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Park TY, Choi MY, Kong D, Yeo JK, Park MG. Do Strength and Anthropometric Size of the Lower Body Correlate with Serum Testosterone Levels? World J Mens Health 2024; 42:42.e49. [PMID: 38772534 DOI: 10.5534/wjmh.230381] [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: 12/26/2023] [Revised: 01/29/2024] [Accepted: 02/03/2024] [Indexed: 05/23/2024] Open
Abstract
PURPOSE Although lower body strength and size are often regarded as symbols of masculinity, their relationship to testosterone is unclear. This study aimed to determine the correlation between lower body strength, size, and testosterone levels. MATERIALS AND METHODS Serum testosterone levels, waist circumference, and body mass index (BMI) were measured in 69 men with erectile dysfunction (age >40 years). The circumferences of the thigh and calf were measured, and the muscle strength of the knee joints was evaluated using an isokinetic dynamometer. Patients were classified into three groups according to testosterone levels (group 1, <230 ng/dL; group 2, 230 to 350 ng/dL; group 3, >350 ng/dL). Differences in calf and thigh circumference, bilateral knee extension, and flexion strength between the three groups were investigated using a one-way analysis of variance. Pearson's chi-square test was used to assess differences in lifestyle habits and underlying diseases. A partial correlation analysis was conducted to determine the association between testosterone levels and lower body size and strength. RESULTS There was no difference in BMI among the three groups, but waist circumference was significantly larger in group 1 than in groups 2 and 3. When comparing weight-adjusted values, bilateral thigh circumference showed a significant difference among the three groups. There was also a significant difference between the three groups in the weight-adjusted left calf circumference and in the weight-adjusted right knee extension strength. The partial correlation test showed a significant positive correlation between thigh and calf circumference values adjusted for weight and serum testosterone levels. Weight-adjusted knee extension strength demonstrated a significant positive correlation with serum testosterone levels. CONCLUSIONS Weight-adjusted thigh and calf circumferences, along with the thigh-to-waist ratio, showed a positive correlation with testosterone levels. Weight-adjusted knee extension strength was positively correlated with testosterone levels. Therefore, a robust thigh and strong lower body are related to testosterone.
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Affiliation(s)
- Tae Yong Park
- Department of Medicine, Graduate School, Korea University, Seoul, Korea
- Department of Urology, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Moon Young Choi
- Department of Sports Science Convergence, Dongguk University, Seoul, Korea
| | - Doohwan Kong
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul, Korea
| | - Jeong Kyun Yeo
- Department of Urology, Inje University College of Medicine, Busan, Korea
| | - Min Gu Park
- Deparment of Urology, Korea University Anam Hospital, Seoul, Korea.
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do Val Lima PR, Ronconi KS, Morra EA, Rodrigues PL, Ávila RA, Merlo E, Graceli JB, Simões MR, Stefanon I, Ribeiro Júnior RF. Testosterone deficiency impairs cardiac interfibrillar mitochondrial function and myocardial contractility while inducing oxidative stress. Front Endocrinol (Lausanne) 2023; 14:1206387. [PMID: 37780627 PMCID: PMC10534000 DOI: 10.3389/fendo.2023.1206387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 07/06/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Clinical studies have shown that low levels of endogenous testosterone are associated with cardiovascular diseases. Considering the intimate connection between oxidative metabolism and myocardial contractility, we determined the effects of testosterone deficiency on the two spatially distinct subpopulations of cardiac mitochondria, subsarcolemmal (SSM) and interfibrillar (IFM). Methods We assessed cardiac function and cardiac mitochondria structure of SSM and IFM after 12 weeks of testosterone deficiency in male Wistar rats. Results and Discussion Results show that low testosterone reduced myocardial contractility. Orchidectomy increased total left ventricular mitochondrial protein in the SSM, but not in IFM. The membrane potential, size and internal complexity in the IFM after orchidectomy were higher compared to the SHAM group. However, the rate of oxidative phosphorylation with all substrates in the IFM after orchidectomy was lower compared to the SHAM group. Testosterone replacement restored these changes. In the testosterone-deficient SSM group, oxidative phosphorylation was decreased with palmitoyl-L-carnitine as substrate; however, the mitochondrial calcium retention capacity in IFM was increased. There was no difference in swelling of the mitochondria in either group. These changes in IFM were followed by a reduction in phosphorylated form of AMP-activated protein kinase (p-AMPK-α), peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α) translocation to mitochondria and decreased mitochondrial transcription factor A (TFAM). Testosterone deficiency increased NADPH oxidase (NOX), angiotensin converting enzyme (ACE) protein expression and reduced mitochondrial antioxidant proteins such as manganese superoxide dismutase (Mn-SOD) and catalase in the IFM. Treatment with apocynin (1.5 mM in drinking water) normalized myocardial contractility and interfibrillar mitochondrial function in the testosterone depleted animals. In conclusion, our findings demonstrate that testosterone deficiency leads to reduced myocardial contractility and impaired cardiac interfibrillar mitochondrial function. Our data suggest the involvement of reactive oxygen species, with a possibility of NOX as an enzymatic source.
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Affiliation(s)
| | - Karoline Sousa Ronconi
- Department of Physiological Sciences, Federal University of Espirito Santo, Vitoria, ES, Brazil
| | - Elis Aguiar Morra
- Department of Physiological Sciences, Federal University of Espirito Santo, Vitoria, ES, Brazil
| | - Paula Lopes Rodrigues
- Department of Physiological Sciences, Federal University of Espirito Santo, Vitoria, ES, Brazil
| | - Renata Andrade Ávila
- Department of Physiological Sciences, Federal University of Espirito Santo, Vitoria, ES, Brazil
| | - Eduardo Merlo
- Department of Morphology, Federal University of Espírito Santo, Vitoria, ES, Brazil
| | - Jones B. Graceli
- Department of Morphology, Federal University of Espírito Santo, Vitoria, ES, Brazil
| | - Maylla Ronacher Simões
- Department of Physiological Sciences, Federal University of Espirito Santo, Vitoria, ES, Brazil
| | - Ivanita Stefanon
- Department of Physiological Sciences, Federal University of Espirito Santo, Vitoria, ES, Brazil
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Liang X, He H, Zeng H, Wei L, Yang J, Wen Y, Fan S, Fan J. The relationship between polycystic ovary syndrome and coronary heart disease: a bibliometric analysis. Front Endocrinol (Lausanne) 2023; 14:1172750. [PMID: 37223024 PMCID: PMC10200869 DOI: 10.3389/fendo.2023.1172750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/14/2023] [Indexed: 05/25/2023] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is one of the most common gynecological endocrine diseases for women of puberty and reproductive age. PCOS can affect women's health for the rest of their lives since the incidence of coronary heart disease (CHD) may increase in the perimenopausal and senile periods among PCOS women compared with non-PCOS women. Method A literature retrieval based on the Science Citation Index Expanded (SCI-E) database. All obtained records results were downloaded in plain text format for subsequent analysis. VOSviewer v1.6.10, Citespace and Microsoft Excel 2010 software were utilized for analyzing the following terms: countries, institutions, authors, journals, references and keywords. Results There were 312 articles retrieved from January 1, 2000 to February 8, 2023, and the frequency of citations was 23,587. The United States, England, and Italy contributed the majority of the records. Harvard University, the University of Athens, and Monash University were the top 3 most productive institutions with publications on the relationship between PCOS and CHD. Journal of clinical endocrinology & metabolism ranked first with the highest publications (24 records), followed by Fertility and sterility (18 records). The keywords were divided into six clusters in the overlay keywords network: (1) the correlation between CHD risk factors and PCOS women; (2) the relationship between cardiovascular disease and female reproductive system hormone secretion; (3) the interaction between CHD and metabolic syndrome; (4) the relationship between c-reactive protein and endothelial function and oxidative stress in PCOS patients; (5) the potential positive effect of metformin on reducing CHD risk factors in PCOS patients; (6) the study of serum cholesterol and body-fat distribution in patients with CHD in PCOS. Oxidative stress, genome-wide association, obesity, primary prevention, and sex difference were main hotspots in this field in recent five years according to the keyword citation burst analysis. Conclusion The article obtained the hotspots and trends and provided a reference for subsequent research on the association between PCOS and CHD. Moreover, it is hypothesized that oxidative stress and genome-wide association were frontier hotspots in studies that explore the relationship between PCOS and CHD, and prevention research may be valued in the future.
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Affiliation(s)
- Xuzhi Liang
- Department of Gynecology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
| | - Haijing He
- Department of Gynecology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
| | - Hao Zeng
- Department of Gynecology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
| | - Liuyi Wei
- Department of Gynecology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
| | - Jiahuang Yang
- Department of Gynecology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
| | - Yuqi Wen
- Department of Gynecology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
| | - Siqi Fan
- Department of Ophthalmology, University of Bonn, Bonn, North Rhin-Westphalia, Germany
| | - Jiangtao Fan
- Department of Gynecology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
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Dearing C, Handa RJ, Myers B. Sex differences in autonomic responses to stress: implications for cardiometabolic physiology. Am J Physiol Endocrinol Metab 2022; 323:E281-E289. [PMID: 35793480 PMCID: PMC9448273 DOI: 10.1152/ajpendo.00058.2022] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 06/21/2022] [Accepted: 07/01/2022] [Indexed: 11/22/2022]
Abstract
Chronic stress is a significant risk factor for negative health outcomes. Furthermore, imbalance of autonomic nervous system control leads to dysregulation of physiological responses to stress and contributes to the pathogenesis of cardiometabolic and psychiatric disorders. However, research on autonomic stress responses has historically focused on males, despite evidence that females are disproportionality affected by stress-related disorders. Accordingly, this mini-review focuses on the influence of biological sex on autonomic responses to stress in humans and rodent models. The reviewed literature points to sex differences in the consequences of chronic stress, including cardiovascular and metabolic disease. We also explore basic rodent studies of sex-specific autonomic responses to stress with a focus on sex hormones and hypothalamic-pituitary-adrenal axis regulation of cardiovascular and metabolic physiology. Ultimately, emerging evidence of sex differences in autonomic-endocrine integration highlights the importance of sex-specific studies to understand and treat cardiometabolic dysfunction.
