Identifying late-onset hypogonadism in older men

Androgen-dependent miR-125a-5p targets LYPLA1 and regulates global protein palmitoylation level in late-onset hypogonadism males

Late-onset hypogonadism (LOH) is defined as a clinical and biochemical syndrome with multiple symptoms caused by testosterone deficiency in aging males. An in-depth exploration of the molecular mechanism underlying LOH development is insufficient. We previously identified miR-125a-5p as a dysregulated microRNA in LOH patients and potential diagnostic biomarker for LOH. The present study demonstrated that plasma miR-125a-5p was upregulated after testosterone supplementation in both LOH patients and castrated mice, and positively associated with the testosterone concentrations, suggesting direct regulation of miR-125a-5p expression by testosterone. Androgen response element in the promoter of miR-125a-5p was subsequently identified. Target gene screening and confirmation verified that LYPLA1, encoding acyl-protein thioesterase 1 which catalyzed protein depalmitoylation process, was a target gene of miR-125a-5p. Furthermore, in cells cultured with testosterone deprivation and organs from castrated mice, testosterone deficiency led to decreased global protein palmitoylation level. In aging males, global protein palmitoylation in peripheral blood showed a notable decline in LOH patients contrast to the normal elderly males. And the palmitoylation level was positively correlative with serum testosterone concentrations. Our results suggested that testosterone could regulate global palmitoylation level through miR-125a-5p/LYPLA1 signaling pathway. Given that protein palmitoylation is pivotal for protein function and constitutes the pathogenesis of various diseases, testosterone/miR-125a-5p/LYPLA1 may contribute to the molecular mechanism underlying multiple symptoms caused by testosterone deficiency in LOH patients, and aberrant global palmitoylation could be a potential biomarker for LOH.

Applying machine learning techniques to the identification of late-onset hypogonadism in elderly men

In the diagnosis of late-onset hypogonadism (LOH), the Androgen Deficiency in the Aging Male (ADAM) questionnaire or Aging Males' Symptoms (AMS) scale can be used to assess related symptoms. Subsequently, blood tests are used to measure serum testosterone levels. However, results obtained using ADAM and AMS have revealed no significant correlations between ADAM and AMS scores and LOH, and the rate of misclassification is high. Recently, many studies have reported significant associations between clinical conditions such as the metabolic syndrome, obesity, lower urinary tract symptoms, and LOH. In this study, we sampled 772 clinical cases of men who completed both a health checkup and two questionnaires (ADAM and AMS). The data were obtained from the largest medical center in Taiwan. Two well-known classification techniques, the decision tree (DT) and logistic regression, were used to construct LOH prediction models on the basis of the aforementioned features. The results indicate that although the sensitivity of ADAM is the highest (0.878), it has the lowest specificity (0.099), which implies that ADAM overestimates LOH occurrence. In addition, DT combined with the AdaBoost technique (AdaBoost DT) has the second highest sensitivity (0.861) and specificity (0.842), resulting in having the best accuracy (0.851) among all classifiers. AdaBoost DT can provide robust predictions that will aid clinical decisions and can help medical staff in accurately assessing the possibilities of LOH occurrence.