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Zhou S, Alerasool P, Kishi N, Joshi H, Sahni G, Tsao CK. Cardiovascular Toxicity Associated With Androgen Receptor Axis-Targeted Agents in Patients With Prostate Cancer: A Meta-analysis of Randomized Controlled Trials. Clin Genitourin Cancer 2024; 22:102066. [PMID: 38584004 DOI: 10.1016/j.clgc.2024.102066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/16/2024] [Accepted: 02/12/2024] [Indexed: 04/09/2024]
Abstract
INTRODUCTION Second-generation androgen receptor axis-targeting (ARAT) agents have become a standard treatment for patients with advanced prostate cancer (PC), however much remains unknown about the potential cardiovascular toxicities. PATIENTS AND METHODS We performed a systematic search of PubMed, Embase, Web of Science, and Cochrane library for randomized controlled trials of patients receiving ARAT agents for PC from inception to March 2023. The odds ratios (ORs) of all-grade and high-grade cardiovascular adverse events (CVAEs) for patients treated with and without ARAT agents were pooled for meta-analysis. Subgroup analyses based on PC type and treatment regimen were conducted. RESULTS A total of 15 double-blind placebo-controlled phase 3 trials comprising 15,842 patients were included. In addition to hot flush and hypertension of any degree of severity, inclusion of ARAT agents was associated with a significantly higher risk of acute myocardial infarction (OR: 1.96, 95% CI: 1.05-3.68, P = .04), myocardial infarction (OR: 2.44, 95% CI: 1.27-4.66, P = .007) and angina pectoris (OR: 2.00, 95% CI: 1.00-4.02, P = .05). With regard to individual ARAT agents, enzalutamide was associated with a significantly higher risk of acute myocardial infarction (OR: 3.11, 95% CI: 1.17-8.28, P = .02), coronary artery disease (OR: 8.33, 95% CI: 1.54-44.95, P = .01), and high-grade hypertension (OR: 4.94, 95% CI: 1.11-22.06, P = .04), while abiraterone and apalutamide were associated with a significantly higher risk of angina pectoris (OR: 5.48, 95% CI: 1.23-24.33, P = .03) and myocardial infarction (OR: 7.00, 95% CI: 1.60-30.62, P = .01), respectively. CONCLUSION The inclusion of ARAT agents was associated with a significantly higher risk of several CVAEs. Clinicians should remain vigilant, both in pre-treatment screening and monitoring for clinical symptoms and signs, when considering ARAT agent particularly for patients with pre-existing risk factors.
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Affiliation(s)
- Susu Zhou
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY.
| | - Parissa Alerasool
- Division of Hematology/Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY; New York Medical College, Valhalla, NY
| | - Noriko Kishi
- Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Himanshu Joshi
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Gagan Sahni
- Mount Sinai Cardiovascular Institute, New York, NY
| | - Che-Kai Tsao
- Division of Hematology/Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY
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Edo GI, Samuel PO, Nwachukwu SC, Ikpekoro VO, Promise O, Oghenegueke O, Ongulu J, Otunuya CF, Rapheal OA, Ajokpaoghene MO, Okolie MC, Ajakaye RS. A review on the biological and bioactive components of Cyperus esculentus L.: insight on food, health and nutrition. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2024. [PMID: 38769860 DOI: 10.1002/jsfa.13570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 04/02/2024] [Accepted: 04/29/2024] [Indexed: 05/22/2024]
Abstract
Tiger nut (Cyperus esculentus L.) is a small, tuberous root vegetable that has gained increasing attention in recent years due to its potential health benefits. This review article provides an elaborate overview of tiger nut, including its botany, historical uses, nutritional composition, potential health benefits and traditional medicinal uses. This review article comprehensively discusses the nutritional profile of tiger nut, providing a detailed understanding of its nutrient content. Furthermore, the potential health benefits of tiger nut are thoroughly reviewed, including its effects on digestive health, cardiovascular health, blood sugar control, immune function and other potential therapeutic uses. Scientific articles used for this review were retrieved from ScienceDirect, Google Scholar, PubMed and SciELO databases. Only articles published between 1997 and 2022 were used for research. This review contributes to a better understanding of tiger nut and its prospective uses in functional foods and medicine by combining the available scientific material. © 2024 Society of Chemical Industry.
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Affiliation(s)
- Great Iruoghene Edo
- Faculty of Science, Department of Chemistry, Delta State University of Science and Technology, Ozoro, Nigeria
- Faculty of Science, Department of Petroleum Chemistry, Delta State University of Science and Technology, Ozoro, Nigeria
| | - Princess Oghenekeno Samuel
- Faculty of Science, Department of Petroleum Chemistry, Delta State University of Science and Technology, Ozoro, Nigeria
| | - Susan Chinedu Nwachukwu
- Faculty of Science, Department of Food Science and Technology, Delta State University of Science and Technology, Ozoro, Nigeria
| | - Victor Ovie Ikpekoro
- Faculty of Science, Department of Petroleum Chemistry, Delta State University of Science and Technology, Ozoro, Nigeria
| | - Obasohan Promise
- Faculty of Science, Department of Petroleum Chemistry, Delta State University of Science and Technology, Ozoro, Nigeria
| | - Ogheneochuko Oghenegueke
- Faculty of Science, Department of Food Science and Technology, Delta State University of Science and Technology, Ozoro, Nigeria
| | - Jonathan Ongulu
- Faculty of Science, Department of Petroleum Chemistry, Delta State University of Science and Technology, Ozoro, Nigeria
| | - Chinenye Favour Otunuya
- Faculty of Science, Department of Petroleum Chemistry, Delta State University of Science and Technology, Ozoro, Nigeria
| | - Opiti Ajiri Rapheal
- Faculty of Science, Department of Petroleum Chemistry, Delta State University of Science and Technology, Ozoro, Nigeria
| | - Mercy Orezimena Ajokpaoghene
- Faculty of Science, Department of Food Science and Technology, Delta State University of Science and Technology, Ozoro, Nigeria
| | - Michael Chukwuma Okolie
- Faculty of Science, Department of Food Science and Technology, Delta State University of Science and Technology, Ozoro, Nigeria
| | - Ruth Sheyi Ajakaye
- Faculty of Science, Department of Petroleum Chemistry, Delta State University of Science and Technology, Ozoro, Nigeria
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3
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Muehlenbein M, Gassen J, Nowak T, Henderson A, Morris B, Weaver S, Baker E. Age-Dependent Relationships Between Disease Risk and Testosterone Levels: Relevance to COVID-19 Disease. Am J Mens Health 2023; 17:15579883221130195. [PMID: 36935555 PMCID: PMC10028446 DOI: 10.1177/15579883221130195] [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: 03/21/2023] Open
Abstract
Testosterone levels in men appear to be prognostic of a number of disease outcomes, including severe COVID-19 disease. Testosterone levels naturally decline with age and are lower in individuals with a number of comorbidities and chronic conditions. Low testosterone may therefore be both a cause and a consequence of illness, including COVID-19 disease. The present project examines whether preexisting conditions for severe COVID-19 disease were themselves related to serum-free testosterone levels in men who had not been infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. A clinical risk score for severe COVID-19 disease was computed based on the results of previously published meta-analyses and cohort studies, and relationships between this score and testosterone levels were tested in 142 men ages 19 to 82 years. Greater burden of preexisting conditions for severe COVID-19 disease was related to lower testosterone levels among men younger than 40 years of age. In older men, the decrease in testosterone that accompanies aging attenuated the effect of the clinical risk score on free testosterone levels. Given that older age itself is a predictor of COVID-19 disease severity, these results together suggest that the presence of preexisting conditions may confound the relationship between testosterone levels and COVID-19 disease outcomes in men. Future research examining relationships among testosterone and outcomes related to infectious and chronic diseases should consider potential confounds, such as the role of preexisting conditions.
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4
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Testosterone deficiency in male organ transplant recipients. Int J Impot Res 2022; 34:679-684. [PMID: 35013565 DOI: 10.1038/s41443-021-00513-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 11/13/2021] [Accepted: 11/26/2021] [Indexed: 11/09/2022]
Abstract
Testosterone deficiency is known to affect men with increasing incidence throughout their lifespan. The clinical manifestations of testosterone deficiency, in turn, negatively impact men's quality of life and perception of overall health. The interaction of chronic systemic disease and androgen deficiency represent an area for potential intervention. Here, we explore the topic of testosterone deficiency amongst men with end-stage organ failure requiring transplantation in order to elucidate the underlying pathophysiology of androgen deficiency of chronic disease and discuss whether intervention, including testosterone replacement and organ transplantation, improve patients' outcomes and quality of life.
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5
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Kean AC, Saroufim R, Meininger E, Fuqua JS, Fortenberry JD. Cardiovascular Health of Youth During Gender-Affirming Testosterone Treatment: A Review. J Adolesc Health 2021; 69:896-904. [PMID: 34627656 DOI: 10.1016/j.jadohealth.2021.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/21/2021] [Accepted: 08/05/2021] [Indexed: 01/13/2023]
Abstract
PURPOSE Many birth-assigned female/transgender male and nonbinary people (identified as masculine spectrum here) begin gender-affirming testosterone therapy by the age of 24 years. Few data inform assessment of cardiovascular health of masculine spectrum youth as a specific subgroup of the 1.5 million transgender people in the United States. The purpose of this review is to help youth-serving practitioners consider, understand, and evaluate cardiovascular health in adolescent and young adult masculine spectrum patients receiving gender-affirming testosterone treatment. METHODS This is a narrative review intended to synthesize a broad body of clinical and research literature. RESULTS Common cardiovascular health changes associated with testosterone include increased red blood cell mass and likely insignificant changes in high-density lipoprotein and low-density lipoprotein levels. Changes in heart mass, heart electrophysiology, and endothelial reactivity are likely, based on extrapolation of data from adults. Testosterone may have indirect effects on cardiovascular health through influences on depression, anxiety, stress, and anorexia nervosa as well as on behaviors such as tobacco use. CONCLUSIONS Testosterone contributes importantly to the cardiovascular health and well-being of masculine spectrum gender-diverse youth. We need to do a better job of supporting these young people with data on cardiovascular health over the life span.
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Affiliation(s)
- Adam C Kean
- Division of Pediatric Cardiology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Rita Saroufim
- Division of Pediatric Endocrinology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Eric Meininger
- Division of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - John S Fuqua
- Division of Pediatric Endocrinology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - J Dennis Fortenberry
- Division of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana.
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6
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Schroeder M, Schaumburg B, Mueller Z, Parplys A, Jarczak D, Roedl K, Nierhaus A, de Heer G, Grensemann J, Schneider B, Stoll F, Bai T, Jacobsen H, Zickler M, Stanelle-Bertram S, Klaetschke K, Renné T, Meinhardt A, Aberle J, Hiller J, Peine S, Kreienbrock L, Klingel K, Kluge S, Gabriel G. High estradiol and low testosterone levels are associated with critical illness in male but not in female COVID-19 patients: a retrospective cohort study. Emerg Microbes Infect 2021; 10:1807-1818. [PMID: 34402750 PMCID: PMC8451658 DOI: 10.1080/22221751.2021.1969869] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/10/2021] [Accepted: 08/15/2021] [Indexed: 11/03/2022]
Abstract
Male sex was repeatedly identified as a risk factor for death and intensive care admission. However, it is yet unclear whether sex hormones are associated with disease severity in COVID-19 patients. In this study, we analysed sex hormone levels (estradiol and testosterone) of male and female COVID-19 patients (n = 50) admitted to an intensive care unit (ICU) in comparison to control non-COVID-19 patients at the ICU (n = 42), non-COVID-19 patients with the most prevalent comorbidity (coronary heart diseases) present within the COVID-19 cohort (n = 39) and healthy individuals (n = 50). We detected significantly elevated estradiol levels in critically ill male COVID-19 patients compared to all control cohorts. Testosterone levels were significantly reduced in critically ill male COVID-19 patients compared to control cohorts. No statistically significant differences in sex hormone levels were detected in critically ill female COVID-19 patients, albeit similar trends towards elevated estradiol levels were observed. Linear regression analysis revealed that among a broad range of cytokines and chemokines analysed, IFN-γ levels are positively associated with estradiol levels in male and female COVID-19 patients. Furthermore, male COVID-19 patients with elevated estradiol levels were more likely to receive ECMO treatment. Thus, we herein identified that disturbance of sex hormone metabolism might present a hallmark in critically ill male COVID-19 patients.
