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For: Faw CA, Brannigan RE. Hypogonadism and cancer survivorship. Curr Opin Endocrinol Diabetes Obes 2020;27:411-418. [PMID: 33003070 DOI: 10.1097/med.0000000000000583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]

For:	Faw CA, Brannigan RE. Hypogonadism and cancer survivorship. Curr Opin Endocrinol Diabetes Obes 2020;27:411-418. [PMID: 33003070 DOI: 10.1097/med.0000000000000583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]

Number

Cited by Other Article(s)

Association between Brain Injury Markers and Testosterone in Critically-Ill COVID-19 Male Patients. Microorganisms 2022;10:microorganisms10112095. [PMID: 36363686 PMCID: PMC9697553 DOI: 10.3390/microorganisms10112095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/19/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open

Marinelli L, Beccuti G, Zavattaro M, Cagnina S, Gesmundo I, Bona C, Lopez C, Scabini S, Canta F, Mornese Pinna S, Lupia T, Di Bisceglie C, Ponzetto F, Settanni F, De Rosa FG, Ghigo E, Motta G. Testosterone as a Biomarker of Adverse Clinical Outcomes in SARS-CoV-2 Pneumonia. Biomedicines 2022;10:biomedicines10040820. [PMID: 35453570 PMCID: PMC9025790 DOI: 10.3390/biomedicines10040820] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/23/2022] [Accepted: 03/29/2022] [Indexed: 12/12/2022] Open

Abstract

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may affect testicles. Lower testosterone levels have been associated with worse clinical outcomes and higher mortality. Our objective was to evaluate the hypothalamic−pituitary−gonadal axis of men admitted with SARS-CoV-2 pneumonia and its link with the pneumonia-treatment intensification. Short-term changes in hormonal parameters were also assessed. Methods: Men admitted with SARS-CoV-2 pneumonia were recruited in two different hospitals in Piedmont, Italy. In all patients, the assessment of total testosterone (TT), calculated free testosterone (cFT), gonadotropins, inhibin B (InhB), and other biochemical evaluations were performed at admission (T0) and before discharge (T1). Through a review of medical records, clinical history was recorded, including data on pneumonia severity. Results: Thirty-five men (median age 64 [58−74] years) were recruited. Lower TT and cFT levels at T0 were associated with CPAP therapy (p = 0.045 and 0.028, respectively), even after adjusting for age and PaO2/FIO2 ratio in a multivariable analysis. In those discharged alive, lower TT and cFT levels were associated with longer hospital stay (p < 0.01). TT, cFT, and InhB were below the normal range at T0 and significantly increased at T1 (TT 1.98 [1.30−2.72] vs. 2.53 [1.28−3.37] ng/mL, p = 0.038; cFT (0.0441 [0.0256−0.0742] vs. 0.0702 [0.0314−0.0778] ng/mL, p = 0.046; InhB 60.75 [25.35−88.02] vs. 77.05 [51.15−134.50], p < 0.01). Conclusions: Both TT and cFT levels are associated with adverse clinical outcomes in men admitted with SARS-CoV-2 pneumonia. As TT, cFT and InhB levels increase before discharge, short-term functional recovery of steroidogenesis and an indirect improvement of spermatozoa functional status could be hypothesized.

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Affiliation(s)