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Affiliation(s)
- Carley Dearing
- Department of Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Robert J Handa
- Department of Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Brent Myers
- Department of Biomedical Sciences, Colorado State University, Fort Collins, Colorado
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Krysiak R, Kowalcze K, Okopień B. The impact of hypotestosteronemia on cardiometabolic effects of atorvastatin in men with hypercholesterolemia: a pilot study. Coron Artery Dis 2021; 32:706-712. [PMID: 33826536 PMCID: PMC8912965 DOI: 10.1097/mca.0000000000001031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 01/25/2021] [Indexed: 12/02/2022]
Abstract
BACKGROUND Hypothyroidism, hyperprolactinemia, macroprolactinemia and low vitamin D status were found to impair pleiotropic effects of hypolipidemic agents. The aim of the current study was to investigate whether cardiometabolic effects of atorvastatin in men are determined by endogenous testosterone. METHODS We studied three groups of men matched for age, BMI, plasma lipids and blood pressure: 19 untreated subjects with low testosterone levels (group A), 19 normotestosteronemic men receiving testosterone preparations (group B) and 21 untreated men with testosterone levels within the reference range (group C). Because of coexistent hypercholesterolemia, all subjects were managed with atorvastatin (40 mg daily) for 6 months. Glucose homeostasis markers, plasma lipids, as well as circulating levels of testosterone, uric acid, high-sensitivity C-reactive protein (hsCRP), fibrinogen, homocysteine and 25-hydroxyvitamin D were determined at the beginning and at the end of the study. RESULTS At baseline, group A was more insulin-resistant and was characterized by higher levels of hsCRP, fibrinogen and homocysteine, and lower levels of 25-hydroxyvitamin D than the remaining groups of patients. Despite reducing total and low-density lipoprotein cholesterol and hsCRP levels in all treatment groups, this effect was stronger in groups B and C than in group A. In groups B and C, atorvastatin use was also associated with a decrease in uric acid, fibrinogen and homocysteine concentrations and with an increase in 25-hydroxyvitamin D levels. In group A, but not in the remaining groups, the drug decreased insulin sensitivity. CONCLUSION The obtained results suggest that untreated hypotestosteronemia may attenuate cardiometabolic effects of atorvastatin in men.
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Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology
| | - Karolina Kowalcze
- Department of Pediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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Wang YX, Chen XW, Wang SB, Gu LF, Li YF, Ma Y, Wang H, Wang LS. Association Between Androgenic Alopecia and Coronary Artery Disease: A Cross-Sectional Study of Han Chinese Male Population. Int J Gen Med 2021; 14:4809-4818. [PMID: 34475775 PMCID: PMC8406423 DOI: 10.2147/ijgm.s326812] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 08/13/2021] [Indexed: 12/17/2022] Open
Abstract
Purpose This research aimed to investigate the correlation between androgenic alopecia (AGA) and coronary artery disease (CAD) and analyze its value in predicting the severity of coronary atherosclerosis in the Han Chinese male population. Patients and Methods A total of 402 Han Chinese male patients aged 28-75 years were enrolled and performed coronary angiography (CAG) after admission. According to the BASP classification, the participants were divided into mild, moderate and severe AGA. CAD was determined via CAG and defined as stenosis of ≥50% in at least one major coronary artery, and the Gensini score was calculated to evaluate the severity of coronary atherosclerosis. Results In this study, CAD status (P = 0.002), dyslipidemia status (P = 0.002), age (P = 0.003) and coronary atherosclerosis severity (P < 0.001) were different in patients with different levels of AGA. Multivariate logistic regression analysis revealed that severe AGA was independently correlated to CAD risk (OR, 2.111; 95% CI 1.152 to 3.870, P = 0.016), while the relative CAD risk of early-onset AGA was 2.292 (OR, 2.292; 95% CI 1.132 to 4.640, P = 0.021). AGA status (OR, 2.247; 95% CI 1.396 to 3.617, P = 0.001), severe AGA (OR, 2.360; 95% CI 1.506 to 3.699, P < 0.001) and early-onset AGA (OR, 3.474; 95% CI 2.069 to 5.832, P < 0.001) were all independently associated with the severity of coronary atherosclerosis. The area under the receiver operating characteristic (ROC) curve plotted using severe AGA was 0.601, which is predictive of severe coronary atherosclerosis. Moreover, the presence of severe AGA increases the risk of developing CAD associated with obesity (SI = 1.663, SIM = 1.222, AP = 0.289), diabetes (SI = 2.239, SIM = 1.149, AP = 0.503) and dyslipidemia (SI = 1.062, SIM = 0.646, AP = 0.045). Conclusion This study suggested that AGA is independently associated with CAD in a Han Chinese male population. AGA may be a simple and feasible method for screening CAD and indicative of the severity of coronary atherosclerosis.
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Affiliation(s)
- Ya-Xin Wang
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Xiao-Wen Chen
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Si-Bo Wang
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Ling-Feng Gu
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Ya-Fei Li
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Yao Ma
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Hao Wang
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Lian-Sheng Wang
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
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Krysiak R, Basiak M, Szkróbka W, Okopień B. The impact of rosuvastatin on hypothalamic-pituitary-testicular axis activity in metformin-treated and metformin-naïve men with low testosterone levels: a pilot study. Pharmacol Rep 2021; 73:1465-1472. [PMID: 34086261 PMCID: PMC8460565 DOI: 10.1007/s43440-021-00289-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 11/27/2022]
Abstract
Background Intense statin therapy was found to impair testosterone production in men. Metformin administered to subjects with hypergonadotropic hypogonadism decreased gonadotropin production. The current study was aimed at investigating whether metformin treatment modulates the impact of high-dose rosuvastatin therapy on hypothalamic–pituitary–testicular axis activity in men. Methods The study included 43 very high cardiovascular risk men with late-onset hypogonadism, 20 of whom had been treated with metformin (1.7–3 g daily) for at least 6 months. In all subjects, unsuccessful initial statin treatment was replaced with rosuvastatin (20–40 mg daily). Plasma lipid levels, glucose homeostasis markers, as well as circulating levels of gonadotropins, testosterone, bioavailable testosterone, dehydroepiandrosterone-sulfate, prolactin, estradiol and creatinine were measured at the beginning of the study and 4 months later in 28 individuals in whom rosuvastatin reduced LDL cholesterol levels to below 70 mg/dL. Results There were no differences between treatment-induced changes in plasma lipids. In both study groups, rosuvastatin reduced total and bioavailable testosterone levels. However, only in metformin-naïve men, rosuvastatin increased LH and FSH levels and slightly impaired insulin sensitivity. The impact on gonadotropin concentrations correlated with treatment-induced decrease in testosterone levels. There were no significant differences between baseline and posttreatment values of dehydroepiandrosterone-sulfate, prolactin, estradiol and the glomerular filtration rate. Conclusion The obtained results suggest that metformin prevents the compensatory increase in gonadotrope function induced by intense statin therapy.
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Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Medyków 18, 40-752, Katowice, Poland.
| | - Marcin Basiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Medyków 18, 40-752, Katowice, Poland
| | - Witold Szkróbka
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Medyków 18, 40-752, Katowice, Poland
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Medyków 18, 40-752, Katowice, Poland
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Insights into the Functional Role of ADTRP (Androgen-Dependent TFPI-Regulating Protein) in Health and Disease. Int J Mol Sci 2021; 22:ijms22094451. [PMID: 33923232 PMCID: PMC8123165 DOI: 10.3390/ijms22094451] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/18/2021] [Accepted: 04/22/2021] [Indexed: 12/15/2022] Open
Abstract
The novel protein ADTRP, identified and described by us in 2011, is androgen-inducible and regulates the expression and activity of Tissue Factor Pathway Inhibitor, the major inhibitor of the Tissue Factor-dependent pathway of coagulation on endothelial cells. Single-nucleotide polymorphisms in ADTRP associate with coronary artery disease and myocardial infarction, and deep vein thrombosis/venous thromboembolism. Some athero-protective effects of androgen could exert through up-regulation of ADTRP expression. We discovered a critical role of ADTRP in vascular development and vessel integrity and function, manifested through Wnt signaling-dependent regulation of matrix metalloproteinase-9. ADTRP also hydrolyses fatty acid esters of hydroxy-fatty acids, which have anti-diabetic and anti-inflammatory effects and can control metabolic disorders. Here we summarize and analyze the knowledge on ADTRP and try to decipher its functions in health and disease.
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Molodovskaya IN. Functional state of the hypothalamus-pituitary-gonad axis in healthy men with various adaptation potential. Klin Lab Diagn 2021; 66:10-14. [PMID: 33567167 DOI: 10.18821/0869-2084-2021-66-1-10-14] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The characterization of the functioning of the blood circulatory system of the organism in terms of its ability to adapt to environmental conditions includes the definition of adaptive potential (AP). The purpose of the study is to supplement the idea of adaptive potential in the aspect of its association with indicators of the hypothalamus-pituitary-gonadal system in healthy men living in the climatic conditions of the Arctic zone of the Russian Federation. The study involved 94 apparently healthy men. Serum hormone levels of the hypothalamus-pituitary-gonadal system were determined by enzyme-linked immunosorbent assay. Percent of men with satisfactory adaptation was 67%. Markers of increased tension in adaptive mechanisms include a decrease in values of testosterone, sex hormone -binding globulin, and testosterone / estradiol ratio. It has been shown that in individuals with a 4-th degree of adaptive potential, the activity of the pituitary-gonadal and the pituitary-adrenal cortex systems participating in the maintenance of the circulatory system is suppressed. That may be associated with a decrease in the reserves of hormone synthesis in these systems. An increase in the tension of the adaptive mechanisms of the circulatory system occurs with a decrease in the levels of anabolic hormones and a simultaneous increase in the level of estradiol as a compensatory reaction to maintain the function of the cardiovascular system. It is established that when moving northward beyond the border of the Arctic Circle an increase in the tension of the adaptive mechanisms of the circulatory system is noted for men living in extreme climatic conditions. The results of the study show a negative correlation of adaptive potential with the values of testosterone, sex hormone-binding globulin and the testosterone / estradiol ratio. The tension of the adaptive mechanisms of the blood circulatory system occurs with decreased sex hormones levels, which can be considered as a marker of disadaptation changes amid the risk of the ecological well-being of the population.
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Ooi DSQ, Ong SM, Eng MH, Chan YH, Lee YS, Low AFH, Chan MYY, Heng CK. Detection of ADTRP in circulation and its role as a novel biomarker for coronary artery disease. PLoS One 2020; 15:e0237074. [PMID: 32790694 PMCID: PMC7425853 DOI: 10.1371/journal.pone.0237074] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 07/20/2020] [Indexed: 02/01/2023] Open
Abstract
Androgen dependent tissue factor pathway inhibitor regulating protein (ADTRP) is a novel protein associated with coronary artery disease (CAD) susceptibility, and reduced mRNA expression of ADTRP was shown to be associated with increased CAD risk. This study aimed to determine and compare circulating ADTRP levels between CAD patients and controls, and to test the performance of plasma ADTRP as a biomarker for CAD. We measured plasma ADTRP, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and high sensitivity-C reactive protein (hs-CRP) levels in 362 CAD patients, 150 angiographically negative CAD controls, and 83 healthy adults with no known clinical or medical conditions using commercial ELISA. Statistical analyses were performed using receiver operator characteristic (ROC) curves, quantile regression and logistic regression, with adjustments for age, gender, ethnicity and BMI. CAD patients had significantly lower plasma ADTRP levels 1,545 (1,087–2,408) pg/ml as compared to CAD controls 2,259 (1,533–3,778) pg/ml and healthy adults 3,904 (2,732–5,463) pg/ml. Plasma ADTRP outperformed the other three inflammatory biomarkers (TNF-α, IL-6 and hs-CRP) for CAD (Area under ROC curve: 0.67, Odds ratio (OR): 0.907). Our study has shown for the first time that ADTRP is present in circulation, and that plasma ADTRP may be a novel independent biomarker for CAD.