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Affiliation(s)
- Maria Schroeder
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Berfin Schaumburg
- Department for Viral Zoonoses-One Health, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | - Zacharias Mueller
- Department for Viral Zoonoses-One Health, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | - Ann Parplys
- Department for Viral Zoonoses-One Health, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | - Dominik Jarczak
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kevin Roedl
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Axel Nierhaus
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Geraldine de Heer
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Joern Grensemann
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bettina Schneider
- Department of Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Fabian Stoll
- Department for Viral Zoonoses-One Health, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | - Tian Bai
- Department for Viral Zoonoses-One Health, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | - Henning Jacobsen
- Department for Viral Zoonoses-One Health, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | - Martin Zickler
- Department for Viral Zoonoses-One Health, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | | | - Kristin Klaetschke
- Institute for Clinical and Laboratory Chemistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Renné
- Institute for Clinical and Laboratory Chemistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas Meinhardt
- Institute of Anatomy and Cell Biology, Justus-Liebig University of Giessen, Giessen, Germany
| | - Jens Aberle
- Department of Endocrinology, Diabetology, Obesity and Lipids, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens Hiller
- Institute for Transfusion Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sven Peine
- Institute for Transfusion Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lothar Kreienbrock
- Department of Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Karin Klingel
- Institute for Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany
| | - Stefan Kluge
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Guelsah Gabriel
- Department for Viral Zoonoses-One Health, Leibniz Institute for Experimental Virology, Hamburg, Germany
- Institute for Virology, University for Veterinary Medicine Hannover, Hannover, Germany
- German Center for Infection Research (DZIF), Braunschweig, Germany
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7
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The implications of hyperoxia, type 1 diabetes and sex on cardiovascular physiology in mice. Sci Rep 2021; 11:23086. [PMID: 34845324 PMCID: PMC8630164 DOI: 10.1038/s41598-021-02550-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 11/10/2021] [Indexed: 01/09/2023] Open
Abstract
Oxygen supplementation, although a cornerstone of emergency and cardiovascular medicine, often results in hyperoxia, a condition characterized by excessive tissue oxygen which results in adverse cardiac remodeling and subsequent injurious effects to physiological function. Cardiac remodeling is further influenced by various risk factors, including pre-existing conditions and sex. Thus, the purpose of this experiment was to investigate cardiac remodeling in Type I Diabetic (Akita) mice subjected to hyperoxic treatment. Overall, we demonstrated that Akita mice experience distinct challenges from wild type (WT) mice. Specifically, Akita males at both normoxia and hyperoxia showed significant decreases in body and heart weights, prolonged PR, QRS, and QTc intervals, and reduced %EF and %FS at normoxia compared to WT controls. Moreover, Akita males largely resemble female mice (both WT and Akita) with regards to the parameters studied. Finally, statistical analysis revealed hyperoxia to have the greatest influence on cardiac pathophysiology, followed by sex, and finally genotype. Taken together, our data suggest that Type I diabetic patients may have distinct cardiac pathophysiology under hyperoxia compared to uncomplicated patients, with males being at high risk. These findings can be used to enhance provision of care in ICU patients with Type I diabetes as a comorbid condition.
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8
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Pang H, Li J, Wang Y, Su X, Gao Y, Li SJ. Mice lacking the proton channel Hv1 exhibit sex-specific differences in glucose homeostasis. J Biol Chem 2021; 297:101212. [PMID: 34547291 PMCID: PMC8503595 DOI: 10.1016/j.jbc.2021.101212] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/07/2021] [Accepted: 09/16/2021] [Indexed: 02/07/2023] Open
Abstract
Sex as a physiologic factor has a strong association with the features of metabolic syndrome. Our previous study showed that loss of the voltage-gated proton channel Hv1 inhibits insulin secretion and leads to hyperglycemia and glucose intolerance in male mice. However, there are significant differences in blood glucose between male and female Hv1-knockout (KO) mice. Here, we investigated the differences in glucose metabolism and insulin sensitivity between male and female KO mice and how sex steroids contribute to these differences. We found that the fasting blood glucose in female KO mice was visibly lower than that in male KO mice, which was accompanied by hypotestosteronemia. KO mice in both sexes exhibited higher expression of gluconeogenesis-related genes in liver compared with WT mice. Also, the livers from KO males displayed a decrease in glycolysis-related gene expression and an increase in gluconeogenesis-related gene expression compared with KO females. Furthermore, exogenous testosterone supplementation decreased blood glucose levels in male KO mice, as well as enhancing insulin signaling. Taken together, our data demonstrate that knockout of Hv1 results in higher blood glucose levels in male than female mice, despite a decreased insulin secretion in both sexes. This sex-related difference in glucose homeostasis is associated with the glucose metabolism in liver tissue, likely due to the physiological levels of testosterone in KO male mice.
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Affiliation(s)
- Huimin Pang
- Department of Biophysics, School of Physics Science, The Key Laboratory of Bioactive Materials, Ministry of Education, Nankai University, Tianjin, PR China
| | - Jinzhi Li
- Biology Laboratory, Tianjin High School, Tianjin, PR China
| | - Yuzhou Wang
- Laboratory Animal Center, College of Life Sciences, Nankai University, Tianjin, PR China
| | - Xiaomin Su
- Laboratory Animal Center, College of Life Sciences, Nankai University, Tianjin, PR China
| | - Yingtang Gao
- Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary Disease, Nankai University Affiliated Third Center Hospital, Tianjin, PR China.
| | - Shu Jie Li
- Department of Biophysics, School of Physics Science, The Key Laboratory of Bioactive Materials, Ministry of Education, Nankai University, Tianjin, PR China; Biomedical Research Center, Qilu Institute of Technology, Shandong, PR China.
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9
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Akseh S, Karimi MA, Safaie N, Valizadeh A, Rahmanpour D, Pezeshkian M, Nouri M, Faridvand Y, Jodati A. The serum levels of testosterone in coronary artery disease patients; relation to NO, eNOS, endothelin-1, and disease severity. Horm Mol Biol Clin Investig 2021; 43:55-61. [PMID: 34496169 DOI: 10.1515/hmbci-2021-0026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 08/20/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The changes in testosterone level and its correlation with the endothelial nitric oxide systems balance in patients with coronary artery disease (CAD) remains uncertain. Therefore, in our study, we aimed to evaluate the levels of testosterone, endothelin-1 (ET-1), nitric oxide (NO), and endothelial NOS (eNOS) in CAD patients, and control group to find the relationship between these parameters and disease severity. METHODS Forty-four patients as CAD group with significant (≥50%) stenosis confirmed by angiography was included in the study, and 40 healthy men were included as the control group. According to the number of vessels obstruction, CAD severity was determined. The serum indicated parameters were assessed to discriminate between patients and controls. RESULTS It was found that testosterone levels in the CDA group were significantly lower than those of the control group (p<0.05). In addition, the level of ET-1 in the CAD group was higher than that in the control group, but levels of NO and eNOS in observation were significantly lower than those in the control group (p<0.05). The correlation analysis revealed that testosterone was passivity correlated with serum NO levels (r=0.550, p=0.001). CONCLUSIONS The current study reports that serum levels of testosterone are closely related to endothelial NO levels and might be of relevance to the pathogenesis of endothelial dysfunction and disease severity in CAD patients.
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Affiliation(s)
- Saeideh Akseh
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad-Ali Karimi
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nasser Safaie
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Valizadeh
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Dara Rahmanpour
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoud Pezeshkian
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Nouri
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yousef Faridvand
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmadreza Jodati
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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10
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Rojas MM, Villalpando DM, Alexander-Aguilera A, Ferrer M, García HS. Effect of CLA supplementation on factors related to vascular dysfunction in arteries of orchidectomized rats. Prostaglandins Other Lipid Mediat 2021; 157:106586. [PMID: 34438054 DOI: 10.1016/j.prostaglandins.2021.106586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 01/22/2023]
Abstract
The vascular endothelium is a monolayer of flat epithelial cells located between the circulating blood and the underlying connective tissue. It conveys key functions that when impaired, lead to endothelial dysfunction. This condition is responsible for the pathogenesis of vascular diseases. The cardioprotective effect of sex hormones is widely known; hence, a murine orchidectomized model has been employed to study the effects caused by their deficiency. In the search for approaches to maintain vascular health, the effect of dietary fatty acids as CLA on cardiovascular diseases has been studied. Some proven beneficial properties of CLA are antioxidant, antiatherogenic and anti-inflammatory. Our objective was to evaluate the effect of a diet supplemented with 1.8 % (w/w) of CLA, administered during eight weeks, on the amount of cholesterol oxidation products (COPs) produced by orchidectomy and on factors related to vascular dysfunction in the aorta and the mesenteric arteries. The diet with CLA prevented the increase in prostanoids formation and maintained the normal physiological conditions of NO and antioxidant activity. In addition, it prevented the increase in cholesterol and COPs at the vascular wall. CLA-supplemented diet prevented the orchidectomy-induced alterations on prostanoids, NO and COPs and also improved the antioxidant activity. These findings could contribute to understand the mechanisms of actions of CLA involved in the prevention of cardiovascular diseases.
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Affiliation(s)
- Mibsam M Rojas
- Food Research and Development Unit, National Technology of Mexico/Technological Institute of Veracruz, Ver., Mexico
| | - Diva M Villalpando
- Physiology Department, Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
| | | | - Mercedes Ferrer
- Physiology Department, Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain.
| | - Hugo S García
- Food Research and Development Unit, National Technology of Mexico/Technological Institute of Veracruz, Ver., Mexico.
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11
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Advances in stem cell research for the treatment of primary hypogonadism. Nat Rev Urol 2021; 18:487-507. [PMID: 34188209 DOI: 10.1038/s41585-021-00480-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 02/06/2023]
Abstract
In Leydig cell dysfunction, cells respond weakly to stimulation by pituitary luteinizing hormone, and, therefore, produce less testosterone, leading to primary hypogonadism. The most widely used treatment for primary hypogonadism is testosterone replacement therapy (TRT). However, TRT causes infertility and has been associated with other adverse effects, such as causing erythrocytosis and gynaecomastia, worsening obstructive sleep apnoea and increasing cardiovascular morbidity and mortality risks. Stem-cell-based therapy that re-establishes testosterone-producing cell lineages in the body has, therefore, become a promising prospect for treating primary hypogonadism. Over the past two decades, substantial advances have been made in the identification of Leydig cell sources for use in transplantation surgery, including the artificial induction of Leydig-like cells from different types of stem cells, for example, stem Leydig cells, mesenchymal stem cells, and pluripotent stem cells (PSCs). PSC-derived Leydig-like cells have already provided a powerful in vitro model to study the molecular mechanisms underlying Leydig cell differentiation and could be used to treat men with primary hypogonadism in a more specific and personalized approach.
