolemia and atherosclerosis in low-density lipoprotein receptor-deficient mice. ACTA ACUST UNITED AC 2012; 9:319-28. [PMID: 22981166 DOI: 10.1016/j.genm.2012.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 08/07/2012] [Accepted: 08/22/2012] [Indexed: 01/14/2023]
Abstract
BACKGROUND Despite numerous clinical and animal studies, the role of sex steroid hormones on lipoprotein metabolism and atherosclerosis remain controversial. OBJECTIVE We sought to determine the effects of endogenous estrogen and testosterone on lipoprotein levels and atherosclerosis using mice fed a low-fat diet with no added cholesterol. METHODS Male and female low-density lipoprotein receptor-deficient mice were fed an open stock low-fat diet (10% of kcals from fat) for 2, 4, or 17 weeks. Ovariectomy, orchidectomy, or sham surgeries were performed to evaluate the effects of the presence or absence of endogenous hormones on lipid levels, lipoprotein distribution, and atherosclerosis development. RESULTS Female mice fed the study diet for 17 weeks had a marked increase in levels of total cholesterol, triglycerides, apolipoprotein-B containing lipoproteins, and atherosclerosis compared with male mice. Surprisingly, ovariectomy in female mice had no effect on any of these parameters. In contrast, castration of male mice markedly increased total cholesterol concentrations, triglycerides, apolipoprotein B-containing lipoproteins, and atherosclerotic lesion formation compared with male and female mice. CONCLUSIONS These data suggest that endogenous androgens protect against diet-induced increases in cholesterol concentrations, formation of proatherogenic lipoproteins, and atherosclerotic lesions formation. Conversely orchidectomy, which decreases androgen concentrations, promotes increases in cholesterol concentrations, proatherogenic lipoprotein formation, and atherosclerotic lesion formation in low-density lipoprotein receptor-deficient mice in response to a low-fat diet.
Collapse
|
47
|
Schwarz ER, Phan A, Willix RD. Andropause and the development of cardiovascular disease presentation-more than an epi-phenomenon. J Geriatr Cardiol 2012; 8:35-43. [PMID: 22783283 PMCID: PMC3390065 DOI: 10.3724/sp.j.1263.2011.00035] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Revised: 03/14/2011] [Accepted: 03/21/2011] [Indexed: 01/11/2023] Open
Abstract
Andropause refers to a generalized decline of male hormones, including testosterone and dehydroepiandrosterone in middle-aged and aging men. This decline in hormones has been associated with changes such as depression, loss of libido, sexual dysfunction, and changes in body composition. Aging has been associated with an abundance of concomitant diseases, in particular cardiovascular diseases, and although andropause is correlated to aging, a causal relationship between reduction of androgens and the development of chronic diseases such as atherosclerosis and heart failure has not been convincingly established yet. On the other hand, increasing data has emerged that revealed the effects of low levels of androgens on cardiovascular disease progression. As an example, low levels of testosterone have been linked to a higher incidence of coronary artery disease. Whether hormone replacement therapy that is used for andropausal men to alleviate symptoms of "male menopause" can halt progression of cardiovascular disease, remains controversially discussed, primarily due to the lack of well-designed, randomized controlled trials. At least for symptom improvement, the use of androgen replacement therapy in andropausal men may be clinically indicated, and with the appropriate supervision and follow up may prove to be beneficial with regard to preservation of the integrity of cardiovascular health at higher ages.
Collapse
Affiliation(s)
- Ernst R Schwarz
- Cedars Sinai Heart Institute, Cedars Sinai Medical Center, 8700 Beverly Boulevard, Suite 6215, Los Angeles, CA 90048, USA; Cenegenics Medical Institute, 851 Rampart Blvd., Las Vegas, NV 89145, USA
| | | | | |
Collapse
|
48
|
Seisen T, Rouprêt M, Gallais JL, Costa P. Critères cliniques et biologiques pertinents pour poser un diagnostic de déficit androgénique lié à l'âge (DALA). Prog Urol 2012; 22 Suppl 1:S21-6. [DOI: 10.1016/s1166-7087(12)70031-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
49
|
Firtser S, Juonala M, Magnussen CG, Jula A, Loo BM, Marniemi J, Viikari JS, Toppari J, Perheentupa A, Hutri-Kähönen N, Raitakari OT. Relation of total and free testosterone and sex hormone-binding globulin with cardiovascular risk factors in men aged 24–45 years. The Cardiovascular Risk in Young Finns Study. Atherosclerosis 2012; 222:257-62. [DOI: 10.1016/j.atherosclerosis.2012.02.020] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Revised: 02/08/2012] [Accepted: 02/13/2012] [Indexed: 10/28/2022]
|
50
|
Miner MM. Men's health in primary care: an emerging paradigm of sexual function and cardiometabolic risk. Urol Clin North Am 2012; 39:1-23. [PMID: 22118341 DOI: 10.1016/j.ucl.2011.09.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
An office evaluation of men's health in primary care requires a thorough understanding of the implications of male sexual dysfunctions, hypogonadism, and cardiometabolic risk stratification and aggressive risk management. The paradigm of the men's health office visit in primary care is the recognition and assessment of male sexual dysfunction, specifically erectile dysfunction, and its value as a signal of overall cardiometabolic health, including the emerging evidence linking low testosterone and the metabolic syndrome. Indeed, erectile dysfunction may now be thought of as a harbinger of cardiovascular clinical events and other systemic vascular diseases in some men.
Collapse
Affiliation(s)
- Martin M Miner
- Department of Family Medicine and Urology, The Men's Health Center, The Miriam Hospital, The Warren Alpert School of Medicine, Brown University, Providence, RI 02906, USA.
| |
Collapse
|