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Mauvais-Jarvis F, Lindsey SH. Metabolic benefits afforded by estradiol and testosterone in both sexes: clinical considerations. J Clin Invest 2024; 134:e180073. [PMID: 39225098 PMCID: PMC11364390 DOI: 10.1172/jci180073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
Abstract
Testosterone (T) and 17β-estradiol (E2) are produced in male and female humans and are potent metabolic regulators in both sexes. When E2 and T production stops or decreases during aging, metabolic dysfunction develops and promotes degenerative metabolic and vascular disease. Here, we discuss the shared benefits afforded by E2 and T for metabolic function human females and males. In females, E2 is central to bone and vascular health, subcutaneous adipose tissue distribution, skeletal muscle insulin sensitivity, antiinflammatory immune function, and mitochondrial health. However, T also plays a role in female skeletal, vascular, and metabolic health. In males, T's conversion to E2 is fundamental to bone and vascular health, as well as prevention of excess visceral adiposity and the promotion of insulin sensitivity via activation of the estrogen receptors. However, T and its metabolite dihydrotestosterone also prevent excess visceral adiposity and promote skeletal muscle growth and insulin sensitivity via activation of the androgen receptor. In conclusion, T and E2 are produced in both sexes at sex-specific concentrations and provide similar and potent metabolic benefits. Optimizing levels of both hormones may be beneficial to protect patients from cardiometabolic disease and frailty during aging, which requires further study.
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Affiliation(s)
- Franck Mauvais-Jarvis
- Medicine Service, Section of Endocrinology, Hormone Therapy Clinic, Southeast Louisiana VA Medical Center, New Orleans, Louisiana, USA
- Deming Department of Medicine, Section of Endocrinology and Metabolism, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Tulane Center of Excellence in Sex-Based Biology & Medicine, New Orleans, Louisiana, USA
| | - Sarah H. Lindsey
- Tulane Center of Excellence in Sex-Based Biology & Medicine, New Orleans, Louisiana, USA
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana, USA
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Ma J, Zhang H, Liang F, Li G, Pang X, Zhao R, Wang J, Chang X, Guo J, Zhang W. The male-to-female ratio in late-onset multiple acyl-CoA dehydrogenase deficiency: a systematic review and meta-analysis. Orphanet J Rare Dis 2024; 19:72. [PMID: 38365830 PMCID: PMC10873946 DOI: 10.1186/s13023-024-03072-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/03/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Late-onset multiple acyl-CoA dehydrogenase deficiency (MADD) is the most common lipid storage myopathy. There are sex differences in fat metabolism and it is not known whether late-onset MADD affects men and women equally. METHODS In this systematic review and meta-analysis, the PubMed, Embase, Web of Science, CNKI, CBM, and Wanfang databases were searched until 01/08/2023. Studies reporting sex distribution in patients with late-onset MADD were included. Two authors independently screened studies for eligibility, extracted data, and assessed risk of bias. Pre-specified outcomes of interest were the male-to-female ratio (MFR) of patients with late-onset MADD, the differences of clinical characteristics between the sexes, and factors influencing the MFR. RESULTS Of 3379 identified studies, 34 met inclusion criteria, yielding a total of 609 late-onset MADD patients. The overall pooled percentage of males was 58% (95% CI, 54-63%) with low heterogeneity across studies (I2 = 2.99%; P = 0.42). The mean onset ages, diagnostic delay, serum creatine kinase (CK), and allelic frequencies of 3 hotspot variants in ETFDH gene were similar between male and female patients (P > 0.05). Meta-regressions revealed that ethnic group was associated with the MFR in late-onset MADD, and subgroup meta-analyses demonstrated that East-Asian patients had a higher percentage of male, lower CK, and higher proportion of hotspot variants in ETFDH gene than non-East-Asian patients (P < 0.05). CONCLUSIONS Male patients with late-onset MADD were more common than female patients. Ethnicity was proved to be a factor influencing the MFR in late-onset MADD. These findings suggest that male sex may be a risk factor for the disease.
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Affiliation(s)
- Jing Ma
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China
- First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Huiqiu Zhang
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China
- First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Feng Liang
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China
- First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Guanxi Li
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China
- First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Xiaomin Pang
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China
| | - Rongjuan Zhao
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China
| | - Juan Wang
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China
| | - Xueli Chang
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China
| | - Junhong Guo
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China.
| | - Wei Zhang
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China.