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12
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Gheorghe ACD, Ciobanu A, Hodorogea AS, Radavoi GD, Jinga V, Rascu ASC, Nanea IT, Gheorghe GS. Subclinical left ventricular dysfunction in men under androgen deprivation therapy for prostate cancer, revealed by speckle-tracking-derived parameters, repolarization, and myocardial injury markers. Echocardiography 2021; 38:632-640. [PMID: 33764596 PMCID: PMC8252497 DOI: 10.1111/echo.15043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/26/2021] [Accepted: 03/15/2021] [Indexed: 01/02/2023] Open
Abstract
Objective To analyze global left ventricular longitudinal strain (GLS), mechanical dispersion (MD), electrocardiographic repolarization, and myocardial injury markers changes during androgen deprivation therapy (ADT) and subsequent hypogonadism in men with advanced prostate cancer. Methods We included 31 patients 69.7 ± 7.3 years old, in sinus rhythm, with stable cardiac conditions and evaluated them by echocardiography, electrocardiography, and blood sampling for high sensitivity cardiac troponin I (hs‐cTnI), and N‐terminal pro‐brain natriuretic peptide (NTproBNP), at ADT initiation (M0) and after 6 months of treatment (M1). Peak longitudinal strain by speckle‐tracking echocardiography was assessed in 17 left ventricular segments and averaged to GLS. Standard deviation of time intervals from the start of Q/R on electrocardiogram to peak longitudinal strain in the 17 segments (MDSD), and the difference between the longest and shortest time‐to‐peak strain intervals (MDdelta) were calculated as indices of MD. Fridericia corrected electrocardiographic repolarization parameters were analyzed as follows: QT interval (QTc), mean and maximum values of Tpeak‐Tend interval (Tpe), and Tpe/QT ratio, Tpe dispersion (Tped). Results Significant impairments of the following parameters were registered between M0 and M1: GLS (%) (−16.93 ± 3.89; −14.43 ± 3.57, P < .001), MDSD (ms) (77.4 ± 21.4; 89 ± 27, P = .004), MDdelta (ms) (225.3 ± 78.3; 259.9 ± 108.4, P = .02), QTc (ms) (458.8 ± 43.4; 485.6 ± 45.1, P = .01), maxTpe/QT (0.246 ± 0.04; 0.268 ± 0.04, P = .01), maxTpe (ms) (105.4 ± 23.2; 119.5 ± 26.4 P = .01), meanTpe (ms) (83.3 ± 16.8; 90.7 ± 19.3, P = .02), and hs‐cTnI (ng/mL) (4.6 ± 5.4; 5.4 ± 6.4, P = .01). Mean serum testosterone level at M1 was 0.1 ± 0.13 ng/mL. The patients’ clinical cardiological status remained stable during follow‐up. Conclusions ADT and subsequent hypogonadism induce subclinical alterations in GLS, MD, electrocardiographic repolarization parameters, and hs‐cTnI during the first 6 months of treatment.
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Affiliation(s)
- Andrei C D Gheorghe
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Internal Medicine and Cardiology, Theodor Burghele Clinical Hospital, Bucharest, Romania
| | - Ana Ciobanu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Internal Medicine and Cardiology, Theodor Burghele Clinical Hospital, Bucharest, Romania
| | - Andreea S Hodorogea
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Internal Medicine and Cardiology, Theodor Burghele Clinical Hospital, Bucharest, Romania
| | - George D Radavoi
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Urology, Theodor Burghele Clinical Hospital, Bucharest, Romania
| | - Viorel Jinga
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Urology, Theodor Burghele Clinical Hospital, Bucharest, Romania
| | - Alexandru S C Rascu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Urology, Theodor Burghele Clinical Hospital, Bucharest, Romania
| | - Ioan T Nanea
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Internal Medicine and Cardiology, Theodor Burghele Clinical Hospital, Bucharest, Romania
| | - Gabriela S Gheorghe
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Internal Medicine and Cardiology, Theodor Burghele Clinical Hospital, Bucharest, Romania
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13
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Mali S, Irani K, Mohammadi SM, Sarebanhassanabadi M. Serum free testosterone level in coronary artery disease in candidates for coronary artery bypass graft surgery: A cross-sectional study. Int J Reprod Biomed 2021; 19:293-302. [PMID: 33842826 PMCID: PMC8023009 DOI: 10.18502/ijrm.v19i3.8577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 09/09/2020] [Accepted: 10/20/2020] [Indexed: 11/24/2022] Open
Abstract
Background Due to the controversy over the effect of serum testosterone levels on coronary artery diseases, this survey explores the serum levels of free testosterone, luteinizing hormone, and follicle-stimulating hormone in candidates for coronary artery bypass graft compared with an age-matched control group and evaluates the associated factors in these participants.
Objective To determine the testosterone level in elective coronary artery bypass grafting participants. Materials and Methods In this cross-sectional study, all male patients aged > 40 yr as candidates for elective coronary artery bypass grafting, who were referred to the Afshar Hospital, Yazd, Iran, from March 2018 to March 2019, were included. In total, 100 men were enrolled (50 cases and 50 controls). Their serum levels of free and total testosterone, luteinizing hormone, and follicle-stimulating hormone were measured and the results were compared. Results The findings indicated a significant difference between the two groups in total and free testosterone (both p < 0.001); they were lower in the case group. There was also a significant difference in the total testosterone of the participants with diabetes mellitus compared with no-diabetic individuals (p = 0.007). Free testosterone of diabetic subjects taking insulin was lower compared with those taking no insulin (p = 0.04). There was also an association between the body mass index and free testosterone, left ventricular ejection fraction and total testosterone, and a significant and negative relation between the duration of hospital admissions and free testosterone (p < 0.05). Conclusion This study illustrates that participants with coronary artery disease bear a significantly low testosterone level in comparison with the healthy control group.
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Affiliation(s)
- Shahriar Mali
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Kurosh Irani
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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14
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Lynch S, Boyett JE, Smith MR, Giordano-Mooga S. Sex Hormone Regulation of Proteins Modulating Mitochondrial Metabolism, Dynamics and Inter-Organellar Cross Talk in Cardiovascular Disease. Front Cell Dev Biol 2021; 8:610516. [PMID: 33644031 PMCID: PMC7905018 DOI: 10.3389/fcell.2020.610516] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 11/30/2020] [Indexed: 12/11/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death in the U.S. and worldwide. Sex-related disparities have been identified in the presentation and incidence rate of CVD. Mitochondrial dysfunction plays a role in both the etiology and pathology of CVD. Recent work has suggested that the sex hormones play a role in regulating mitochondrial dynamics, metabolism, and cross talk with other organelles. Specifically, the female sex hormone, estrogen, has both a direct and an indirect role in regulating mitochondrial biogenesis via PGC-1α, dynamics through Opa1, Mfn1, Mfn2, and Drp1, as well as metabolism and redox signaling through the antioxidant response element. Furthermore, data suggests that testosterone is cardioprotective in males and may regulate mitochondrial biogenesis through PGC-1α and dynamics via Mfn1 and Drp1. These cell-signaling hubs are essential in maintaining mitochondrial integrity and cell viability, ultimately impacting CVD survival. PGC-1α also plays a crucial role in inter-organellar cross talk between the mitochondria and other organelles such as the peroxisome. This inter-organellar signaling is an avenue for ameliorating rampant ROS produced by dysregulated mitochondria and for regulating intrinsic apoptosis by modulating intracellular Ca2+ levels through interactions with the endoplasmic reticulum. There is a need for future research on the regulatory role of the sex hormones, particularly testosterone, and their cardioprotective effects. This review hopes to highlight the regulatory role of sex hormones on mitochondrial signaling and their function in the underlying disparities between men and women in CVD.
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Affiliation(s)
- Shannon Lynch
- Biomedical Sciences Program, Graduate School, University of Alabama at Birmingham, Birmingham, AL, United States
| | - James E Boyett
- Biomedical Sciences Program, Department of Clinical and Diagnostic Science, University of Alabama at Birmingham, Birmingham, AL, United States
| | - M Ryan Smith
- Division of Pulmonary, Allergy and Critical Care Medicine, Emory University, Atlanta, GA, United States
| | - Samantha Giordano-Mooga
- Biomedical Sciences Program, Department of Clinical and Diagnostic Science, University of Alabama at Birmingham, Birmingham, AL, United States
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15
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Diaconu R, Donoiu I, Mirea O, Bălşeanu TA. Testosterone, cardiomyopathies, and heart failure: a narrative review. Asian J Androl 2021; 23:348-356. [PMID: 33433530 PMCID: PMC8269837 DOI: 10.4103/aja.aja_80_20] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Testosterone exerts an important regulation of cardiovascular function through genomic and nongenomic pathways. It produces several changes in cardiomyocytes, the main actor of cardiomyopathies, which are characterized by pathological remodeling, eventually leading to heart failure. Testosterone is involved in contractility, in the energy metabolism of myocardial cells, apoptosis, and the remodeling process. In myocarditis, testosterone directly promotes the type of inflammation that leads to fibrosis, and influences viremia with virus localization. At the same time, testosterone exerts cardioprotective effects that have been observed in different studies. There is increasing evidence that low endogenous levels of testosterone have a negative impact in some cardiomyopathies and a protective impact in others. This review focuses on the interrelationships between testosterone and cardiomyopathies and heart failure.
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Affiliation(s)
- Rodica Diaconu
- Department of Cardiology, University of Medicine and Pharmacy, Craiova 200349, Romania
| | - Ionuţ Donoiu
- Department of Cardiology, University of Medicine and Pharmacy, Craiova 200349, Romania
| | - Oana Mirea
- Department of Cardiology, University of Medicine and Pharmacy, Craiova 200349, Romania
| | - Tudor Adrian Bălşeanu
- Department of Physiology, University of Medicine and Pharmacy, Craiova 200349, Romania
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Masoudkabir F, Yavari N, Pashang M, Sadeghian S, Jalali A, Poorhosseini H, Tafti SHA, Bagheri J, Abbasi K, Omran AS, Mansourian S, Momtahan S, Mortazavi SH, Karimi A. Effect of persistent opium consumption after surgery on the long-term outcomes of surgical revascularisation. Eur J Prev Cardiol 2020; 27:1996-2003. [DOI: 10.1177/2047487320932010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background
A wrong traditional belief persists among people that opium consumption beneficially affects cardiovascular disease and its risk factors. However, no evidence exists regarding the effect of opium consumption or cessation on the long-term risk of major adverse cardio-cerebrovascular events after coronary artery bypass grafting. We therefore aimed to evaluate the effect of persistent opium consumption after surgery on the long-term outcomes of coronary artery bypass grafting.
Methods
The study population consisted of 28,691 patients (20,924 men, mean age 60.9 years), who underwent coronary artery bypass grafting between 2007 and 2016 at our centre. The patients were stratified into three groups according to the status of opium consumption: never opium consumers (n = 23,619), persistent postoperative opium consumers (n = 3636) and enduring postoperative opium withdrawal (n = 1436). Study endpoints were 5-year mortality and 5-year major adverse cardio-cerebrovascular events, comprising all-cause mortality, acute coronary syndrome, cerebrovascular accident and revascularisation.
Results
After surgery, 3636 patients continued opium consumption, while 1436 patients persistently avoided opium use. The multivariable survival analysis demonstrated that persistent post-coronary artery bypass grafting opium consumption increased 5-year mortality and 5-year major adverse cardio-cerebrovascular events by 28% (hazard ratio (HR) 1.28, 95% confidence interval (CI) 1.06–1.54; P = 0.009) and 25% (HR 1.25, 95% CI 1.13–1.40; P < 0.0001), respectively. It also increased the 5-year risk of acute coronary syndrome by 34% (sub-distribution HR 1.34, 95% CI 1.16–1.55; P < 0.0001).