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Affiliation(s)
- Delicia Shu Qin Ooi
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore
| | - Sze Min Ong
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore
| | - Ming Hui Eng
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School Medicine, National University of Singapore, Singapore, Singapore
| | - Yung Seng Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore
| | - Adrian Fatt Hoe Low
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- National University Heart Centre, National University Health System, Singapore, Singapore
| | - Mark Yan-Yee Chan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- National University Heart Centre, National University Health System, Singapore, Singapore
| | - Chew-Kiat Heng
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore
- * E-mail:
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Huo YN, Yeh SD, Lee WS. Androgen receptor activation reduces the endothelial cell proliferation through activating the cSrc/AKT/p38/ERK/NFκB-mediated pathway. J Steroid Biochem Mol Biol 2019; 194:105459. [PMID: 31470108 DOI: 10.1016/j.jsbmb.2019.105459] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/06/2019] [Accepted: 08/25/2019] [Indexed: 12/23/2022]
Abstract
The effect of androgen on angiogenesis has been documented. However, its underlying molecular mechanisms have not been well illustrated. Here, we show that treatment with an androgen receptor (AR) agonist, metribolone (R1881; 0.05-5 nM), or dihydrotestosterone (DHT; 0.5-2 nM), concentration- and time-dependently inhibited proliferation in human umbilical venous endothelial cells (HUVEC). This inhibitory effect was confirmed in human microvascular endothelial cells (HMEC-1). Flow cytometric analysis demonstrated that R1881 induced G0/G1 phase cell cycle arrest in HUVEC. Blockade of the AR activity by pre-treatment with an AR antagonist, hydroxyflutamide (HF), or knockdown of AR expression using the shRNA technique abolished the R1881-induced HUVEC proliferation inhibition, suggesting that AR activation can inhibit endothelial cell proliferation. We further investigated the signaling pathway contributing to the proliferation inhibition induced by AR activation. Our data suggest that R1881 reduced the proliferation rate of HUVEC through activating the AR/cSrc/AKT/p38/ERK/NFκB pathway, subsequently up-regulating p53 expression, which in turn increased the levels of p21 and p27 protein, hence decreasing the activities of cyclin-dependent kinase 2 (CDK2) and CDK4, and finally reduced the cell proliferation rate. An extra-nuclear pathway involved in the proliferation inhibition induced by AR activation in vascular endothelial cells was confirmed by showing that membrane-impermeable testosterone-bovine serum albumin (BSA) treatment significantly increased the levels of p53, p27 and p21 protein and reduced cell proliferation. These data highlight the underlying molecular mechanisms by which AR activation induced proliferation inhibition in vascular endothelial cells.
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Affiliation(s)
- Yen-Nien Huo
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Shauh-Der Yeh
- Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan; Department of Urology, Taipei Medical University Hospital, Taipei 110, Taiwan; Comprehensive Cancer Center, Taipei Medical University, Taipei 110, Taiwan
| | - Wen-Sen Lee
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 110, Taiwan; Department of Physiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan; Cancer Research Center, Taipei Medical University Hospital, Taipei 110, Taiwan; Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taiwan.
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12
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Chistiakov DA, Myasoedova VA, Melnichenko AA, Grechko AV, Orekhov AN. Role of androgens in cardiovascular pathology. Vasc Health Risk Manag 2018; 14:283-290. [PMID: 30410343 PMCID: PMC6198881 DOI: 10.2147/vhrm.s173259] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Cardiovascular effects of android hormones in normal and pathological conditions can lead to either positive or negative effects. The reason for this variation is unknown, but may be influenced by gender-specific effects of androids, heterogeneity of the vascular endothelium, differential expression of the androgen receptor in endothelial cells (ECs) and route of androgen administration. Generally, androgenic hormones are beneficial for ECs because these hormones induce nitric oxide production, proliferation, motility, and growth of ECs and inhibit inflammatory activation and induction of procoagulant, and adhesive properties in ECs. This indeed prevents endothelial dysfunction, an essential initial step in the development of vascular pathologies, including atherosclerosis. However, androgens can also activate endothelial production of some vasoconstrictors, which can have detrimental effects on the vascular endothelium. Androgens also activate proliferation, migration, and recruitment of endothelial progenitor cells (EPCs), thereby contributing to vascular repair and restoration of the endothelial layer. In this paper, we consider effects of androgen hormones on EC and EPC function in physiological and pathological conditions.
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Affiliation(s)
- Dimitry A Chistiakov
- Department of Neurochemistry, Division of Basic and Applied Neurobiology, Serbsky Federal Medical Research Center of Psychiatry and Narcology, Moscow, Russia
| | - Veronika A Myasoedova
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, Moscow, Russia,
| | - Alexandra A Melnichenko
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, Moscow, Russia,
| | - Andrey V Grechko
- Federal Scientific Clinical Center for Resuscitation and Rehabilitation, Moscow, Russia
| | - Alexander N Orekhov
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, Moscow, Russia, .,Institute for Atherosclerosis Research, Skolkovo Innovative Center, Moscow, Russia,
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13
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Luo C, Pook E, Tang B, Zhang W, Li S, Leineweber K, Cheung SH, Chen Q, Bechem M, Hu JS, Laux V, Wang QK. Androgen inhibits key atherosclerotic processes by directly activating ADTRP transcription. Biochim Biophys Acta Mol Basis Dis 2017. [PMID: 28645652 DOI: 10.1016/j.bbadis.2017.06.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Low androgen levels are associated with an increased risk of coronary artery disease (CAD), thrombosis and myocardial infarction (MI), suggesting that androgen has a protective role. However, little is known about the underlying molecular mechanism. Our genome-wide association study identified the ADTRP gene encoding the androgen-dependent TFPI regulating protein as a susceptibility gene for CAD and MI. The expression level of ADTRP was regulated by androgen, but the molecular mechanism is unknown. In this study, we identified the molecular mechanism by which androgen regulates ADTRP expression and tested the hypothesis that androgen plays a protective role in cardiovascular disease by activating ADTRP expression. Luciferase assays with an ADTRP promoter luciferase reporter revealed that androgen regulated ADTRP transcription in a dose- and time-dependent manner, and the effect was abolished by three different androgen inhibitors, including pyrvinium pamoate, bicalutamide, and cyproterone acetate. Chromatin-immunoprecipitation showed that the androgen receptor bound to a half androgen response element (ARE, TGTTCT) located at +324bp from the ADTRP transcription start site. The ARE is required for concentration-dependent transcriptional activation of ADTRP. HL-60 monocyte adhesion to EAhy926 endothelial cells (ECs) and transmigration across the EC layer, the two processes critical to development of CAD and MI, were inhibited by androgen, but the effect was rescued by ADTRP siRNA and exacerbated by overexpression of ADTRP and its downstream genes PIK3R3 and MIA3. These data suggest that one molecular mechanism by which androgen confers protection against CAD is stimulation of ADTRP expression.
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Affiliation(s)
- Chunyan Luo
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Cardio-Institute, Huazhong University of Science and Technology, Wuhan 430074, PR China
| | | | - Bo Tang
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Cardio-Institute, Huazhong University of Science and Technology, Wuhan 430074, PR China
| | - Weiyi Zhang
- Bayer Healthcare Co Ltd, Innovation Center China, Beijing, PR China
| | - Sisi Li
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Cardio-Institute, Huazhong University of Science and Technology, Wuhan 430074, PR China
| | | | - Shing-Hu Cheung
- Bayer Healthcare Co Ltd, Innovation Center China, Beijing, PR China
| | - Qiuyun Chen
- Center for Cardiovascular Genetics, Department of Molecular Cardiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH 44195, USA
| | | | - Jing-Shan Hu
- Bayer Healthcare Co Ltd, Innovation Center China, Beijing, PR China
| | - Volker Laux
- Bayer AG, Drug Discovery, 42096 Wuppertal, Germany.
| | - Qing Kenneth Wang
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Cardio-Institute, Huazhong University of Science and Technology, Wuhan 430074, PR China; Center for Cardiovascular Genetics, Department of Molecular Cardiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH 44195, USA.
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14
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Atwood CS, Hayashi K, Meethal SV, Gonzales T, Bowen RL. Does the degree of endocrine dyscrasia post-reproduction dictate post-reproductive lifespan? Lessons from semelparous and iteroparous species. GeroScience 2017; 39:103-116. [PMID: 28271270 PMCID: PMC5352586 DOI: 10.1007/s11357-016-9955-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 12/23/2016] [Indexed: 12/16/2022] Open
Abstract
Post-reproductive lifespan varies greatly among species; human post-reproductive lifespan comprises ~30-50% of their total longevity, while semelparous salmon and dasyurid marsupials post-reproductive lifespan comprises <4% of their total longevity. To examine if the magnitude of hypothalamic-pituitary-gonadal (HPG) axis dyscrasia at the time of reproductive senescence determines post-reproductive lifespan, we examined the difference between pre- and post-reproductive (1) circulating sex hormones and (2) the ratio of sex steroids to gonadotropins (e.g., 17β-estradiol/follicle-stimulating hormone (FSH)), an index of the dysregulation of the HPG axis and the level of dyotic (death) signaling post-reproduction. Animals with a shorter post-reproductive lifespan (<4% total longevity) had a more marked decline in circulating sex steroids and corresponding elevation in gonadotropins compared to animals with a longer post-reproductive lifespan (30-60% total longevity). In semelparous female salmon of short post-reproductive lifespan (1%), these divergent changes in circulating hormone concentration post-reproduction equated to a 711-fold decrease in the ratio of 17β-estradiol/FSH between the reproductive and post-reproductive periods. In contrast, the decrease in the ratio of 17β-estradiol/FSH in iteroparous female mammals with long post-reproductive lifespan was significantly less (1.7-34-fold) post-reproduction. Likewise, in male semelparous salmon, the decrease in the ratio of testosterone/FSH (82-fold) was considerably larger than for iteroparous species (1.3-11-fold). These results suggest that (1) organisms with greater reproductive endocrine dyscrasia more rapidly undergo senescence and die, and (2) the contribution post-reproduction by non-gonadal (and perhaps gonadal) tissues to circulating sex hormones dictates post-reproductive tissue health and longevity. In this way, reproduction and longevity are coupled, with the degree of non-gonadal tissue hormone production dictating the rate of somatic tissue demise post-reproduction and the differences in post-reproductive lifespans between species.
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Affiliation(s)
- Craig S Atwood
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, William S. Middleton Memorial VA (GRECC 11G), 2500 Overlook Terrace, Madison, WI, 53705, USA.