Lorenzo Marinelli Division of Endocrinology, Diabetes, and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (G.B.); (S.C.); (I.G.); (C.B.); (C.L.); (C.D.B.); (F.P.); (E.G.) Correspondence: (L.M.); (G.M.)
Guglielmo Beccuti Division of Endocrinology, Diabetes, and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (G.B.); (S.C.); (I.G.); (C.B.); (C.L.); (C.D.B.); (F.P.); (E.G.)
Marco Zavattaro Division of Endocrinology, University Hospital “Maggiore della Carità”, 28100 Novara, Italy;
Serena Cagnina Division of Endocrinology, Diabetes, and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (G.B.); (S.C.); (I.G.); (C.B.); (C.L.); (C.D.B.); (F.P.); (E.G.)
Iacopo Gesmundo Division of Endocrinology, Diabetes, and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (G.B.); (S.C.); (I.G.); (C.B.); (C.L.); (C.D.B.); (F.P.); (E.G.)
Chiara Bona Division of Endocrinology, Diabetes, and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (G.B.); (S.C.); (I.G.); (C.B.); (C.L.); (C.D.B.); (F.P.); (E.G.)
Chiara Lopez Division of Endocrinology, Diabetes, and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (G.B.); (S.C.); (I.G.); (C.B.); (C.L.); (C.D.B.); (F.P.); (E.G.)
Silvia Scabini Division of Infectious Diseases, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (S.S.); (F.C.); (S.M.P.); (F.G.D.R.)
Francesca Canta Division of Infectious Diseases, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (S.S.); (F.C.); (S.M.P.); (F.G.D.R.)
Simone Mornese Pinna Division of Infectious Diseases, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (S.S.); (F.C.); (S.M.P.); (F.G.D.R.)
Tommaso Lupia Unit of Infectious Diseases, Cardinal Massaia Hospital, 14100 Asti, Italy;
Cataldo Di Bisceglie Division of Endocrinology, Diabetes, and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (G.B.); (S.C.); (I.G.); (C.B.); (C.L.); (C.D.B.); (F.P.); (E.G.)
Federico Ponzetto Division of Endocrinology, Diabetes, and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (G.B.); (S.C.); (I.G.); (C.B.); (C.L.); (C.D.B.); (F.P.); (E.G.)
Fabio Settanni Clinical Biochemistry Laboratory, AOU Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy;
Francesco Giuseppe De Rosa Division of Infectious Diseases, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (S.S.); (F.C.); (S.M.P.); (F.G.D.R.)
Ezio Ghigo Division of Endocrinology, Diabetes, and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (G.B.); (S.C.); (I.G.); (C.B.); (C.L.); (C.D.B.); (F.P.); (E.G.)
Giovanna Motta Division of Endocrinology, Diabetes, and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (G.B.); (S.C.); (I.G.); (C.B.); (C.L.); (C.D.B.); (F.P.); (E.G.) Correspondence: (L.M.); (G.M.)

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Bhasin S, Ozimek N. Optimizing the Diagnostic Accuracy and Treatment Decisions in Men with Testosterone Deficiency. Endocr Pract 2021;27:1252-1259. [PMID: 34390882 DOI: 10.1016/j.eprac.2021.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 11/19/2022]

Abstract

OBJECTIVE

This narrative review offers a guideline-based approach to optimizing the diagnostic evaluation and treatment decision-making in men being evaluated for testosterone deficiency.

METHODS

A narrative review RESULTS: Testosterone deficiency is a clinical syndrome that results from the inability of the testes to produce normal amounts of testosterone, and is characterized by a constellation of symptoms and signs associated with consistently low testosterone concentrations. The diagnosis of testosterone deficiency is made by ascertainment of symptoms and signs; measurement of total and, if indicated, free testosterone levels, in early morning fasting samples on 2 or more days; measurement of LH and FSH to distinguish primary from secondary hypogonadism; and additional evaluation to ascertain the cause of testosterone deficiency. Non-specificity of symptoms and signs; variations in testosterone levels over time; inaccuracy in the measurement of total and free testosterone levels; variations in binding protein concentrations; and the suboptimal reference ranges contribute to diagnostic inaccuracy. Testosterone treatment is indicated for men with symptomatic testosterone deficiency. Testosterone treatment should be avoided in men with prostate or breast cancer, erythrocytosis, thrombophilia, increased risk of prostate cancer or severe lower urinary tract symptoms without prior urological evaluation, recent major adverse cardiovascular event, uncontrolled heart failure or severe untreated sleep apnea. Testosterone replacement therapy should be accompanied by a standardized monitoring plan.

CONCLUSION

The shared decision to treat should be guided by consideration of the burden of symptoms, potential benefits and risks, patient's values, and the cost and burden of long-term treatment and monitoring.

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