Conclusions
The present data suggest that persistent post-coronary artery bypass grafting opium consumption may significantly increase mortality, major adverse cardio-cerebrovascular events and acute coronary syndrome in the long term. Future studies are needed to confirm our findings.
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Affiliation(s)
- Farzad Masoudkabir
- Department of Cardiology, Tehran University of Medical Sciences, Iran
- Cardiac Primary Prevention Research Center, Tehran University of Medical Sciences, Iran
| | - Negin Yavari
- Tehran Heart Center, Tehran University of Medical Sciences, Iran
| | - Mina Pashang
- Tehran Heart Center, Tehran University of Medical Sciences, Iran
| | - Saeed Sadeghian
- Department of Cardiology, Tehran University of Medical Sciences, Iran
- Tehran Heart Center, Tehran University of Medical Sciences, Iran
| | - Arash Jalali
- Tehran Heart Center, Tehran University of Medical Sciences, Iran
| | | | | | - Jamshid Bagheri
- Department of Cardiac Surgery, Tehran University of Medical Sciences, Iran
| | - Kiomars Abbasi
- Department of Cardiac Surgery, Tehran University of Medical Sciences, Iran
| | - Abbas Salehi Omran
- Department of Cardiac Surgery, Tehran University of Medical Sciences, Iran
| | - Soheil Mansourian
- Department of Cardiac Surgery, Tehran University of Medical Sciences, Iran
| | - Shahram Momtahan
- Department of Cardiac Surgery, Tehran University of Medical Sciences, Iran
| | - Seyedeh Hamideh Mortazavi
- Department of Cardiology, Tehran University of Medical Sciences, Iran
- Tehran Heart Center, Tehran University of Medical Sciences, Iran
| | - Abbasali Karimi
- Department of Cardiac Surgery, Tehran University of Medical Sciences, Iran
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17
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Bomfim JHGG. Pharmaceutical Care in Sports. PHARMACY 2020; 8:E218. [PMID: 33207610 PMCID: PMC7712766 DOI: 10.3390/pharmacy8040218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 10/29/2020] [Accepted: 11/02/2020] [Indexed: 11/17/2022] Open
Abstract
Pharmaceutical care in sports is a new field of work to clinical pharmacists, focused on promoting pharmacotherapeutic follow up and clinical services to athletes, physical activity practitioners and enthusiasts of any sports modality. A broad range of pharmaceuticals, dietary supplements and herbal drugs have been used historically as performance promoters, doping or ergogenic aids. In this context, the role of pharmacists in prevent adverse events, drug interactions or any drug related problems, as doping issues, was described. Its actions can be important to contribute with a multi professional clinical health team, leading athletes to use these resources in a rational way, promoting and optimizing the therapeutic when its necessary.
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18
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Roayaei P, Aminorroaya A, Vasheghani-Farahani A, Oraii A, Sadeghian S, Poorhosseini H, Masoudkabir F. Opium and cardiovascular health: A devil or an angel? Indian Heart J 2020; 72:482-490. [PMID: 33357635 PMCID: PMC7772609 DOI: 10.1016/j.ihj.2020.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 09/24/2020] [Accepted: 10/14/2020] [Indexed: 01/18/2023] Open
Abstract
Opioids have the highest rate of illicit drug consumption after cannabis worldwide. Opium, after tobacco, is still the most commonly abused substance in the Middle East. In addition to the ease of availability, one reason for the high consumption of opium in Asian countries might be a traditional belief among Eastern people and even medical staff that opium may have ameliorating effects on cardiovascular diseases (CVDs) as well as diabetes mellitus, hypertension, and dyslipidemia. Over the last decade, many studies have been performed on humans and animals to evaluate the interplay between opium consumption and stable coronary artery disease, acute coronary syndromes, and atherosclerosis. In this review, we conclude that opium consumption should be considered a risk factor for CVDs. Healthy individuals, as well as cardiac and diabetic patients, should be informed and educated about the hazardous effects of opium consumption on cardiovascular and other chronic diseases.
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Affiliation(s)
- Pegah Roayaei
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Arya Aminorroaya
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran.
| | - Ali Vasheghani-Farahani
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Alireza Oraii
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran.
| | - Saeed Sadeghian
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Farzad Masoudkabir
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
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19
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Surveying the Effect of Opioid Abuse on the Extent of Coronary Artery Diseases in Diabetic Patients. JOURNAL OF ADDICTION 2020; 2020:8619805. [PMID: 32765923 PMCID: PMC7387960 DOI: 10.1155/2020/8619805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 04/13/2020] [Accepted: 06/11/2020] [Indexed: 11/25/2022]
Abstract
Background Diabetes mellitus is recognized as one of the most common, serious, and costly chronic diseases. Opium addiction is also a common health problem in Iran. Given the high prevalence of opium use in South Khorasan Province and the increasing prevalence of opioid abuse in the community, this study was performed to investigate the effect of opioid abuse on the extent of disease in diabetic patients undergoing coronary angiography in the cardiology department of Vali-e-Asr Hospital in Birjand city, South Khorasan Province, Iran. Methods This study recruited a total of 1051 diabetic patients who underwent coronary angiography in the cardiology department of Vali-e-Asr Hospital of Birjand city from 2011 to 2015. The collected data were analyzed using SPSS version 22.0 with the chi-square test and univariate regression analysis. P value <0.05 was considered as statistically significant. Results Among opiate-addicted diabetics, the risk of coronary artery disease was 0.44 times higher than among nonaddicted diabetics (range 0.24–0.77, P=0.004). The extent of coronary vessel involvement, when present, was not different between the two groups. Conclusion Opiate-addicted diabetics appear to be more susceptible to CAD than their nonaddicted counterparts. The determinants and correlates of this interaction must be the subject of further study.
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20
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Muniyan S, Xi L, Datta K, Das A, Teply BA, Batra SK, Kukreja RC. Cardiovascular risks and toxicity - The Achilles heel of androgen deprivation therapy in prostate cancer patients. Biochim Biophys Acta Rev Cancer 2020; 1874:188383. [PMID: 32535158 PMCID: PMC7473503 DOI: 10.1016/j.bbcan.2020.188383] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/31/2020] [Accepted: 06/02/2020] [Indexed: 01/04/2023]
Abstract
Androgen deprivation therapy (ADT) is the primary systemic therapy for treating locally advanced or metastatic prostate cancer (PCa). Despite its positive effect on PCa patient survival, ADT causes various adverse effects, including increased cardiovascular risk factors and cardiotoxicity. Lifespans extension, early use of ADT, and second-line treatment with next-generation androgen receptor pathway inhibitors would further extend the duration of ADT and possibly increase the risk of ADT-induced cardiotoxicity. Meanwhile, information on the molecular mechanisms underlying ADT-induced cardiotoxicity and measures to prevent it is limited, mainly due to the lack of specifically designed preclinical studies and clinical trials. This review article compiles up-to-date evidence obtained from observational studies and clinical trials, in order to gain new insights for deciphering the association between ADT use and cardiotoxicity. In addition, potential cardioprotective strategies involving GnRH receptors and second messenger cGMP are discussed.
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Affiliation(s)
- Sakthivel Muniyan
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198-5870, USA
| | - Lei Xi
- Pauley Heart Center, Department of Internal Medicine, Virginia Commonwealth University Richmond, VA 23298-0204, USA
| | - Kaustubh Datta
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198-5870, USA; Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE 68198-5870, USA
| | - Anindita Das
- Pauley Heart Center, Department of Internal Medicine, Virginia Commonwealth University Richmond, VA 23298-0204, USA
| | - Benjamin A Teply
- Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE 68198-5870, USA; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198-3332, USA
| | - Surinder K Batra
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198-5870, USA; Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE 68198-5870, USA.
| | - Rakesh C Kukreja
- Pauley Heart Center, Department of Internal Medicine, Virginia Commonwealth University Richmond, VA 23298-0204, USA.
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Rojas MM, Villalpando DM, Ferrer M, Alexander‐Aguilera A, García HS. Conjugated Linoleic Acid Supplemented Diet Influences Serum Markers in Orchidectomized Sprague‐Dawley Rats. EUR J LIPID SCI TECH 2020. [DOI: 10.1002/ejlt.201900098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Mibsam Margot Rojas
- UNIDA Tecnológico Nacional de Mexico/Instituto Tecnológico de Veracruz M. A. de Quevedo 2779, Colonia Formando Hogar Veracruz Veracruz 91897 México
| | - Diva María Villalpando
- Departamento de Fisiología, Facultad de Medicina Universidad Autónoma de Madrid C/Arzobispo Morcillo 4 Madrid 28029 Spain
| | - Mercedes Ferrer
- Departamento de Fisiología, Facultad de Medicina Universidad Autónoma de Madrid C/Arzobispo Morcillo 4 Madrid 28029 Spain
- Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) Madrid Spain
| | - Alfonso Alexander‐Aguilera
- Facultad de Bioanálisis Universidad Veracruzana Carmen Serdán s/n, Col. Flores Magón Veracruz 91700 México
| | - Hugo Sergio García
- UNIDA Tecnológico Nacional de Mexico/Instituto Tecnológico de Veracruz M. A. de Quevedo 2779, Colonia Formando Hogar Veracruz Veracruz 91897 México
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Karolczak K, Konieczna L, Kostka T, Witas PJ, Soltysik B, Baczek T, Watala C. Testosterone and dihydrotestosterone reduce platelet activation and reactivity in older men and women. Aging (Albany NY) 2019; 10:902-929. [PMID: 29723157 PMCID: PMC5990384 DOI: 10.18632/aging.101438] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 04/26/2018] [Indexed: 12/22/2022]
Abstract
The cardiovascular effects of testosterone and dihydrotestosterone are generally attributed to their modulatory action on lipid and glucose metabolism. However, no ex vivo studies suggest that circulating androgen levels influence the activation and reactivity of blood platelets - one of the main components of the haemostasis system directly involved in atherosclerosis. The levels of testosterone, dihydrotestosterone and oestradiol in plasma from men and women aged from 60 to 65 years were measured by LC-MS; the aim was to identify any potential relationships between sex steroid levels and the markers of platelet activation (surface membrane expression of GPII/IIIa complex and P-selectin) and platelet reactivity in response to arachidonate, collagen or ADP, monitored with whole blood aggregometry and flow cytometry. The results of the ex vivo part of the study indicate that the concentrations of testosterone and its reduced form, dihydrotestosterone are significantly negatively associated with platelet activation and reactivity. These observations were confirmed in an in vitro model: testosterone and dihydrotestosterone significantly inhibited platelet aggregation triggered by arachidonate or collagen. Our findings indicate that testosterone and dihydrotestosterone are significant haemostatic steroids with inhibitory action on blood platelets in older people.
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Affiliation(s)
- Kamil Karolczak
- Department of Haemostatic Disorders, Medical University, Lodz, Poland
| | - Lucyna Konieczna
- Department of Pharmaceutical Chemistry, Medical University of Gdansk, Gdansk, Poland
| | - Tomasz Kostka
- Department of Geriatrics, Healthy Ageing Research Centre (HARC), Medical University, Lodz, Poland
| | - Piotr J Witas
- Department of Haemostatic Disorders, Medical University, Lodz, Poland
| | - Bartlomiej Soltysik
- Department of Geriatrics, Healthy Ageing Research Centre (HARC), Medical University, Lodz, Poland
| | - Tomasz Baczek
- Department of Pharmaceutical Chemistry, Medical University of Gdansk, Gdansk, Poland
| | - Cezary Watala
- Department of Haemostatic Disorders, Medical University, Lodz, Poland
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23
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Obesity’s role in secondary male hypogonadism: a review of pathophysiology and management issues. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s42399-019-00056-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Ebdali RT, Tabaee SS, Tabaei S. Cardiovascular complications and related risk factors underlying opium consumption. J Cell Physiol 2018; 234:8487-8495. [PMID: 30478829 DOI: 10.1002/jcp.27780] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 10/30/2018] [Indexed: 12/23/2022]
Abstract
Opium is considered as the second most abused addictive compound in worldwide. It seems that one of the causes for common consumption of opium in many countries is a traditional belief, even among medical personnel, through which opium might have advantageous influences on cardiovascular events and be beneficial in controlling hypertension, dyslipidemia, and diabetes. According to several investigations, it is thought that opium not only has no beneficial effects on cardiovascular events, but it might have deleterious influences on these settings. As a result, people need to be trained with regard to the adverse effects of opium on cardiovascular events. In this review, we try to go through the understanding of the effects of opium cardiovascular disorders and related complications such as blood pressure, blood sugar, lipid circumstances, and finally atherosclerosis.