- Geriatric Research, Education and Clinical Center, Veterans Administration Hospital, Madison, WI, 53705, USA.
- School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Joondalup, WA, 6027, Australia.
| | - Kentaro Hayashi
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, William S. Middleton Memorial VA (GRECC 11G), 2500 Overlook Terrace, Madison, WI, 53705, USA
| | - Sivan Vadakkadath Meethal
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, William S. Middleton Memorial VA (GRECC 11G), 2500 Overlook Terrace, Madison, WI, 53705, USA
| | - Tina Gonzales
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, William S. Middleton Memorial VA (GRECC 11G), 2500 Overlook Terrace, Madison, WI, 53705, USA
| | - Richard L Bowen
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, 29425, USA
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15
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Hamilton EJ, Davis WA, Makepeace A, Lim EM, Yeap BB, Peters KE, Davis TME. Prevalence and prognosis of a low serum testosterone in men with type 2 diabetes: the Fremantle Diabetes Study Phase II. Clin Endocrinol (Oxf) 2016; 85:444-52. [PMID: 27106511 DOI: 10.1111/cen.13087] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 03/17/2016] [Accepted: 04/21/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Because published studies have usually involved imprecise assays and selected patients with limited additional data and follow-up, the consequences of a low serum testosterone in diabetes are unclear. This study assessed the prevalence, associates and prognosis of a low testosterone in community-dwelling men with type 2 diabetes. DESIGN Longitudinal observational study. PATIENTS 788 men (mean ± SD age: 65·8 ± 11·3 years) followed for 4·0 ± 1·1 years. MEASUREMENTS Serum testosterone, SHBG, erectile dysfunction (ED; Sexual Health Inventory for Men score <22), anaemia (haemoglobin <130 g/l), all-cause mortality. RESULTS The mean ± SD total serum testosterone by liquid chromatography/mass spectrometry was 13·1 ± 5·9 nmol/l (30·6% <10 nmol/l). Most men with a total testosterone <10 nmol/l (67·0%) had a normal/low serum LH. Serum testosterone was independently associated with anaemia (P < 0·001), but not ED (P = 0·80), in logistic regression models. The optimal cut-point (Youden Index) for anaemia was 9·8 nmol/l (sensitivity 53·6%, specificity 75·4%). During the follow-up, 102 men (12·9%) died. There was a U-shaped relationship between total serum testosterone quintiles and death (P = 0·003, log rank test). The middle quintile (>11·1 to ≤13·7 nmol/l) had the lowest risk and there was a 78% increased risk for highest (>16·9 nmol/l) vs lowest (≤8·6 nmol/l) quintile in Cox proportional hazards modelling (P = 0·036). Free serum testosterone and SHBG quintiles were not associated with death. CONCLUSIONS These data provide some support for the general conventional serum testosterone <10 nmol/l cut-point in identifying an increased risk of anaemia and the subsequent death in men with type 2 diabetes, but indicate that high-normal levels are also an adverse prognostic indicator.
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Affiliation(s)
- Emma J Hamilton
- School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley and Fremantle Hospitals, Murdoch and Fremantle, WA, Australia
| | - Wendy A Davis
- School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia
| | - Ashley Makepeace
- School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley and Fremantle Hospitals, Murdoch and Fremantle, WA, Australia
| | - Ee Mun Lim
- Department of Biochemistry, PathWest Laboratory Medicine WA, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Bu B Yeap
- School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley and Fremantle Hospitals, Murdoch and Fremantle, WA, Australia
| | - Kirsten E Peters
- School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia
| | - Timothy M E Davis
- School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia
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16
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Bielanowicz A, Johnson RW, Goh H, Moody SC, Poulton IJ, Croce N, Loveland KL, Hedger MP, Sims NA, Itman C. Prepubertal Di-n-Butyl Phthalate Exposure Alters Sertoli and Leydig Cell Function and Lowers Bone Density in Adult Male Mice. Endocrinology 2016; 157:2595-603. [PMID: 27058814 DOI: 10.1210/en.2015-1936] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Phthalate exposure impairs testis development and function; however, whether phthalates affect nonreproductive functions is not well understood. To investigate this, C57BL/6J mice were fed 1-500 mg di-n-butyl phthalate (DBP) in corn oil, or vehicle only, daily from 4 to 14 days, after which tissues were collected (prepubertal study). Another group was fed 1-500 mg/kg·d DBP from 4 to 21 days and then maintained untreated until 8 weeks for determination of adult consequences of prepubertal exposure. Bones were assessed by microcomputed tomography and dual-energy X-ray absorptiometry and T by RIA. DBP exposure decreased prepubertal femur length, marrow volume, and mean moment of inertia. Adult animals exposed prepubertally to low DBP doses had lower bone mineral content and bone mineral density and less lean tissue mass than vehicle-treated animals. Altered dynamics of the emerging Leydig population were found in 14-day-old animals fed 100-500 mg/kg·d DBP. Adult mice had variable testicular T and serum T and LH concentrations after prepubertal exposure and a dose-dependent reduction in cytochrome p450, family 11, subfamily A, polypeptide 1. Insulin-like 3 was detected in Sertoli cells of adult mice administered the highest dose of 500 mg/kg·d DBP prepubertally, a finding supported by the induction of insulin-like 3 expression in TM4 cells exposed to 50 μM, but not 5 μM, DBP. We propose that low-dose DBP exposure is detrimental to bone but that normal bone mineral density/bone mineral content after high-dose DBP exposure reflects changes in testicular somatic cells that confer protection to bones. These findings will fuel concerns that low-dose DBP exposure impacts health beyond the reproductive axis.
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Affiliation(s)
- Amanda Bielanowicz
- Priority Research Centres for Reproductive Science and Chemical Biology, School of Environmental and Life Sciences (A.B., C.I.), and School of Mathematical and Physical Sciences (N.C.), Faculty of Science and Information Technology, University of Newcastle, Callaghan, New South Wales 2308, Australia; St Vincent's Institute of Medical Research (R.W.J., I.J.P., N.A.S.) and Department of Medicine at St. Vincent's Hospital (R.W.J., I.J.P., N.A.S.), The University of Melbourne, Fitzroy, Victoria 3065, Australia; Departments of Biochemistry and Molecular Biology (H.G., K.L.L.), Anatomy and Developmental Biology (S.C.M., K.L.L.), and Molecular Translational Sciences (K.L.L.), Monash University, and Hudson Institute of Medical Research (K.L.L., M.P.H.), Clayton, Victoria 3800, Australia; and Faculty of Science, Health, Education, and Engineering (C.I.), School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, Queensland 4556, Australia
| | - Rachelle W Johnson
- Priority Research Centres for Reproductive Science and Chemical Biology, School of Environmental and Life Sciences (A.B., C.I.), and School of Mathematical and Physical Sciences (N.C.), Faculty of Science and Information Technology, University of Newcastle, Callaghan, New South Wales 2308, Australia; St Vincent's Institute of Medical Research (R.W.J., I.J.P., N.A.S.) and Department of Medicine at St. Vincent's Hospital (R.W.J., I.J.P., N.A.S.), The University of Melbourne, Fitzroy, Victoria 3065, Australia; Departments of Biochemistry and Molecular Biology (H.G., K.L.L.), Anatomy and Developmental Biology (S.C.M., K.L.L.), and Molecular Translational Sciences (K.L.L.), Monash University, and Hudson Institute of Medical Research (K.L.L., M.P.H.), Clayton, Victoria 3800, Australia; and Faculty of Science, Health, Education, and Engineering (C.I.), School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, Queensland 4556, Australia
| | - Hoey Goh
- Priority Research Centres for Reproductive Science and Chemical Biology, School of Environmental and Life Sciences (A.B., C.I.), and School of Mathematical and Physical Sciences (N.C.), Faculty of Science and Information Technology, University of Newcastle, Callaghan, New South Wales 2308, Australia; St Vincent's Institute of Medical Research (R.W.J., I.J.P., N.A.S.) and Department of Medicine at St. Vincent's Hospital (R.W.J., I.J.P., N.A.S.), The University of Melbourne, Fitzroy, Victoria 3065, Australia; Departments of Biochemistry and Molecular Biology (H.G., K.L.L.), Anatomy and Developmental Biology (S.C.M., K.L.L.), and Molecular Translational Sciences (K.L.L.), Monash University, and Hudson Institute of Medical Research (K.L.L., M.P.H.), Clayton, Victoria 3800, Australia; and Faculty of Science, Health, Education, and Engineering (C.I.), School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, Queensland 4556, Australia
| | - Sarah C Moody
- Priority Research Centres for Reproductive Science and Chemical Biology, School of Environmental and Life Sciences (A.B., C.I.), and School of Mathematical and Physical Sciences (N.C.), Faculty of Science and Information Technology, University of Newcastle, Callaghan, New South Wales 2308, Australia; St Vincent's Institute of Medical Research (R.W.J., I.J.P., N.A.S.) and Department of Medicine at St. Vincent's Hospital (R.W.J., I.J.P., N.A.S.), The University of Melbourne, Fitzroy, Victoria 3065, Australia; Departments of Biochemistry and Molecular Biology (H.G., K.L.L.), Anatomy and Developmental Biology (S.C.M., K.L.L.), and Molecular Translational Sciences (K.L.L.), Monash University, and Hudson Institute of Medical Research (K.L.L., M.P.H.), Clayton, Victoria 3800, Australia; and Faculty of Science, Health, Education, and Engineering (C.I.), School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, Queensland 4556, Australia
| | - Ingrid J Poulton
- Priority Research Centres for Reproductive Science and Chemical Biology, School of Environmental and Life Sciences (A.B., C.I.), and School of Mathematical and Physical Sciences (N.C.), Faculty of Science and Information Technology, University of Newcastle, Callaghan, New South Wales 2308, Australia; St Vincent's Institute of Medical Research (R.W.J., I.J.P., N.A.S.) and Department of Medicine at St. Vincent's Hospital (R.W.J., I.J.P., N.A.S.), The University of Melbourne, Fitzroy, Victoria 3065, Australia; Departments of Biochemistry and Molecular Biology (H.G., K.L.L.), Anatomy and Developmental Biology (S.C.M., K.L.L.), and Molecular Translational Sciences (K.L.L.), Monash University, and Hudson Institute of Medical Research (K.L.L., M.P.H.), Clayton, Victoria 3800, Australia; and Faculty of Science, Health, Education, and Engineering (C.I.), School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, Queensland 4556, Australia
| | - Nic Croce
- Priority Research Centres for Reproductive Science and Chemical Biology, School of Environmental and Life Sciences (A.B., C.I.), and School of Mathematical and Physical Sciences (N.C.), Faculty of Science and Information Technology, University of Newcastle, Callaghan, New South Wales 2308, Australia; St Vincent's Institute of Medical Research (R.W.J., I.J.P., N.A.S.) and Department of Medicine at St. Vincent's Hospital (R.W.J., I.J.P., N.A.S.), The University of Melbourne, Fitzroy, Victoria 3065, Australia; Departments of Biochemistry and Molecular Biology (H.G., K.L.L.), Anatomy and Developmental Biology (S.C.M., K.L.L.), and Molecular Translational Sciences (K.L.L.), Monash University, and Hudson Institute of Medical Research (K.L.L., M.P.H.), Clayton, Victoria 3800, Australia; and Faculty of Science, Health, Education, and Engineering (C.I.), School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, Queensland 4556, Australia