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Shen L. Effects of Pelvic Floor Muscle Massage on the Pregnancy Outcome of Frozen Embryo Transfer in Patients with Thin Endometrium. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2803363. [PMID: 35813410 PMCID: PMC9259337 DOI: 10.1155/2022/2803363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 11/18/2022]
Abstract
Objective To observe the effects of pelvic floor muscle mass on the priority outcome of frozen embryo transfer in patients with thin endometrium. Methods The patients who were prepared for freeze-thaw embryo transfer were randomly divided into the study group and control group. Both groups of patients began to take estradiol valerate tablets 3 mg on the third day of menstrual cycle and added progesterone for luteal support after 14 days. Both groups selected high-quality embryos for embryo transfer on the day of embryo transfer. The basic information, embryo transfer, intimal thickness, intimal type, clinical pregnancy rate, and early abortion rate of the two groups were compared. Results The intimal thickness of patients in the control group and the study group on the second day of menstruation was (0.49 ± 0.03) and (0.45 ± 0.02) and that before progesterone was (1.17 ± 0.03) and (1.20 ± 0.04), respectively (P < 0.05). At the same time, the number of excellent embryos in the study group was significantly higher than that in the control group (P < 0.05), but there was no significant difference in the number of transplants between the two groups (P > 0.05). The proportion of intimal blood flow of type III + II in the study group was significantly higher than that in the control group (P < 0.05). The main adverse pregnancy outcomes of the whole group included biochemical pregnancy, early abortion, and ectopic pregnancy. The incidence of biochemical pregnancy in the control group and the study group was 63.3% (38/60) and 40.0% (24/60), respectively. The incidence of biochemical pregnancy in the control group was significantly higher than that in the study group, but there was no significant difference in the incidence of early abortion and ectopic pregnancy between the two groups (P > 0.05). Conclusion Pelvic floor muscle massage can improve endometrial thickness and subendometrial blood flow, so as to improve the pregnancy rate of frozen thawed embryo transfer patients.
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Affiliation(s)
- Longying Shen
- Kuishan Health Center of Rizhao Economic and Technological Development Zone, China
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Huang LT, Wang JH. The Therapeutic Intervention of Sex Steroid Hormones for Sarcopenia. Front Med (Lausanne) 2021; 8:739251. [PMID: 34760899 PMCID: PMC8573092 DOI: 10.3389/fmed.2021.739251] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 09/29/2021] [Indexed: 01/09/2023] Open
Abstract
Sarcopenia, characterized by the excessive loss of skeletal muscle mass, strength, and function, is associated with the overall poor muscle performance status of the elderly, and occurs more frequently in those with chronic diseases. The causes of sarcopenia are multifactorial due to the inherent relationship between muscles and molecular mechanisms, such as mitochondrial function, inflammatory pathways, and circulating hormones. Age-related changes in sex steroid hormone concentrations, including testosterone, estrogen, progesterone, and their precursors and derivatives, are an important aspect of the pathogenesis of sarcopenia. In this review, we provide an understanding of the treatment of sarcopenia through the regulation of sex steroid hormones. The potential benefits and future research emphasis of each sex steroid hormone therapeutic intervention (testosterone, SARMs, estrogen, SERMs, DHEA, and progesterone) for sarcopenia are discussed. Enhanced understanding of the role of sex steroid hormones in the treatment for sarcopenia could lead to the development of hormone therapeutic approaches in combination with specific exercise and nutrition regimens.
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Affiliation(s)
- Le-Tian Huang
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jia-He Wang
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, China
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Association between vasomotor symptoms and sarcopenia assessed by L3 skeletal muscle index among Korean menopausal women. Menopause 2021; 29:48-53. [PMID: 34964723 DOI: 10.1097/gme.0000000000001879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the association between vasomotor symptoms (VMS), skeletal muscle index (SMI), and sarcopenia in menopausal women. METHODS This cross-sectional study included 295 Korean menopausal women 40 to 65 years old who underwent abdominal computed tomography during routine health checkups between January 2014 and May 2016. The cross-sectional areas of adipose and skeletal muscles were measured at the L3 level using computed tomography. The SMI is defined as the sum of the skeletal muscle area (cm2)/height2 (m2). Sarcopenia was identified by an SMI of <34.9 cm2/m2. VMS were assessed using the Menopause Rating Scale. RESULTS The mean age of the participants was 54.93 ± 6.20 years. VMS were reported in 160 women (54.2%). Sarcopenia was more prevalent in women without VMS (18.5%) than in those with (6.9%). Multivariate logistic regression showed that the prevalence of sarcopenia was inversely associated with the prevalence of VMS (odds ratio, 0.32; 95% CI, 0.15-0.67). Moreover, the paraspinal muscle index was positively associated with the prevalence of VMS (odds ratio, 1.06; 95% CI, 1.01-1.11) after adjusting for age, body mass index, waist circumference, adipose tissue area, history of hormone therapy, systolic and diastolic blood pressures, total cholesterol, insulin resistance, alcohol intake, and exercise. CONCLUSIONS VMS are less common in women with sarcopenia than in those without and are positively associated with paraspinal muscle mass in Korean menopausal women. Further longitudinal studies are required to investigate the causal relationships and underlying mechanisms.
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