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Affiliation(s)
- Reyhaneh T Ebdali
- Department of Cardiology, Neyshabur University of Medical Science, Neyshabur, Iran
| | | | - Samira Tabaei
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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25
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Darbey A, Smith LB. Deliverable transgenics & gene therapy possibilities for the testes. Mol Cell Endocrinol 2018; 468:81-94. [PMID: 29191697 DOI: 10.1016/j.mce.2017.11.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 11/24/2017] [Accepted: 11/24/2017] [Indexed: 11/30/2022]
Abstract
Male infertility and hypogonadism are clinically prevalent conditions with a high socioeconomic burden and are both linked to an increased risk in cardiovascular-metabolic diseases and earlier mortality. Therefore, there is an urgent need to better understand the causes and develop new treatments for these conditions that affect millions of men. The accelerating advancement in gene editing and delivery technologies promises improvements in both diagnosis as well as affording the opportunity to develop bespoke treatment options which would both prove beneficial for the millions of individuals afflicted with these reproductive disorders. In this review, we summarise the systems developed and utilised for the delivery of gene therapy and discuss how each of these systems could be applied for the development of a gene therapy system in the testis and how they could be of use for the future diagnosis and repair of common male reproductive disorders.
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Affiliation(s)
- Annalucia Darbey
- MRC Centre for Reproductive Health, University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Lee B Smith
- MRC Centre for Reproductive Health, University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK; School of Environmental and Life Sciences, University of Newcastle, Callaghan, NSW 2308, Australia.
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Rossetti ML, Fukuda DH, Gordon BS. Androgens induce growth of the limb skeletal muscles in a rapamycin-insensitive manner. Am J Physiol Regul Integr Comp Physiol 2018; 315:R721-R729. [PMID: 29897818 DOI: 10.1152/ajpregu.00029.2018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Signaling through the mechanistic target of rapamycin complex 1 (mTORC1) has been well defined as an androgen-sensitive transducer mediating skeletal muscle growth in vitro; however, this has yet to be tested in vivo. As such, male mice were subjected to either sham or castration surgery and allowed to recover for 7 wk to induce atrophy of skeletal muscle. Then, castrated mice were implanted with either a control pellet or a pellet that administered rapamycin (~2.5 mg·kg-1·day-1). Seven days postimplant, a subset of castrated mice with control pellets and all castrated mice with rapamycin pellets were given once weekly injections of nandrolone decanoate (ND) to induce muscle growth over a six-week period. Effective blockade of mTORC1 by rapamycin was noted in the skeletal muscle by the inability of insulin to induce phosphorylation of ribosomal S6 kinase 1 70 kDa (Thr389) and uncoordinated-like kinase 1 (Ser757). While castration reduced tibialis anterior (TA) mass, muscle fiber cross-sectional area, and total protein content, ND administration restored these measures to sham levels in a rapamycin-insensitive manner. Similar findings were also observed in the plantaris and soleus, suggesting this rapamycin-insensitive effect was not specific to the TA or fiber type. Androgen-mediated growth was not due to changes in translational capacity. Despite these findings in the limb skeletal muscle, rapamycin completely prevented the ND-mediated growth of the heart. In all, these data indicate that mTORC1 has a limited role in the androgen-mediated growth of the limb skeletal muscle; however, mTORC1 was necessary for androgen-mediated growth of heart muscle.
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Affiliation(s)
- Michael L Rossetti
- Department of Nutrition, Food, and Exercise Sciences, Florida State University , Tallahassee, Florida
| | - David H Fukuda
- Institute of Exercise Physiology and Wellness, University of Central Florida , Orlando, Florida
| | - Bradley S Gordon
- Department of Nutrition, Food, and Exercise Sciences, Florida State University , Tallahassee, Florida
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Ho HJ, Shirakawa H, Giriwono PE, Ito A, Komai M. A novel function of geranylgeraniol in regulating testosterone production. Biosci Biotechnol Biochem 2018; 82:956-962. [PMID: 29303051 DOI: 10.1080/09168451.2017.1415129] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Isoprenoids play widely differing roles in various physiological processes in animals and plants. Geranylgeraniol (GGOH) is an isoprenoid found in plants, and is an important metabolic derivative in the isoprenoid/cholesterol synthesis pathway. Earlier studies focused on GGOH's ability to improve the side effects of bisphosphonate therapy by regulating the mevalonate pathway. More recently, the mevalonate pathway-independent effects of GGOH have been described, including anti-inflammatory, anti-tumorigenic, and neuroprotective activities. It is noteworthy that GGOH regulates the steroidogenesis pathway in testis-derived I-10 tumor cells. Testosterone is a hormone produced via steroidogenesis in testicles and plays a role in fetal development and the male reproductive system. GGOH enhanced testosterone and progesterone (its precursor) levels in I-10 cells by activating adenylate cyclase via cAMP/PKA signaling, without altering phosphodiesterase activity. These findings highlight the potential benefits of GGOH as a therapeutic agent for low testosterone levels, such as late-onset hypogonadism in men.
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Affiliation(s)
- Hsin-Jung Ho
- a Laboratory of Nutrition, Graduate School of Agricultural Science , Tohoku University , Sendai , Japan
| | - Hitoshi Shirakawa
- a Laboratory of Nutrition, Graduate School of Agricultural Science , Tohoku University , Sendai , Japan.,b International Education and Research Center for Food Agricultural Immunology, Graduate School of Agricultural Science , Tohoku University , Sendai , Japan
| | - Puspo E Giriwono
- a Laboratory of Nutrition, Graduate School of Agricultural Science , Tohoku University , Sendai , Japan.,c Southeast Asian Food & Agriculture Science & Technology (SEAFAST) Center , Bogor Agricultural University , Bogor , Indonesia
| | - Asagi Ito
- a Laboratory of Nutrition, Graduate School of Agricultural Science , Tohoku University , Sendai , Japan
| | - Michio Komai
- a Laboratory of Nutrition, Graduate School of Agricultural Science , Tohoku University , Sendai , Japan
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Elagizi A, Köhler TS, Lavie CJ. Testosterone and Cardiovascular Health. Mayo Clin Proc 2018; 93:83-100. [PMID: 29275030 DOI: 10.1016/j.mayocp.2017.11.006] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 11/07/2017] [Accepted: 11/13/2017] [Indexed: 12/29/2022]
Abstract
There is an ongoing debate in the medical community regarding the effects of testosterone on cardiovascular (CV) health. For decades, there has been conflicting evidence regarding the association of endogenous testosterone levels and CV disease (CVD) events that has resulted in much debate and confusion among health care providers and patients alike. Testosterone therapy has become increasingly widespread, and after the emergence of studies that reported increased CVD events in patients receiving testosterone therapy, the US Food and Drug Administration (FDA) released a warning statement about testosterone and its potential risk regarding CV health. Some of these studies were later found to be critically flawed, and some experts, including the American Association of Clinical Endocrinologists and an expert panel regarding testosterone deficiency and its treatment, reported that some of the FDA statements regarding testosterone therapy were lacking scientific evidence. This article summarizes the current evidence regarding the relationship between testosterone (endogenous and supplemental) and CV health. A literature review was conducted via search using PubMed and specific journal databases, including the New England Journal of Medicine and the Journal of the American College of Cardiology. Key search terms included testosterone and cardiovascular health, coronary artery disease, heart failure, androgen deprivation therapy, intima-media thickness, and adrenal androgens. Initial study selection was limited to publications within the past 10 years (January 1, 2007, through December 31, 2016); however, key publications outside of this time frame were selected if they provided important quantitative data or historical perspectives for the review of this topic. The search was further supplemented by reviewing references in selected articles.
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Affiliation(s)
- Andrew Elagizi
- Department of Internal Medicine, Leonard J. Chabert Medical Center, Houma, LA
| | - Tobias S Köhler
- Department of Urology, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, MN
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, LA.
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Chen H, Wang Y, Ge R, Zirkin BR. Leydig cell stem cells: Identification, proliferation and differentiation. Mol Cell Endocrinol 2017; 445:65-73. [PMID: 27743991 PMCID: PMC5346484 DOI: 10.1016/j.mce.2016.10.010] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 10/03/2016] [Accepted: 10/11/2016] [Indexed: 01/21/2023]
Abstract
Adult Leydig cells develop from undifferentiated mesenchymal-like stem cells (stem Leydig cells, SLCs) present in the interstitial compartment of the early postnatal testis. Putative SLCs also have been identified in peritubular and perivascular locations of the adult testis. The latter cells, which normally are quiescent, are capable of regenerating new Leydig cells upon the loss of the adult cells. Recent studies have identified several protein markers to identify these cells, including nestin, PDGFRα, COUP-TFII, CD51 and CD90. We have shown that the proliferation of the SLCs is stimulated by DHH, FGF2, PDGFBB, activin and PDGFAA. Suppression of proliferation occurred with TGFβ, androgen and PKA signaling. The differentiation of the SLCs into testosterone-producing Leydig cells was found to be regulated positively by DHH (Desert hedgehog), lithium-induced signaling and activin; and negatively by TGFβ, PDGFBB, FGF2, Notch and Wnt signaling. DHH, by itself, was found to induce SLC differentiation into LH-responsive steroidogenic cells, suggesting that DHH plays a critical role in the commitment of SLC into the Leydig lineage. These studies, taken together, address the function and regulation of low turnover stem cells in a complex, adult organ, and also have potential application to the treatment of androgen deficiency.
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Affiliation(s)
- Haolin Chen
- Center for Scientific Research, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China; Department of Biochemistry and Molecular Biology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Yiyan Wang
- Center for Scientific Research, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Renshan Ge
- Center for Scientific Research, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Barry R Zirkin
- Department of Biochemistry and Molecular Biology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Who Gets Testosterone? Patient Characteristics Associated with Testosterone Prescribing in the Veteran Affairs System: a Cross-Sectional Study. J Gen Intern Med 2017; 32:304-311. [PMID: 27995426 PMCID: PMC5331013 DOI: 10.1007/s11606-016-3940-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 08/22/2016] [Accepted: 11/29/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND There has been concern about the growing off-label use of testosterone. Understanding the context within which testosterone is prescribed may contribute to interventions to improve prescribing. OBJECTIVE To evaluate patient characteristics associated with receipt of testosterone. DESIGN Cross-sectional. SETTING A national cohort of male patients, who had received at least one outpatient prescription within the Veterans Affairs (VA) system during Fiscal Year 2008- Fiscal Year 2012. PARTICIPANTS The study sample consisted of 682,915 non-HIV male patients, of whom 132,764 had received testosterone and a random 10% sample, 550,151, had not. MAIN MEASURES Conditions and medications associated with testosterone prescription. KEY RESULTS Only 6.3% of men who received testosterone from the VA during the study period had a disorder of the testis, pituitary or hypothalamus associated with male hypogonadism. Among patients without a diagnosed disorder of hypogonadism, the use of opioids and obesity were the strongest predictors of testosterone prescription. Patients receiving >100 mg/equivalents of oral morphine daily (adjusted odds ratio = 5.75, p < 0.001) and those with body mass index (BMI) >40 kg/m2 (adjusted odds ratio = 3.01, p < 0.001) were more likely to receive testosterone than non-opioid users and men with BMI <25 kg/m2. Certain demographics (age 40-54, White race), comorbid conditions (sleep apnea, depression, and diabetes), and medications (antidepressants, systemic corticosteroids) also predicted a higher likelihood of testosterone receipt, all with an adjusted odds ratio less than 2 (p < 0.001). CONCLUSIONS In the VA, 93.7% of men receiving testosterone did not have a diagnosed condition of the testes, pituitary, or hypothalamus. The strongest predictors of testosterone receipt (e.g., obesity, receipt of opioids), which though are associated with unapproved, off-label use, may be valid reasons for therapy. Interventions should aim to increase the proportion of testosterone recipients who have a valid indication.