| | - Kate L Loveland
- Priority Research Centres for Reproductive Science and Chemical Biology, School of Environmental and Life Sciences (A.B., C.I.), and School of Mathematical and Physical Sciences (N.C.), Faculty of Science and Information Technology, University of Newcastle, Callaghan, New South Wales 2308, Australia; St Vincent's Institute of Medical Research (R.W.J., I.J.P., N.A.S.) and Department of Medicine at St. Vincent's Hospital (R.W.J., I.J.P., N.A.S.), The University of Melbourne, Fitzroy, Victoria 3065, Australia; Departments of Biochemistry and Molecular Biology (H.G., K.L.L.), Anatomy and Developmental Biology (S.C.M., K.L.L.), and Molecular Translational Sciences (K.L.L.), Monash University, and Hudson Institute of Medical Research (K.L.L., M.P.H.), Clayton, Victoria 3800, Australia; and Faculty of Science, Health, Education, and Engineering (C.I.), School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, Queensland 4556, Australia
| | - Mark P Hedger
- Priority Research Centres for Reproductive Science and Chemical Biology, School of Environmental and Life Sciences (A.B., C.I.), and School of Mathematical and Physical Sciences (N.C.), Faculty of Science and Information Technology, University of Newcastle, Callaghan, New South Wales 2308, Australia; St Vincent's Institute of Medical Research (R.W.J., I.J.P., N.A.S.) and Department of Medicine at St. Vincent's Hospital (R.W.J., I.J.P., N.A.S.), The University of Melbourne, Fitzroy, Victoria 3065, Australia; Departments of Biochemistry and Molecular Biology (H.G., K.L.L.), Anatomy and Developmental Biology (S.C.M., K.L.L.), and Molecular Translational Sciences (K.L.L.), Monash University, and Hudson Institute of Medical Research (K.L.L., M.P.H.), Clayton, Victoria 3800, Australia; and Faculty of Science, Health, Education, and Engineering (C.I.), School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, Queensland 4556, Australia
| | - Natalie A Sims
- Priority Research Centres for Reproductive Science and Chemical Biology, School of Environmental and Life Sciences (A.B., C.I.), and School of Mathematical and Physical Sciences (N.C.), Faculty of Science and Information Technology, University of Newcastle, Callaghan, New South Wales 2308, Australia; St Vincent's Institute of Medical Research (R.W.J., I.J.P., N.A.S.) and Department of Medicine at St. Vincent's Hospital (R.W.J., I.J.P., N.A.S.), The University of Melbourne, Fitzroy, Victoria 3065, Australia; Departments of Biochemistry and Molecular Biology (H.G., K.L.L.), Anatomy and Developmental Biology (S.C.M., K.L.L.), and Molecular Translational Sciences (K.L.L.), Monash University, and Hudson Institute of Medical Research (K.L.L., M.P.H.), Clayton, Victoria 3800, Australia; and Faculty of Science, Health, Education, and Engineering (C.I.), School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, Queensland 4556, Australia
| | - Catherine Itman
- Priority Research Centres for Reproductive Science and Chemical Biology, School of Environmental and Life Sciences (A.B., C.I.), and School of Mathematical and Physical Sciences (N.C.), Faculty of Science and Information Technology, University of Newcastle, Callaghan, New South Wales 2308, Australia; St Vincent's Institute of Medical Research (R.W.J., I.J.P., N.A.S.) and Department of Medicine at St. Vincent's Hospital (R.W.J., I.J.P., N.A.S.), The University of Melbourne, Fitzroy, Victoria 3065, Australia; Departments of Biochemistry and Molecular Biology (H.G., K.L.L.), Anatomy and Developmental Biology (S.C.M., K.L.L.), and Molecular Translational Sciences (K.L.L.), Monash University, and Hudson Institute of Medical Research (K.L.L., M.P.H.), Clayton, Victoria 3800, Australia; and Faculty of Science, Health, Education, and Engineering (C.I.), School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, Queensland 4556, Australia
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17
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Krysiak R, Gilowski W, Okopien B. The Effect of Testosterone and Fenofibrate, Administered Alone or in Combination, on Cardiometabolic Risk Factors in Men with Late-Onset Hypogonadism and Atherogenic Dyslipidemia. Cardiovasc Ther 2016; 33:270-4. [PMID: 26031507 DOI: 10.1111/1755-5922.12139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Oral testosterone was found to reduce plasma levels of HDL cholesterol. No previous study has examined the effect of fibrates, known to increase HDL cholesterol, in patients with low testosterone levels requiring testosterone replacement. AIMS The study included three age-, weight-, and lipid-matched groups of older men with atherogenic dyslipidemia and late-onset hypogonadism, treated with oral testosterone undecanoate (120 mg daily, n = 15), micronized fenofibrate (200 mg daily, n = 15), or testosterone plus fenofibrate (n = 18). Plasma lipids, glucose homeostasis markers, as well as plasma levels of androgens, uric acid, high-sensitivity C-reactive protein (hsCRP), homocysteine, and fibrinogen were assessed before and after 16 weeks of therapy. RESULTS Apart from an increase in plasma testosterone and a reduction in HDL cholesterol, testosterone undecanoate tended to decrease hsCRP and to improve insulin sensitivity. Fenofibrate administered alone increased HDL cholesterol, reduced triglycerides, decreased insulin resistance, reduced circulating levels of uric acid, hsCRP, and fibrinogen, as well as increased plasma levels of homocysteine. The strongest effect on testosterone, HOMA1-IR, uric acid, hsCRP, and fibrinogen was observed if fenofibrate was administered together with testosterone. Testosterone-fenofibrate combination therapy was also devoid of unfavorable effect on HDL cholesterol and homocysteine. CONCLUSIONS Our study shows that fenofibrate produces a stronger effect on cardiometabolic risk factors in men with late-onset hypogonadism and atherogenic dyslipidemia than oral testosterone undecanoate. The obtained results suggest that this group of patients may benefit the most from the combined treatment with oral testosterone undecanoate and micronized fenofibrate.
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Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
| | - Wojciech Gilowski
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.,Cardiology Department, Chrzanow District Hospital, Chrzanow, Poland
| | - Bogusław Okopien
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
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18
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Travison TG, O'Donnell CJ, Bhasin S, Massaro JM, Hoffmann U, Vasan RS, D'Agostino RB, Basaria S. Circulating Sex Steroids and Vascular Calcification in Community-Dwelling Men: The Framingham Heart Study. J Clin Endocrinol Metab 2016; 101:2160-7. [PMID: 26930184 PMCID: PMC4870846 DOI: 10.1210/jc.2015-4299] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The relationship between sex steroids and atherosclerosis is poorly understood. OBJECTIVE To describe the association of serum total T (TT), calculated free T (cFT), estrone (E1), estradiol (E2), and SHBG to vascular calcification in adult men. DESIGN Observational study (Framingham Heart Study). Analyses are cross-sectional. TT, E1, and E2 were measured by liquid chromatography-tandem mass spectrometry, and SHBG by immunofluorometric assay. Estimates of association were obtained by Tobit regression, which acknowledges the influence of floor effects on outcomes. SETTING General community. PARTICIPANTS A total of 1654 community-dwelling men from the Offspring and Third Generation cohorts of the Framingham Heart Study. MAIN OUTCOME MEASURES Coronary artery calcification (CAC), abdominal aortic calcification, and thoracic aortic calcification were measured by computed tomography. RESULTS Mean (standard deviation [SD]) age was 49 (10) years. Mean (SD) TT, cFT, and SHBG were: 616 (224) ng/dL, 111 (45) pg/mL, and 46 (23) nmol/L, respectively. Mean (SD) E2 and E1 were 28 (10) and 39 (14) pg/mL. Vascular calcification at all sites was negatively associated with TT and cFT and positively associated with E2 and E1. A 100-ng/dL between-subjects increase in TT was associated with a mean (95% confidence interval) age-adjusted difference in CAC of -23% (-41%, -4%) (P = .02). After model adjustment for other cardiovascular risk factors, the estimated associations between T and vascular calcification scores were statistically nonsignificant. CONCLUSIONS Decreased circulating T and E2 levels are associated with an age-adjusted increase in CAC, but these associations appear to express relationships either attributable to or mediated by established cardiovascular risk factors.
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Affiliation(s)
- Thomas G Travison
- Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215
| | - Christopher J O'Donnell
- Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215
| | - Shalender Bhasin
- Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215
| | - Joseph M Massaro
- Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215
| | - Udo Hoffmann
- Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215
| | - Ramachandran S Vasan
- Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215
| | - Ralph B D'Agostino
- Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215
| | - Shehzad Basaria
- Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215
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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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20
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Krysiak R, Gilowski W, Okopień B. The effect of testosterone on cardiometabolic risk factors in atorvastatin-treated men with late-onset hypogonadism. Pharmacol Rep 2015; 68:196-200. [PMID: 26721373 DOI: 10.1016/j.pharep.2015.08.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 07/29/2015] [Accepted: 08/12/2015] [Indexed: 01/02/2023]
Abstract
BACKGROUND By reducing LDL cholesterol levels, statins may decrease androgen production. This study was aimed at investigating whether testosterone treatment has an impact on cardiometabolic risk factors in statin-treated men with late-onset hypogonadism (LOH). METHODS The study included 31 men with LOH who had been treated for at least 6 months with atorvastatin (20-40mg daily). On the basis of patient preference, atorvastatin-treated patients were divided into two matched groups of patients: receiving intramuscular testosterone enanthate (100mg weekly, n=16) and not treated with this hormone (n=15). Plasma lipids, glucose homeostasis markers, as well as plasma levels of androgens, uric acid, high-sensitivity C-reactive protein (hsCRP), homocysteine, and fibrinogen were assessed before and after 4 months of therapy. RESULTS Compared with the control age-, weight, and lipid-matched statin-naïve subjects with LOH (n=12), atorvastatin-treated patients were characterized by decreased levels of testosterone, hsCRP, and homocysteine. In patients not receiving testosterone therapy, plasma lipids, glucose homeostasis markers, as well as plasma levels of the investigated risk factors remained at the similar levels throughout the whole period of atorvastatin treatment. In atorvastatin-naïve patients, testosterone increased its plasma levels and decreased HDL cholesterol. Apart from an increase in testosterone levels, if administered to atorvastatin-treated subjects with LOH, testosterone reduced plasma levels of LDL cholesterol, uric acid, hsCRP, homocysteine, and fibrinogen, as well as improved insulin sensitivity. CONCLUSIONS Our study may suggest the clinical benefits associated with combination therapy with a statin and testosterone in elderly men with LOH.