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Madhu SV, Aslam M, Aiman AJ, Siddiqui A, Dwivedi S. Prevalence of hypogonadism in male Type 2 diabetes mellitus patients with and without coronary artery disease. Indian J Endocrinol Metab 2017; 21:31-37. [PMID: 28217495 PMCID: PMC5240077 DOI: 10.4103/2230-8210.195999] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
AIM The present study is carried out to investigate hypogonadism using serum testosterone levels in male Type 2 diabetes mellitus (T2DM) subjects with and without coronary artery disease (CAD). SUBJECTS AND METHODS A total of 150 age and body mass index-matched male subjects in the age group of 30-70 years were recruited in three groups; Group A - subjects with normal glucose tolerance, Group B - T2DM subjects without CAD, and Group C - T2DM subjects with CAD (n = 50 each group). Subjects with CAD were diagnosed on the basis of electrocardiogram, treadmill testing, stress echocardiography, or coronary angiography. Total testosterone (TT), free testosterone (FT), bioavailable testosterone, calculated FT and glycemic parameters were measured and compared between all the three study groups. One-way ANOVA followed by post hoc Tukey's test and Pearson's coefficient of correlation tests were used for analysis. RESULTS Hypogonadism (TT <3 ng/ml) was observed in 40% (20/50) of subjects in Group C and 32% (16/50) of subjects in Group B as compared to only 14% (7/50) of subjects in Group A (Groups A vs. B; P = 0.055, Groups A vs. C; P = 0.006 and Groups B vs. C; P = 0.53). Group C subjects had significantly lower levels of TT (3.55 ± 1.46 ng/ml vs. 4.73 ± 2.17 ng/ml, P = 0.005), calculated FT (0.062 ± 0.0255 pg/ml vs. 0.0951 ± 0.0508 pg/ml, P ≤ 0.001), and bioavailable testosterone (1.48 ± 0.65 ng/ml vs. 2.18 ± 1.20 ng/ml, P ≤ 0.001) compared to control Group A subjects. There was no significant difference in any of the testosterone parameters between Groups A and B. Furthermore, an overall positive correlation was found between hypogonadism and CAD (r = 0.177, P = 0.030, n = 150). CONCLUSION We observed hypogonadism as indicated by low testosterone levels in a significant proportion of male T2DM subjects with CAD.
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Affiliation(s)
- S. V. Madhu
- Department of Medicine, Centre for Diabetes Endocrinology and Metabolism, University College of Medical Sciences (University of Delhi) and GTB Hospital, New Delhi, India
| | - M. Aslam
- Department of Medicine, Centre for Diabetes Endocrinology and Metabolism, University College of Medical Sciences (University of Delhi) and GTB Hospital, New Delhi, India
| | - A. J. Aiman
- Department of Medicine, Centre for Diabetes Endocrinology and Metabolism, University College of Medical Sciences (University of Delhi) and GTB Hospital, New Delhi, India
| | - A. Siddiqui
- Department of Medicine, Centre for Diabetes Endocrinology and Metabolism, University College of Medical Sciences (University of Delhi) and GTB Hospital, New Delhi, India
| | - S. Dwivedi
- Department of Medicine, Centre for Diabetes Endocrinology and Metabolism, University College of Medical Sciences (University of Delhi) and GTB Hospital, New Delhi, India
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Viveka S, Sagar TV, Kumar A J. Evaluation of 2D:4D digit ratio and diagonal earlobe crease as markers of coronary artery disease. J ANAT SOC INDIA 2016. [DOI: 10.1016/j.jasi.2017.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chen H, Jin S, Huang S, Folmer J, Liu J, Ge R, Zirkin BR. Transplantation of alginate-encapsulated seminiferous tubules and interstitial tissue into adult rats: Leydig stem cell differentiation in vivo? Mol Cell Endocrinol 2016; 436:250-8. [PMID: 27591121 PMCID: PMC5050555 DOI: 10.1016/j.mce.2016.08.046] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 08/09/2016] [Accepted: 08/29/2016] [Indexed: 01/06/2023]
Abstract
In vivo and in vitro studies were conducted to determine whether testosterone-producing Leydig cells are able to develop from cells associated with rat seminiferous tubules, interstitium, or both. Adult rat seminiferous tubules and interstitium were isolated, encapsulated separately in alginate, and implanted subcutaneously into castrated rats. With implanted tubules, serum testosterone increased through two months. Tubules removed from the implanted rats and incubated with LH produced testosterone, and cells on the tubule surfaces expressed steroidogenic enzymes. With implanted interstitial tissue, serum levels of testosterone remained undetectable. However, co-culture of interstitium plus tubules in vitro resulted in the formation of Leydig cells by both compartments. These results indicate that seminiferous tubules contain both cellular and paracrine factors necessary for the differentiation of Leydig cells, and that the interstitial compartment contains precursor cells capable of forming testosterone-producing Leydig cells but requires stimulation by paracrine factors from the seminiferous tubules to do so.
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Affiliation(s)
- Haolin Chen
- Center for Scientific Research, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China; Department of Biochemistry and Molecular Biology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shiying Jin
- Department of Biochemistry and Molecular Biology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shengsong Huang
- Department of Biochemistry and Molecular Biology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Urology, Tongji Hospital, Tongji University School of Medicine, Putuo, Shanghai 200065, China
| | - Janet Folmer
- Department of Biochemistry and Molecular Biology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - June Liu
- Department of Biochemistry and Molecular Biology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Renshan Ge
- Center for Scientific Research, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Barry R Zirkin
- Department of Biochemistry and Molecular Biology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Pesonen E, Pussinen P, Huhtaniemi I. Adaptation to acute coronary syndrome-induced stress with lowering of testosterone: a possible survival factor. Eur J Endocrinol 2016; 174:481-9. [PMID: 26772984 DOI: 10.1530/eje-15-0757] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 01/15/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The objective of this study was to explore whether circulating testosterone (T) concentration is associated with the occurrence and risk for acute coronary syndromes (ACS). METHOD This case-control study included male patients with acute myocardial infarction (AMI) (n=174) or unstable angina pectoris (UAP) (n=90) and healthy controls (n=238). Patients gave serum samples during the acute (n=264) and recovery (n=132) phases after a median of 10.5 months after the incident event. Secondary events (ACS or cardiovascular death) were registered during the following 6 years. RESULTS During the acute phase, AMI and UAP patients had similar significantly reduced concentrations of serum testosterone in comparison to controls. Testosterone associated inversely with weight, the degree of inflammation (i.e. C-reactive protein concentration) and signs of a chronic infection. In a multiadjusted Cox regression, when compared to testosterone concentrations considered high-normal (14.91-34.0 nmol/l), low-normal testosterone (9.26-14.90 nmol/l) in the acute phase predicted better prognosis for cardiovascular death rate with a hazard ratio (HR) of 0.17 (0.04-0.68, P=0.012). The increased testosterone concentrations after the recovery period did not associate with future cardiovascular disease events. CONCLUSION Low-normal testosterone levels in the acute phase of ACS predicted better survival. The observation may indicate better adaptation to stress in survivors and warrants further study.
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Affiliation(s)
- Erkki Pesonen
- Department of PaediatricsSkåne University Hospital, Skåne University, Lund, SwedenOral and Maxillofacial DiseasesUniversity of Helsinki, Helsinki, FinlandDepartment of Surgery and CancerInstitute of Reproductive and Developmental Biology, Hammersmith Campus, Du Cane Road, Imperial College London, London W12 0NN, UKDepartment of PhysiologyInstitute of Biomedicine, University of Turku, 20520 Turku, Finland
| | - Pirkko Pussinen
- Department of PaediatricsSkåne University Hospital, Skåne University, Lund, SwedenOral and Maxillofacial DiseasesUniversity of Helsinki, Helsinki, FinlandDepartment of Surgery and CancerInstitute of Reproductive and Developmental Biology, Hammersmith Campus, Du Cane Road, Imperial College London, London W12 0NN, UKDepartment of PhysiologyInstitute of Biomedicine, University of Turku, 20520 Turku, Finland
| | - Ilpo Huhtaniemi
- Department of PaediatricsSkåne University Hospital, Skåne University, Lund, SwedenOral and Maxillofacial DiseasesUniversity of Helsinki, Helsinki, FinlandDepartment of Surgery and CancerInstitute of Reproductive and Developmental Biology, Hammersmith Campus, Du Cane Road, Imperial College London, London W12 0NN, UKDepartment of PhysiologyInstitute of Biomedicine, University of Turku, 20520 Turku, Finland Department of PaediatricsSkåne University Hospital, Skåne University, Lund, SwedenOral and Maxillofacial DiseasesUniversity of Helsinki, Helsinki, FinlandDepartment of Surgery and CancerInstitute of Reproductive and Developmental Biology, Hammersmith Campus, Du Cane Road, Imperial College London, London W12 0NN, UKDepartment of PhysiologyInstitute of Biomedicine, University of Turku, 20520 Turku, Finland
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Gosai JN, Charalampidis P, Nikolaidou T, Parviz Y, Morris PD, Channer KS, Jones TH, Grech ED. Revascularization with percutaneous coronary intervention does not affect androgen status in males with chronic stable angina pectoris. Andrology 2016; 4:486-91. [PMID: 27027684 DOI: 10.1111/andr.12189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 02/17/2016] [Accepted: 02/22/2016] [Indexed: 11/27/2022]
Abstract
There is a clear association between low serum testosterone and coronary artery disease (CAD) in men. Hypotestosteronaemia is associated with accelerated atherosclerosis and a quarter of men with CAD are biochemically hypogonadal. Amongst those with CAD, hypotestosteronaemia is associated with increased mortality. Testosterone vasodilates coronary arteries, and exogenous testosterone reduces ischaemia. Whether hypotestosteronaemia is a cause or a consequence of CAD remains unanswered. The aim of this prospective observational study was to investigate whether coronary revascularization affected androgen status in men with stable angina pectoris. Twenty five men (mean age 62.7, SD 9.18) with angiographically significant CAD and symptomatic angina underwent full coronary revascularization by percutaneous coronary intervention. Androgen status and symptoms of angina, stress, depression and sexual function were assessed before, and at one and 6 months after the coronary revascularization. All patients underwent complete revascularization which was associated with a significant reduction in angina symptoms and ischaemia. No significant difference was seen in total testosterone (11.33 nmol/L baseline; 12.56, 1 month post; 13.04 at 6 months; p = 0.08). A significant and sustained rise in sex hormone-binding globulin was seen (33.99 nm/L baseline; 36.11 nm/L 1 month post PCI; 37.94 nm/L at 6 months; p = 0.03) Overall, there was no significant alteration in any other marker of androgen status including free testosterone or bioavailable testosterone. There was no change in symptoms of anxiety, depression or sexual function. Coronary revascularization has no sustained effect on androgen status. This supports the hypothesis that hypotestosteronaemia is not a consequence of angina pectoris or myocardial ischaemia.