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Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
| | - Wojciech Gilowski
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland; Cardiology Department, Chrzanow District Hospital, Chrzanów, Poland
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
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21
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The effect of testosterone on cardiovascular risk factors in men with type 2 diabetes and late-onset hypogonadism treated with metformin or glimepiride. Pharmacol Rep 2015; 68:75-9. [PMID: 26721356 DOI: 10.1016/j.pharep.2015.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 06/03/2015] [Accepted: 06/05/2015] [Indexed: 01/11/2023]
Abstract
BACKGROUND Men with type 2 diabetes are often characterized by abnormal plasma testosterone levels. This study was aimed at investigating whether testosterone treatment has an impact on cardiovascular risk factors in patients with type 2 diabetes and late-onset hypogonadism (LOH), chronically treated with hypoglycemic agents. METHODS This study included 51 men with type 2 diabetes, 26 of whom had already been treated with metformin and 25 with glimepiride for at least 6 months. On the basis of patient preference, 15 men receiving metformin and 12 receiving glimepiride were treated with intramuscular testosterone enanthate (100mg weekly) for 12 weeks. Plasma lipids, glucose homeostasis markers, as well as plasma levels of androgens, uric acid, high-sensitivity C-reactive protein (hsCRP), homocysteine and fibrinogen were determined before and at the end of the study. RESULTS With the exception of insulin sensitivity, plasma hsCRP and homocysteine, there were no differences between patients treated with metformin and glimepiride. Testosterone enanthate administered to both groups of patients increased plasma testosterone, reduced plasma hsCRP and improved insulin sensitivity. Testosterone-metformin combination therapy reduced also circulating levels of uric acid, homocysteine and fibrinogen. These effects, stronger in patients treated with metformin than glimepiride, correlated with the impact of testosterone on insulin sensitivity. CONCLUSIONS Our results suggest that testosterone may bring more clinical benefits to metformin- than sulfonylurea-treated men with diabetes and LOH.
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22
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Pongkan W, Chattipakorn SC, Chattipakorn N. Roles of Testosterone Replacement in Cardiac Ischemia-Reperfusion Injury. J Cardiovasc Pharmacol Ther 2015; 21:27-43. [PMID: 26015457 DOI: 10.1177/1074248415587977] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 04/20/2015] [Indexed: 01/08/2023]
Abstract
Testosterone is an anabolic steroid hormone, which is the major circulating androgen hormone in males. Testosterone levels decreasing below the normal physiological levels lead to a status known as androgen deficiency. Androgen deficiency has been shown to be a major risk factor in the development of several disorders, including obesity, metabolic syndrome, and ischemic heart disease. In the past decades, although several studies from animal models as well as clinical studies demonstrated that testosterone exerted cardioprotection, particularly during ischemia-reperfusion (I/R) injury, other preclinical and clinical studies have shown an inverse relationship between testosterone levels and cardioprotective effects. As a result, the effects of testosterone replacement on the heart remain controversial. In this review, reports regarding the roles of testosterone replacement in the heart following I/R injury are comprehensively summarized and discussed. At present, it may be concluded that chronic testosterone replacement at a physiological dose demonstrated cardioprotective effects, whereas acute testosterone replacement can cause adverse effects in the I/R heart.
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Affiliation(s)
- Wanpitak Pongkan
- Faculty of Medicine, Cardiac Electrophysiology Research and Training Center, Chiang Mai University, Chiang Mai, Thailand Department of Physiology, Faculty of Medicine, Cardiac Electrophysiology Unit, Chiang Mai University, Chiang Mai, Thailand Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Siriporn C Chattipakorn
- Department of Physiology, Faculty of Medicine, Cardiac Electrophysiology Unit, Chiang Mai University, Chiang Mai, Thailand Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Nipon Chattipakorn
- Faculty of Medicine, Cardiac Electrophysiology Research and Training Center, Chiang Mai University, Chiang Mai, Thailand Department of Physiology, Faculty of Medicine, Cardiac Electrophysiology Unit, Chiang Mai University, Chiang Mai, Thailand Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
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23
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Low testosterone in men predicts impaired arterial elasticity and microvascular function. Int J Cardiol 2015; 194:94-9. [PMID: 26022684 DOI: 10.1016/j.ijcard.2015.05.065] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 05/01/2015] [Accepted: 05/10/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND A low testosterone level in men is associated with increased adiposity, insulin resistance, and dyslipidemia. Whether low testosterone level is associated with arterial stiffness and endothelial and microvascular dysfunction remains unknown and was investigated in this study. METHODS Serum testosterone was measured in 237 healthy men aged 50 years (SD 12). Endothelial and microvascular function were assessed as brachial artery flow-mediated dilation (FMD) and digital reactive hyperemia index (RHI), respectively. Arterial stiffness was evaluated by tonometry-derived pulse wave velocity (PWV) and central augmentation index (AIX). RESULTS Mean total testosterone level was 16.3 nmol/L (SD 6.11) and 25% of subjects had low levels (<12.0 nmol/L). Testosterone level correlated positively with RHI (r=0.24, p<0.001) and inversely with AIX (r=-0.14, p=0.033) but not with FMD or PWV, indicating impaired microvascular hyperemia and arterial elasticity with lower testosterone levels. After multivariate adjustment for the Framingham Risk Score and weight, testosterone level remained an independent predictor of RHI and AIX (β=0.23, -0.13; p=0.001, 0.04, respectively). CONCLUSION In men with few co-morbidities, lower serum testosterone level is associated with microvascular dysfunction and increased pulse wave reflections, mechanisms by which lower testosterone levels may confer increased cardiovascular risk. Whether normalization of low testosterone level improves vascular function needs further investigation.
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Iglesias P, Prado F, Muñoz A, Guerrero MT, Macías MC, Ridruejo E, Tajada P, García-Arévalo C, Díez JJ. Natural course of hypogonadism diagnosed during hospitalization in aged male patients. Endocrine 2015; 48:978-84. [PMID: 25205450 DOI: 10.1007/s12020-014-0417-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 09/01/2014] [Indexed: 12/24/2022]
Abstract
Our aim was to assess short-term natural course of hypogonadism diagnosed during hospitalization for acute disease in aged male patients after discharge. A group of 43 hypogonadal males, aged 86.7±5.7 year, was studied. Serum concentrations of testosterone (T) and gonadotropins (follicle-stimulating hormone, FSH, and luteinizing hormone, LH) were measured in every patient both at admission and one month after discharge. Mean serum T at entry was 115.4±48.0 ng/dl. Hypogonadism was hyper-, hypo-, and normogonadotropic in 20 (46.5%), 20 (46.5%), and 3 (7.0%) patients, respectively. One month after discharge serum T concentrations increased significantly (230.9±135.6 ng/dl, p<0.001). At this point, more than half of the patients (n=27, 62.8%) showed normal serum T concentrations. Both gonadotropins, FSH (p<0.001), and LH (p=0.04) also increased one month after discharge. Approximately, half of the patients (13, 48.1%) who normalized serum T concentrations also showed normal serum gonadotropin concentrations. Patients who normalized their serum T concentrations one month after discharge showed significantly higher baseline values of T (134.7±33.9 ng/dl) than those who persisted with hypogonadism (n=16, 32.7%; 82.8±51.6 ng/dl, p<0.001). Lastly, serum T was the only independent predictor for achieving eugonadal status (OR 1.030; CI 95%, 1.010-1.050; p<0.001). In conclusion, about 63% of aged patients hospitalized for acute illness with hypogonadism discovered during hospitalization spontaneously normalize their serum T concentrations one month after discharge. Serum gonadotropin concentrations also increased after discharge. Serum T levels at admission was an independent predictor for the normalization of serum T concentrations.
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Affiliation(s)
- P Iglesias
- Department of Endocrinology, Hospital Ramón y Cajal, Ctra. de Colmenar km 9.100, 28034, Madrid, Spain,
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Pongkan W, Chattipakorn SC, Chattipakorn N. Chronic testosterone replacement exerts cardioprotection against cardiac ischemia-reperfusion injury by attenuating mitochondrial dysfunction in testosterone-deprived rats. PLoS One 2015; 10:e0122503. [PMID: 25822979 PMCID: PMC4379072 DOI: 10.1371/journal.pone.0122503] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 02/18/2015] [Indexed: 12/03/2022] Open
Abstract
Background Although testosterone deficiency is associated with increased risks of heart disease, the benefits of testosterone therapy are controversial. Moreover, current understanding on the cardiac effect of testosterone during cardiac ischemia-reperfusion (I/R) periods is unclear. We tested the hypothesis that testosterone replacement attenuates the impairment of left ventricular (LV) function and heart rate variability (HRV), and reduces the infarct size and arrhythmias caused by I/R injury in orchiectomized (ORX) rats. Methodology ORX or sham-operated male Wistar rats (n = 24) were randomly divided and received either testosterone (2 mg/kg, subcutaneously administered) or the vehicle for 8 weeks. The ejection fraction (EF) and HRV were determined at baseline and the 4th and 8th week. I/R was performed by left anterior descending coronary artery ligation for 30 minutes, followed by a 120-minute reperfusion. LV pressure, arrhythmia scores, infarct size and cardiac mitochondrial function were determined. Results Prior to I/R, EF and HRV were impaired in the ORX group, but were restored in the testosterone-treated group. During I/R, arrhythmia scores and the infarct size were greater, and cardiac mitochondrial function was impaired, whereas the time to 1st VT/VF onset and the LV end-systolic pressure were decreased in the ORX group when compared to the sham group. Testosterone replacement attenuated the impairment of these parameters in ORX rats during I/R injury, but did not show any benefit or adverse effect in non-ORX rats. Conclusions Testosterone replacement restores cardiac function and autonomic regulation, and exerts cardioprotective effects during the I/R period via mitochondrial protection in ORX rats.
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Affiliation(s)
- Wanpitak Pongkan
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Siriporn C. Chattipakorn
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Nipon Chattipakorn
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
- * E-mail:
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26
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Krysiak R, Kowalska B, Żmuda W, Okopień B. The effect of ezetimibe-statin combination on steroid hormone production in men with coronary artery disease and low cholesterol levels. Pharmacol Rep 2015; 67:305-9. [PMID: 25712655 DOI: 10.1016/j.pharep.2014.10.004] [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: 09/10/2014] [Revised: 10/06/2014] [Accepted: 10/08/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Aggressive statin treatment was found to slightly reduce testosterone production. The aim of this study was to compare the effects of ezetimibe-statin combination and high-dose statin therapy on testicular and adrenal cortex function in men with LDL cholesterol levels below 70 mg/dL. METHODS The study included 26 adult men with coronary artery disease. Twelve of these patients did not tolerate high-dose statin therapy and were treated with lower doses of a statin plus ezetimibe. Fourteen patients tolerating high-dose simvastatin or rosuvastatin treatment continued high-dose statin therapy throughout the study period. Plasma lipids, glucose homeostasis markers and plasma levels of testosterone, cortisol, dehydroepiandrosterone sulphate, sex hormone-binding globulin, gonadotropins and ACTH, as well as urine free cortisol were assessed at baseline and after 16 weeks of treatment. RESULTS Replacing high-dose statin therapy with ezetimibe/statin combination therapy reduced plasma levels of LH by 32% (p=0.043), as well as increased plasma levels of testosterone by 20% (p=0.038). Ezetimibe/statin combination did not induce any significant changes in plasma levels or urine excretion of the remaining hormones. At the end of the study, plasma LH levels were higher, while plasma testosterone levels were lower in patients receiving the combination therapy than in those treated only with high-dose statin. CONCLUSIONS Our results indicate that ezetimibe combined with moderate statin dose exerts a less pronounced effect on testicular function in comparison with high-dose statin therapy.
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Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
| | - Beata Kowalska
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland; Department of Endocrinology, Provincial Hospital, Opole, Poland
| | - Witold Żmuda
- Invasive Cardiology, Electrotherapy and Angiology Centre, Oświęcim, Poland
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
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27
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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: 156] [Impact Index Per Article: 17.3] [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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Novo S, Iacona R, Bonomo V, Evola V, Corrado E, Di Piazza M, Novo G, Pavone C. Erectile dysfunction is associated with low total serum testosterone levels and impaired flow-mediated vasodilation in intermediate risk men according to the Framingham risk score. Atherosclerosis 2014; 238:415-9. [PMID: 25562576 DOI: 10.1016/j.atherosclerosis.2014.12.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 11/26/2014] [Accepted: 12/01/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND The role erectile dysfunction (ED) coupled with low testosterone levels as early markers of atherosclerosis is not well understood. OBJECTIVES To analyze the relationship between serum testosterone levels with both ED and brachial artery flow-mediated vasodilation (FMD), in a primary prevention sample of men. METHODS We enrolled 802 asymptomatic, intermediate CV risk patients, according to the Framingham Risk Score, aged 40-80 years, who underwent the ultrasound examination of FMD, the evaluation of ED and the assessment of total serum testosterone levels. RESULTS Testosterone levels correlated both with FMD (r = 0.85; p < 0.0001) and IIEF-5 score (rs = 0.65; p < 0.0001). Multivariable logistic regression analyses revealed that lower serum testosterone levels were strongly associated (p < 0.001) with severe (OR 0.78; 95% CI: 0.62-0.86), and moderate ED (OR 0.85; 95% CI: 0.72-0.97), while impaired FMD percentages were strongly associated (p < 0.001) with severe (OR 0.68; 95% CI: 0.59-0.79), moderate (OR 0.76; 95% CI: 0.63-0.83) and mild to moderate ED (OR 0.8; 95% CI: 0.69-0.94). Mild ED resulted statistically associated with lower FMD (OR 0.94; 95% CI: 0.82 - 1.07; p = 0.03) but not with serum testosterone levels. These relations were not substantially affected by adjustments for further potential confounders including smoking status, hypertension, diabetes mellitus and body mass index. CONCLUSIONS lower total serum testosterone levels are associated with impaired FMD and ED in this sample of intermediate CV risk men according to the Framingham Risk Score.
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Affiliation(s)
- Salvatore Novo
- Chair and Division of Cardiology, University Hospital "Paolo Giaccone", via del Vespro 129, 90127 Palermo, Italy.
| | - Rosanna Iacona
- Chair and Division of Cardiology, University Hospital "Paolo Giaccone", via del Vespro 129, 90127 Palermo, Italy
| | - Vito Bonomo
- Chair and Division of Cardiology, University Hospital "Paolo Giaccone", via del Vespro 129, 90127 Palermo, Italy
| | - Vincenzo Evola
- Chair and Division of Cardiology, University Hospital "Paolo Giaccone", via del Vespro 129, 90127 Palermo, Italy
| | - Egle Corrado
- Chair and Division of Cardiology, University Hospital "Paolo Giaccone", via del Vespro 129, 90127 Palermo, Italy
| | - Mariaconcetta Di Piazza
- Chair and Division of Cardiology, University Hospital "Paolo Giaccone", via del Vespro 129, 90127 Palermo, Italy
| | - Giuseppina Novo
- Chair and Division of Cardiology, University Hospital "Paolo Giaccone", via del Vespro 129, 90127 Palermo, Italy
| | - Carlo Pavone
- Chair and Division of Urology, University Hospital "Paolo Giaccone", via del Vespro 129, 90127 Palermo, Italy.
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O'Hara L, McInnes K, Simitsidellis I, Morgan S, Atanassova N, Slowikowska-Hilczer J, Kula K, Szarras-Czapnik M, Milne L, Mitchell RT, Smith LB. Autocrine androgen action is essential for Leydig cell maturation and function, and protects against late-onset Leydig cell apoptosis in both mice and men. FASEB J 2014; 29:894-910. [PMID: 25404712 PMCID: PMC4422361 DOI: 10.1096/fj.14-255729] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Leydig cell number and function decline as men age, and low testosterone is associated with all “Western” cardio-metabolic disorders. However, whether perturbed androgen action within the adult Leydig cell lineage predisposes individuals to this late-onset degeneration remains unknown. To address this, we generated a novel mouse model in which androgen receptor (AR) is ablated from ∼75% of adult Leydig stem cell/cell progenitors, from fetal life onward (Leydig cell AR knockout mice), permitting interrogation of the specific roles of autocrine Leydig cell AR signaling through comparison to adjacent AR-retaining Leydig cells, testes from littermate controls, and to human testes, including from patients with complete androgen insensitivity syndrome (CAIS). This revealed that autocrine AR signaling is dispensable for the attainment of final Leydig cell number but is essential for Leydig cell maturation and regulation of steroidogenic enzymes in adulthood. Furthermore, these studies reveal that autocrine AR signaling in Leydig cells protects against late-onset degeneration of the seminiferous epithelium in mice and inhibits Leydig cell apoptosis in both adult mice and patients with CAIS, possibly via opposing aberrant estrogen signaling. We conclude that autocrine androgen action within Leydig cells is essential for the lifelong support of spermatogenesis and the development and lifelong health of Leydig cells.—O’Hara, L., McInnes, K., Simitsidellis, I., Morgan, S., Atanassova, N., Slowikowska-Hilczer, J., Kula, K., Szarras-Czapnik, M., Milne, L., Mitchell, R. T., Smith, L. B. Autocrine androgen action is essential for Leydig cell maturation and function, and protects against late-onset Leydig cell apoptosis in both mice and men.
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Affiliation(s)
- Laura O'Hara
- *MRC Centre for Reproductive Health and BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, United Kingdom; Institute of Experimental Morphology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia, Bulgaria; Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; and Clinic of Endocrinology and Diabetology, Children's Memorial Health Institute, Warsaw, Poland
| | - Kerry McInnes
- *MRC Centre for Reproductive Health and BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, United Kingdom; Institute of Experimental Morphology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia, Bulgaria; Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; and Clinic of Endocrinology and Diabetology, Children's Memorial Health Institute, Warsaw, Poland
| | - Ioannis Simitsidellis
- *MRC Centre for Reproductive Health and BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, United Kingdom; Institute of Experimental Morphology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia, Bulgaria; Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; and Clinic of Endocrinology and Diabetology, Children's Memorial Health Institute, Warsaw, Poland
| | - Stephanie Morgan
- *MRC Centre for Reproductive Health and BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, United Kingdom; Institute of Experimental Morphology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia, Bulgaria; Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; and Clinic of Endocrinology and Diabetology, Children's Memorial Health Institute, Warsaw, Poland
| | - Nina Atanassova
- *MRC Centre for Reproductive Health and BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, United Kingdom; Institute of Experimental Morphology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia, Bulgaria; Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; and Clinic of Endocrinology and Diabetology, Children's Memorial Health Institute, Warsaw, Poland
| | - Jolanta Slowikowska-Hilczer
- *MRC Centre for Reproductive Health and BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, United Kingdom; Institute of Experimental Morphology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia, Bulgaria; Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; and Clinic of Endocrinology and Diabetology, Children's Memorial Health Institute, Warsaw, Poland
| | - Krzysztof Kula
- *MRC Centre for Reproductive Health and BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, United Kingdom; Institute of Experimental Morphology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia, Bulgaria; Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; and Clinic of Endocrinology and Diabetology, Children's Memorial Health Institute, Warsaw, Poland
| | - Maria Szarras-Czapnik
- *MRC Centre for Reproductive Health and BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, United Kingdom; Institute of Experimental Morphology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia, Bulgaria; Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; and Clinic of Endocrinology and Diabetology, Children's Memorial Health Institute, Warsaw, Poland
| | - Laura Milne
- *MRC Centre for Reproductive Health and BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, United Kingdom; Institute of Experimental Morphology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia, Bulgaria; Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; and Clinic of Endocrinology and Diabetology, Children's Memorial Health Institute, Warsaw, Poland
| | - Rod T Mitchell
- *MRC Centre for Reproductive Health and BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, United Kingdom; Institute of Experimental Morphology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia, Bulgaria; Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; and Clinic of Endocrinology and Diabetology, Children's Memorial Health Institute, Warsaw, Poland
| | - Lee B Smith
- *MRC Centre for Reproductive Health and BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, United Kingdom; Institute of Experimental Morphology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia, Bulgaria; Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; and Clinic of Endocrinology and Diabetology, Children's Memorial Health Institute, Warsaw, Poland
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Rebourcet D, O’Shaughnessy PJ, Monteiro A, Milne L, Cruickshanks L, Jeffrey N, Guillou F, Freeman TC, Mitchell RT, Smith LB. Sertoli cells maintain Leydig cell number and peritubular myoid cell activity in the adult mouse testis. PLoS One 2014; 9:e105687. [PMID: 25144714 PMCID: PMC4140823 DOI: 10.1371/journal.pone.0105687] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 07/23/2014] [Indexed: 01/08/2023] Open
Abstract
The Sertoli cells are critical regulators of testis differentiation and development. In the adult, however, their known function is restricted largely to maintenance of spermatogenesis. To determine whether the Sertoli cells regulate other aspects of adult testis biology we have used a novel transgenic mouse model in which Amh-Cre induces expression of the receptor for Diphtheria toxin (iDTR) specifically within Sertoli cells. This causes controlled, cell-specific and acute ablation of the Sertoli cell population in the adult animal following Diphtheria toxin injection. Results show that Sertoli cell ablation leads to rapid loss of all germ cell populations. In addition, adult Leydig cell numbers decline by 75% with the remaining cells concentrated around the rete and in the sub-capsular region. In the absence of Sertoli cells, peritubular myoid cell activity is reduced but the cells retain an ability to exclude immune cells from the seminiferous tubules. These data demonstrate that, in addition to support of spermatogenesis, Sertoli cells are required in the adult testis both for retention of the normal adult Leydig cell population and for support of normal peritubular myoid cell function. This has implications for our understanding of male reproductive disorders and wider androgen-related conditions affecting male health.