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Affiliation(s)
- J N Gosai
- South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, UK.,Department of Cardiovascular Science, University of Sheffield, Sheffield, UK
| | - P Charalampidis
- South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, UK
| | - T Nikolaidou
- South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, UK
| | - Y Parviz
- South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, UK
| | - P D Morris
- South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, UK.,Department of Cardiovascular Science, University of Sheffield, Sheffield, UK
| | | | - T H Jones
- Robert Hague Centre for Diabetes and Endocrinology, Barnsley Hospital NHS Foundation Trust, Barnsley, UK.,Department of Human Metabolism, University of Sheffield, Sheffield, UK
| | - E D Grech
- South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, UK
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Abstract
Despite increased global interest in testosterone deficiency in men and its treatment with testosterone therapy, practical aspects of care remain confusing to many practitioners. Testosterone deficiency can result from testicular dysfunction (primary hypogonadism) or hypothalamic-pituitary dysfunction (secondary hypogonadism), and be congenital or acquired. Sexual and nonsexual symptoms of testosterone deficiency can negatively affect quality of life and cause considerable general health concerns. Investigation of testosterone deficiency should be undertaken in men with symptoms of reduced libido, erectile dysfunction, depression, fatigue, poor concentration, and poor memory. Total and free testosterone are the most frequently used tests and evaluating serum concentrations of luteinizing hormone aids determination of primary versus secondary testosterone deficiency. Multiple formulations of testosterone therapy are available, but symptomatic benefits might not manifest for several weeks to many months; long-acting formulations are convenient and improve compliance. Concerns regarding cardiovascular and prostate cancer risks are not supported by current evidence, monitoring during therapy is mandatory. On balance, testosterone therapy can be considered a safe and effective treatment for testosterone deficiency.
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Affiliation(s)
- Antonio Aversa
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Abraham Morgentaler
- Men's Health Boston, 200 Boylston Street, A309, Chestnut Hill, MA 02647, USA
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Aghazadeh Y, Zirkin BR, Papadopoulos V. Pharmacological regulation of the cholesterol transport machinery in steroidogenic cells of the testis. VITAMINS AND HORMONES 2015; 98:189-227. [PMID: 25817870 DOI: 10.1016/bs.vh.2014.12.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Reduced serum testosterone (T), or hypogonadism, is estimated to affect about 5 million American men, including both aging and young men. Low serum T has been linked to mood changes, worsening cognition, fatigue, depression, decreased lean body mass and bone mineral density, increased visceral fat, metabolic syndrome, decreased libido, and sexual dysfunction. Administering exogenous T, known as T-replacement therapy (TRT), reverses many of the symptoms of low T levels. However, this treatment can result in luteinizing hormone suppression which, in turn, can lead to reduced sperm numbers and infertility, making TRT inappropriate for men who wish to father children. Additionally, TRT may result in supraphysiologic T levels, skin irritation, and T transfer to others upon contact; and there may be increased risk of prostate cancer and cardiovascular disease, particularly in aging men. Therefore, the development of alternate therapies for treating hypogonadism would be highly desirable. To do so requires greater understanding of the series of steps leading to T formation and how they are regulated, and the identification of key steps that are amenable to pharmacological modulation so as to induce T production. We review herein our current understanding of mechanisms underlying the pharmacological induction of T formation in hypogonadal testis.
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Affiliation(s)
- Yasaman Aghazadeh
- The Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Barry R Zirkin
- Department of Biochemistry and Molecular Biology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Vassilios Papadopoulos
- The Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Department of Biochemistry, McGill University, Montreal, Quebec, Canada; Department of Pharmacology & Therapeutics, McGill University, Montreal, Quebec, Canada.
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Bauman WA, La Fountaine MF, Cirnigliaro CM, Kirshblum SC, Spungen AM. Lean tissue mass and energy expenditure are retained in hypogonadal men with spinal cord injury after discontinuation of testosterone replacement therapy. J Spinal Cord Med 2015; 38:38-47. [PMID: 24968251 PMCID: PMC4293532 DOI: 10.1179/2045772314y.0000000206] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To determine whether favorable changes to lean tissue mass (LTM), resting energy expenditure (REE), and testosterone (T) that occurred with 12 months of physiological testosterone replacement therapy (TRT) were retained 6 months after discontinuing treatment. DESIGN Prospective, open-label, controlled drug intervention trial. SETTING Metropolitan area hospitals. SUBJECTS Eugonadal (n = 11) and hypogonadal (n = 13) men with chronic spinal cord injury (SCI). INTERVENTIONS Hypogonadal subjects received a 5 or 10 mg transdermal T patch daily for 12 months, with adjustment of the dose to normalize the serum T concentration; TRT was discontinued after 12 months (TRT-12M) and subjects were followed for an additional 6 months and re-evaluated (Post-TRT). Total body dual energy X-ray absorptiometry and blood draws were performed at baseline (BL) prior to TRT, TRT-12M, and Post-TRT. Eugonadal subjects did not receive treatment and were evaluated at comparable time points. RESULTS There were no significant differences between groups prior to TRT at BL for any of the study endpoints. In the hypogonadal group, a significant increase in LTM was observed from BL to TRT-12M (50.2 ± 7.4 vs. 52.9 ± 6.8 kg, P < 0.01), which persisted Post-TRT compared to BL (52.2 ± 7.8 kg, P < 0.05). The increase in REE from BL to TRT-12M (1283 ± 246 vs. 1410 ± 250 kcal/day) was also retained at Post-TRT (1393 ± 220 kcal/day). These sustained improvements in LTM and REE after termination of anabolic hormonal therapy may be associated with persistent beneficial effects on health and physical function of hypogonadal men with chronic SCI.
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Affiliation(s)
- William A. Bauman
- Correspondence to: William A Bauman, Center of Excellence for the Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA.
| | | | - Christopher M. Cirnigliaro
- VA RR&D National Center of Excellence for the Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center, Bronx, NY, USA
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Liu HH, Li JJ. Aging and dyslipidemia: a review of potential mechanisms. Ageing Res Rev 2015; 19:43-52. [PMID: 25500366 DOI: 10.1016/j.arr.2014.12.001] [Citation(s) in RCA: 160] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 11/25/2014] [Accepted: 12/01/2014] [Indexed: 01/02/2023]
Abstract
Elderly adults constitute a rapidly growing part of the global population, thus resulting in an increase in morbidity and mortality related to cardiovascular disease (CVD), which remains the major cause of death in elderly population, including men and women. Dyslipidemia is a well-established risk factor for CVD and is estimated to account for more than half of the worldwide cases of coronary artery disease (CAD). Many studies have shown a strong correlation between serum cholesterol levels and risk of developing CAD. In this paper, we review the changes of plasma lipids that occur in men and women during aging and the potential mechanisms of age-related disorders of lipoprotein metabolism covering humans and/or animals, in which changes of the liver sinusoidal endothelium, postprandial lipemia, insulin resistance induced by free fatty acid (FFA), growth hormone (GH), androgen (only for men) and expression and activity of peroxisome proliferator-activated receptor α (PPARα) are mainly focused.
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Testosterone and cardiovascular disease. Cardiovasc Endocrinol 2014. [DOI: 10.1097/xce.0000000000000038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Huhtaniemi I. Late-onset hypogonadism: current concepts and controversies of pathogenesis, diagnosis and treatment. Asian J Androl 2014; 16:192-202. [PMID: 24407185 PMCID: PMC3955328 DOI: 10.4103/1008-682x.122336] [Citation(s) in RCA: 122] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Although suppressed serum testosterone (T) is common in ageing men, only a small proportion of them develop the genuine syndrome of low T associated with diffuse sexual (e.g., erectile dysfunction), physical (e.g. loss of vigor and frailty) and psychological (e.g., depression) symptoms. This syndrome carries many names, including male menopause or climacterium, andropause and partial androgen deficiency of the ageing male (PADAM). Late-onset hypogonadism (LOH) describes it best and is therefore generally preferred. The decrease of T in LOH is often marginal, and hypogonadism can be either due to primary testicular failure (low T, high luteinizing hormone (LH)) or secondary to a hypothalamic-pituitary failure (low T, low or inappropriately normal LH). The latter form is more common and it is usually associated with overweight/obesity or chronic diseases (e.g., type 2 diabetes mellitus, the metabolic syndrome, cardiovascular and chronic obstructive pulmonary disease, and frailty). A problem with the diagnosis of LOH is that often the symptoms (in 20%–40% of unselected men) and low circulating T (in 20% of men >70 years of age) do not coincide in the same individual. The European Male Ageing Study (EMAS) has recently defined the strict diagnostic criteria for LOH to include the simultaneous presence of reproducibly low serum T (total T <11 nmol l−1 and free T <220 pmol l−1) and three sexual symptoms (erectile dysfunction, and reduced frequency of sexual thoughts and morning erections). By these criteria, only 2% of 40- to 80-year-old men have LOH. In particular obesity, but also impaired general health, are more common causes of low T than chronological age per se. Evidence-based information whether, and how, LOH should be treated is sparse. The most logical approach is lifestyle modification, weight reduction and good treatment of comorbid diseases. T replacement is widely used for the treatment, but evidence-based information about its real benefits and short- and long-term risks, is not yet available. In this review, we will summarize the current concepts and controversies in the pathogenesis, diagnosis and treatment of LOH.
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Affiliation(s)
- Ilpo Huhtaniemi
- Institute of Reproductive and Developmental Biology, Imperial College London, Hammersmth Campus, London, UK; Department of Physiology, University of Turku, Kiinamyllynkatu, Turku, Finland,
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Passeri E, Bonomi M, Dangelo F, Persani L, Corbetta S. Wasting syndrome with deep bradycardia as presenting manifestation of long-standing severe male hypogonadotropic hypogonadism: a case series. BMC Endocr Disord 2014; 14:78. [PMID: 25260871 PMCID: PMC4179860 DOI: 10.1186/1472-6823-14-78] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 09/23/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physiological functioning of the testes is important for cardiac health besides for virilisation, physical strength, behavior and reproduction; moreover, hypogonadism has been demonstrated as a significant risk marker of increased all-cause and cardiovascular mortality. CASES PRESENTATION We reported two cases of long-standing hypogonadotropic hypogonadism presenting with wasting, bradycardia and heart failure. The two patients were admitted to emergency department for deep weakness, unresponsive anemia and severe bradycardia, requiring in one case the implanting of a monocameral pace-maker for treatment of heart failure. No previous cardiologic disorders were known and cardiac ischemia was ruled out in both patients. The first patient presented congenital hypogonadotropic hypogonadism combined with mild central hypothyroidism and growth hormone deficiency occurred in the peripubertal age, while the second one was diagnosed with isolated adult-onset severe central hypogonadism. Testosterone deficiency was the main feature in both patients as physical examination revealed clinical stigmata of hypogonadism and testosterone replacement induced a dramatic improvement of general condition. Genetic analysis of genes involved in hypogonadotropic hypogonadism failed to identify alterations. CONCLUSION Long-standing hypogonadism in males can be associated with life threatening body alterations including severe bradycardia and heart failure.
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Affiliation(s)
- Elena Passeri
- Endocrinology and Diabetology Unit, Department of Biomedical Sciences for Health, University of Milan, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato M.se, Milan, Italy
| | - Marco Bonomi
- Division of Endocrine and Metabolic Diseases and Laboratory of Endocrine-Metabolic Research, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149 Milan, Italy
| | - Francesco Dangelo
- Division of Internal Medicine, Cernusco sul Naviglio Hospital, Via Uboldo 21, 20063 Cernusco sul Naviglio, Milan, Italy
| | - Luca Persani
- Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Department of Clinical Science and Community Health, University of Milan, Piazzale Brescia 20, 20149 Milan, Italy
| | - Sabrina Corbetta
- Endocrinology and Diabetology Unit, Department of Biomedical Sciences for Health, University of Milan, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato M.se, Milan, Italy
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Wu J, Hadoke PWF, Mair I, Lim WG, Miller E, Denvir MA, Smith LB. Modulation of neointimal lesion formation by endogenous androgens is independent of vascular androgen receptor. Cardiovasc Res 2014; 103:281-90. [PMID: 24903497 PMCID: PMC4094672 DOI: 10.1093/cvr/cvu142] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Aims Low androgen levels have been linked with an increased risk of cardiovascular disease in men. Previous studies have suggested that androgens directly inhibit atherosclerotic lesion formation although the underlying mechanisms for this remain unclear. This study addressed the hypothesis that endogenous androgens inhibit arterial remodelling by a direct action on the androgen receptor (AR) in the vascular wall. Methods and results We studied a series of novel mouse lines with cell-specific deletion of the AR in either the endothelium or in smooth muscle cells or both cell types. Findings were compared with a model of global androgen deficiency in wild-type mice (castrated). We characterized the cardiovascular phenotype, vascular pharmacology and histology, and assessed neointimal lesion formation following vascular injury to the femoral artery. Cell-specific AR deletion did not alter body weight, circulating testosterone levels or seminal vesicle weight, but caused limited alterations in arterial contractility and blood pressure. Neointimal lesion formation was unaltered by selective deletion of AR from the vascular endothelium, smooth muscle, or both cell types. Castration in wild-type mice increased neointimal lesion volume (Sham vs. Castration: 2.4 × 107 ± 4.5 × 106 vs. 3.9 × 107 ± 4.9 × 106 µm3, P = 0.04, n = 9–10). Conclusion Vascular cell-specific AR deletion had no effect on neointimal lesion formation, while low systemic androgen levels adversely affect neointimal lesion size. These findings suggest that the cardio-protective effects of androgens are mediated either by AR outside the vasculature or by AR-independent mechanisms.
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Affiliation(s)
- Junxi Wu
- MRC Centre for Reproductive Health, University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK University/BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Patrick W F Hadoke
- University/BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Iris Mair
- University/BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Win Gel Lim
- University/BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Eileen Miller
- University/BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Martin A Denvir
- University/BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Lee B Smith
- MRC Centre for Reproductive Health, University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
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Kang L, Li S, Xing Z, Li J, Su Y, Fan P, Wang L, Cui H. Dihydrotestosterone treatment delays the conversion from mild cognitive impairment to Alzheimer's disease in SAMP8 mice. Horm Behav 2014; 65:505-15. [PMID: 24717850 DOI: 10.1016/j.yhbeh.2014.03.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 03/07/2014] [Accepted: 03/31/2014] [Indexed: 01/25/2023]
Abstract
The senescence-accelerated-prone mouse 8 (SAMP8) has been proposed as a suitable, naturally derived animal model for Alzheimer's disease (AD). In the current study, we focus on the problem whether SAMP8 mice show abnormal behavioral and neuropathological signs before they present the characteristic of AD. Our results demonstrated that given the presence of the senescent, behavioral and neuropathological characteristics, the "middle-aged" SAMP8 mice appear to be a suitable and naturally derived animal model for MCI basic research. There is relatively less evidence that androgen may be involved in the pathogenesis of AD. We determined testosterone (T) levels of SAMR1 and SAMP8 mice and found that the marked age-related decrease in serum androgen levels may be one of the risk factors for Alzheimer's dementia. We also evaluated the interventional effect on MCI phase by dihydrotestosterone (DHT) in male SAMP8 mice and found that timely and appropriate androgen intervention can postpone the onset and improve the symptoms of dementia.
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Affiliation(s)
- Lin Kang
- Department of Human Anatomy, Hebei Medical University, Hebei, PR China
| | - Sha Li
- Department of Human Anatomy, Hebei Medical University, Hebei, PR China
| | - Zhaoguo Xing
- Department of Human Anatomy, Hebei Medical University, Hebei, PR China
| | - Jianzhong Li
- Department of Human Anatomy, Hebei Medical University, Hebei, PR China
| | - Yuhong Su
- Department of Human Anatomy, Hebei Medical University, Hebei, PR China
| | - Ping Fan
- Department of Human Anatomy, Hebei Medical University, Hebei, PR China
| | - Lei Wang
- Department of Human Anatomy, Hebei Medical University, Hebei, PR China
| | - Huixian Cui
- Department of Human Anatomy, Hebei Medical University, Hebei, PR China; Hebei Key Laboratory for Brain Aging and Cognitive Neuroscience, Hebei, PR China.
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Yazawa T, Imamichi Y, Miyamoto K, Umezawa A, Taniguchi T. Differentiation of mesenchymal stem cells into gonad and adrenal steroidogenic cells. World J Stem Cells 2014; 6:203-212. [PMID: 24772247 PMCID: PMC3999778 DOI: 10.4252/wjsc.v6.i2.203] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 12/24/2013] [Accepted: 01/20/2014] [Indexed: 02/06/2023] Open
Abstract
Hormone replacement therapy is necessary for patients with adrenal and gonadal failure. Steroid hormone treatment is also employed in aging people for sex hormone deficiency. These patients undergo such therapies, which have associated risks, for their entire life. Stem cells represent an innovative tool for tissue regeneration and the possibility of solving these problems. Among various stem cell types, mesenchymal stem cells have the potential to differentiate into steroidogenic cells both in vivo and in vitro. In particular, they can effectively be differentiated into steroidogenic cells by expressing nuclear receptor 5A subfamily proteins (steroidogenic factor-1 and liver receptor homolog-1) with the aid of cAMP. This approach will provide a source of cells for future regenerative medicine for the treatment of diseases caused by steroidogenesis deficiencies. It can also represent a useful tool for studying the molecular mechanisms of steroidogenesis and its related diseases.
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Masoudkabir F, Sarrafzadegan N, Eisenberg MJ. Effects of opium consumption on cardiometabolic diseases. Nat Rev Cardiol 2013; 10:733-40. [PMID: 24145895 DOI: 10.1038/nrcardio.2013.159] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Opium is the second-most-commonly abused substance (after tobacco) in developing countries of the Middle East region, and in many Asian nations. One of the reasons for the high prevalence of opium abuse in these countries is a traditional belief among Eastern people, even including some medical staff, that opium might have beneficial effects on cardiovascular health and in the control of diabetes mellitus, hypertension, and dyslipidaemia. In this Perspectives article, we summarize the current understanding of the pharmacotoxicology of opium and its specific effects on glycaemic control, blood pressure, lipid profile, and atherosclerosis. On the basis of the available evidence, we believe not only that opium has no ameliorating effect on cardiovascular diseases, but also that the use of this drug might have adverse effects on these conditions. Therefore, people should be educated about the hazardous effects of opium consumption on cardiometabolic diseases.
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Affiliation(s)
- Farzad Masoudkabir
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Karegar Shomali Street, Jalal al-Ahmad Cross, 14117-13138, Tehran, Iran
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Abstract
Testosterone is a hormone that plays a key role in carbohydrate, fat and protein metabolism. It has been known for some time that testosterone has a major influence on body fat composition and muscle mass in the male. Testosterone deficiency is associated with an increased fat mass (in particular central adiposity), reduced insulin sensitivity, impaired glucose tolerance, elevated triglycerides and cholesterol and low HDL-cholesterol. All these factors are found in the metabolic syndrome (MetS) and type 2 diabetes, contributing to cardiovascular risk. Clinical trials demonstrate that testosterone replacement therapy improves the insulin resistance found in these conditions as well as glycaemic control and also reduces body fat mass, in particular truncal adiposity, cholesterol and triglycerides. The mechanisms by which testosterone acts on pathways to control metabolism are not fully clear. There is, however, an increasing body of evidence from animal, cell and clinical studies that testosterone at the molecular level controls the expression of important regulatory proteins involved in glycolysis, glycogen synthesis and lipid and cholesterol metabolism. The effects of testosterone differ in the major tissues involved in insulin action, which include liver, muscle and fat, suggesting a complex regulatory influence on metabolism. The cumulative effects of testosterone on these biochemical pathways would account for the overall benefit on insulin sensitivity observed in clinical trials. This review discusses the current knowledge of the metabolic actions of testosterone and how testosterone deficiency contributes to the clinical disease states of obesity, MetS and type 2 diabetes and the role of testosterone replacement.
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Affiliation(s)
- Daniel M Kelly
- Department of Human Metabolism, Medical School, The University of Sheffield, Sheffield S10 2RX, UK
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Rydlewska A, Maj J, Katkowski B, Biel B, Ponikowska B, Banasiak W, Ponikowski P, Jankowska EA. Circulating testosterone and estradiol, autonomic balance and baroreflex sensitivity in middle-aged and elderly men with heart failure. Aging Male 2013; 16:58-66. [PMID: 23581721 DOI: 10.3109/13685538.2013.768979] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Heart failure (HF) is considered as a cardiogeriatric syndrome. Its fundamental pathophysiological feature is autonomic imbalance (and associated abnormalities within cardiovascular reflex control), but recent evidence suggests the involvement of deranged hormone metabolism. Both these neural and endocrine pathologies have serious clinical and prognostic consequences in patients with HF. We investigated the relations between autonomic status, baroreflex sensitivity (BRS) and hormone status in men with mild systolic HF. METHODS We examined 46 men with stable systolic HF (age: 62 ± 10 years, NYHA class I/II: 10/36 [22%/78%], ischemic aetiology: 72%, left ventricular ejection fraction: 32 ± 8%). Serum hormone levels (i.e. total testosterone [TT], dehydroepiandrosterone sulphate [DHEAS], oestradiol [E2], insulin-like growth factor type 1 [IGF-1] and cortisol) were assessed using immunoassays. Estimated free testosterone (eFT) was estimated using the Vermeulen's equation. Heart rate variability (HRV) was assessed in time and frequency domains, based on 10-min resting recordings. BRS was estimated using the sequence method (BRS-Seq) and the phenylephrine test (BRS-Phe). RESULTS Deficiencies in circulating TT, eFT, DHEAS and IGF-1 (defined as a serum hormone ≤the 10th percentile calculated for the adequate age category in the cohort of healthy men) were found in respectively 13%, 30%, 55% and 93% of men with systolic HF. Serum SHBG ≥50 nmol/L and cortisol ≥700 nmol/L characterised, respectively 44% and 29% of men with HF. In multivariable models after the adjustment for clinical variables, the following relationships were found in examined men: DHEAS and SDNN (time domain of HRV defined as a standard deviation of average R-R intervals) (β = 0.29, p = 0.03); E2 and: HRV-LF (ms(2)) (β = 0.37, p = 0.01), HRV-HF (ms2) (β = 0.44, p = 0.02) and BRS-Phe (β = 0.51, p = 0.008); TT and: HRV-HF (%) (β = 0.35, p = 0.02), HRV-LF/HF ratio (β = -0.35, p = 0.02) and BRS-Seq (β = 0.33, p = 0.04). CONCLUSIONS The observed associations between reduced circulating androgens, oestrogens and lower HRV and depleted BRS, irrespectively of HF severity suggest the pathophysiological links between these two mechanisms. These results constitute the premises to investigate whether the pharmacological supplementation of depleted hormones would enable to restore the autonomic balance and improve the efficacy of reflex control within the cardiovascular system in men with systolic HF.
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Affiliation(s)
- Agnieszka Rydlewska
- Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
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