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Affiliation(s)
- Diane Rebourcet
- MRC Centre for Reproductive Health, University of Edinburgh, The Queen’s Medical Research Institute, Edinburgh, United Kingdom
| | - Peter J. O’Shaughnessy
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Garscube Campus, Glasgow, United Kingdom
| | - Ana Monteiro
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Garscube Campus, Glasgow, United Kingdom
| | - Laura Milne
- MRC Centre for Reproductive Health, University of Edinburgh, The Queen’s Medical Research Institute, Edinburgh, United Kingdom
| | - Lyndsey Cruickshanks
- MRC Centre for Reproductive Health, University of Edinburgh, The Queen’s Medical Research Institute, Edinburgh, United Kingdom
| | - Nathan Jeffrey
- MRC Centre for Reproductive Health, University of Edinburgh, The Queen’s Medical Research Institute, Edinburgh, United Kingdom
| | - Florian Guillou
- Station de Physiologie de la Reproduction et des Comportements (PRC), Institut National de la Recherche Agronomique, UMR 6073 INRA-CNRS-Université de Tours, Nouzilly, France
| | - Tom C. Freeman
- The Roslin Institute, University of Edinburgh, Easter Bush, Edinburgh, United Kingdom
| | - Rod T. Mitchell
- MRC Centre for Reproductive Health, University of Edinburgh, The Queen’s Medical Research Institute, Edinburgh, United Kingdom
| | - Lee B. Smith
- MRC Centre for Reproductive Health, University of Edinburgh, The Queen’s Medical Research Institute, Edinburgh, United Kingdom
- * E-mail:
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31
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Canoy D, Barber TM, Pouta A, Hartikainen AL, McCarthy MI, Franks S, Järvelin MR, Tapanainen JS, Ruokonen A, Huhtaniemi IT, Martikainen H. Serum sex hormone-binding globulin and testosterone in relation to cardiovascular disease risk factors in young men: a population-based study. Eur J Endocrinol 2014; 170:863-72. [PMID: 24670886 DOI: 10.1530/eje-13-1046] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Reduced sex hormone-binding globulin (SHBG) concentration predicts insulin resistance and type 2 diabetes, but its association with cardiovascular disease (CVD) risk is unclear. We examined the association between SHBG and cardiovascular risk factors, independently of total testosterone (TT), in young men. DESIGN Observational, cross-sectional study. SETTING General community. PARTICIPANTS The study included 2716 men aged 31 years in the Northern Finland Birth Cohort in 1996 with clinical examination data and fasting blood samples. OUTCOME VARIABLES Blood pressure (BP), lipids and C-reactive protein (CRP) as biological CVD risk markers. RESULTS SHBG concentration was significantly and inversely related to systolic and diastolic BP, triglycerides and CRP, but positively to HDL cholesterol after adjusting for insulin, BMI, waist circumference, smoking, education and physical activity (all P<0.05). These linearly graded associations persisted with additional adjustment for TT. SHBG was significantly associated with total cholesterol only with adjustment for covariates and TT (P<0.05). The direction and magnitude of associations between TT and risk factors were variable, but further adjustment for insulin, adiposity and SHBG showed positive associations between TT and BP, total and LDL-cholesterol and triglycerides and an inverse association with CRP (all P<0.05), but its relation with HDL-cholesterol was no longer significant. CONCLUSIONS In this cohort of young adult men, higher SHBG concentration was associated with a more favourable CVD risk profile, independently of TT. SHBG concentration modified the associations of TT with CVD risk factors.
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Affiliation(s)
- D Canoy
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
| | - T M Barber
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
| | - A Pouta
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
| | - A L Hartikainen
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
| | - M I McCarthy
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, FinlandCancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of
| | - S Franks
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
| | - M R Järvelin
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, FinlandCancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of
| | - J S Tapanainen
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, FinlandCancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of
| | - A Ruokonen
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, FinlandCancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of
| | - I T Huhtaniemi
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
| | - H Martikainen
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
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Iglesias P, Prado F, Macías MC, Guerrero MT, Muñoz A, Ridruejo E, Tajada P, García-Arévalo C, Díez JJ. Hypogonadism in aged hospitalized male patients: prevalence and clinical outcome. J Endocrinol Invest 2014; 37:135-41. [PMID: 24497212 DOI: 10.1007/s40618-013-0009-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 11/17/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Male hypogonadism is common in the elderly and has been associated with increased risk of mortality. Our objective has been to assess the prevalence of primary and central hypogonadism in elderly male patients admitted to the hospital because of acute illness. We also evaluated the relationships between gonadal dysfunction and in-hospital mortality. PATIENTS AND METHODS 150 patients, aged ≥65 years, admitted during 2010 and 2011 in our geriatric unit, were studied. Serum concentrations total, bioavailable and free testosterone, as well as of follicle-stimulating hormone and luteinizing hormone were quantified in every patient. Hypogonadism was defined by the presence of serum testosterone levels lower than 200 ng/dl. RESULTS Hypogonadism was found in 80 patients (53.3 %). Serum gonadotropin concentrations were elevated in 43.7 % of these patients, whereas 41.3 % of hypogonadic patients showed normal and 15 % low gonadotropin concentrations. Respiratory tract infection and congestive heart failure were the main causes of hospitalization in hypogonadal men, whereas acute cerebrovascular disease was the main reason for admission in eugonadal patients. Of the 13 patients who died during hospitalization, 12 were hypogonadic. Patients who died showed significantly lower serum levels of total, free and bioavailable testosterone than those found in patients who survived. CONCLUSION Our results show that about half of patients admitted for acute illness have hypogonadism, mainly of non-hypergonadotropic type. Gonadal hypofunction is significantly related with in-hospital mortality. A low value of serum testosterone may be a predictor for mortality in elderly male patients.
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Affiliation(s)
- P Iglesias
- Department of Endocrinology, Hospital Ramón y Cajal, Ctra. de Colmenar, Km 9,100, 28034, Madrid, Spain,
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Krysiak R, Okopien B. The effect of aggressive rosuvastatin treatment on steroid hormone production in men with coronary artery disease. Basic Clin Pharmacol Toxicol 2013; 114:330-5. [PMID: 24330280 DOI: 10.1111/bcpt.12169] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Accepted: 10/30/2013] [Indexed: 11/30/2022]
Abstract
Most steroid hormones are produced from cholesterol contained in low-density lipoproteins, which is uptaken by the gonads and adrenal cortex, and used as a substrate for steroidogenesis. Theoretically, in states associated with very low-density lipoprotein (LDL) cholesterol levels, cholesterol conversion to steroid hormones may be impaired. The study included 15 men with coronary artery disease, in whom initial statin treatment had been unsuccessful and therefore was replaced with rosuvastatin (20-40 mg daily). Although in 11 patients, rosuvastatin decreased plasma LDL cholesterol levels to below 70 mg/dL, the drug only moderately reduced testosterone levels and increased gonadotropin levels, as well as insignificantly increased plasma ACTH levels. Aggressive rosuvastatin treatment did not affect plasma cortisol and dehydroepiandrosterone sulphate levels, and urine free cortisol. Our results suggest that intensive rosuvastatin treatment is associated with only small changes in adrenal and testicular steroidogenesis.
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Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
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Yeap BB, Alfonso H, Chubb SAP, Handelsman DJ, Hankey GJ, Golledge J, Flicker L, Norman PE. Lower plasma testosterone or dihydrotestosterone, but not estradiol, is associated with symptoms of intermittent claudication in older men. Clin Endocrinol (Oxf) 2013; 79:725-32. [PMID: 23509861 DOI: 10.1111/cen.12208] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 01/27/2013] [Accepted: 03/14/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE In men, testosterone (T) levels decline with age, and lower T predicts all-cause and cardiovascular mortality. However, the associations of T and its metabolites, dihydrotestosterone (DHT) and estradiol (E2), with symptomatic peripheral arterial disease remain unclear. We assessed associations of T, DHT and E2 with lower limb intermittent claudication in older men. DESIGN Cross-sectional study. PARTICIPANTS Community-dwelling men aged 70-89 years resident in Perth, Western Australia. MEASUREMENTS Intermittent claudication was ascertained by the Edinburgh Claudication Questionnaire. Early morning, plasma T, DHT and E2 were assayed using liquid chromatography-tandem mass spectrometry. RESULTS There were 268 men with intermittent claudication and 2435 without claudication or any leg pain. Men with nonspecific leg pain (n = 986) were excluded. After adjusting for age, smoking, BMI, waist/hip ratio, hypertension, dyslipidaemia, diabetes, creatinine and prevalent cardiovascular disease (CVD), higher T was associated with reduced risk of having claudication (per 1 SD increase, odds ratio [OR] = 0·80, 95% confidence interval [CI] = 0·69-0·94, P = 0·006; quartiles, Q4/Q1, OR = 0·54, 95% CI = 0·36-0·81). Higher DHT was associated with reduced risk of having claudication (per 1 SD increase, OR = 0·86, 95% CI = 0·73-1·00, P = 0·048; Q4/Q1, OR = 0·64, 95% CI = 0·43-0·95). E2 was not associated with claudication (per 1 SD increase, OR = 0·96, 95% CI = 0·83-1·11, P = 0·565; Q4/Q1, OR = 0·88, 95% CI = 0·60-1·29). CONCLUSIONS Lower T or DHT levels, but not E2, are associated with symptoms of intermittent claudication in older men. Reduced exposure to androgens may represent a causal factor or biomarker for symptomatic peripheral arterial disease. Further studies are needed to examine underlying mechanisms and evaluate therapeutic options in ageing men.
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Affiliation(s)
- Bu B Yeap
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia; Department of Endocrinology and Diabetes, Fremantle Hospital, Fremantle, WA, Australia
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Ohlsson C, Barrett-Connor E, Bhasin S, Orwoll E, Labrie F, Karlsson MK, Ljunggren O, Vandenput L, Mellström D, Tivesten A. High serum testosterone is associated with reduced risk of cardiovascular events in elderly men. The MrOS (Osteoporotic Fractures in Men) study in Sweden. J Am Coll Cardiol 2013; 58:1674-81. [PMID: 21982312 DOI: 10.1016/j.jacc.2011.07.019] [Citation(s) in RCA: 192] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2011] [Revised: 07/05/2011] [Accepted: 07/07/2011] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We tested the hypothesis that serum total testosterone and sex hormone-binding globulin (SHBG) levels predict cardiovascular (CV) events in community-dwelling elderly men. BACKGROUND Low serum testosterone is associated with increased adiposity, an adverse metabolic risk profile, and atherosclerosis. However, few prospective studies have demonstrated a protective link between endogenous testosterone and CV events. Polymorphisms in the SHBG gene are associated with risk of type 2 diabetes, but few studies have addressed SHBG as a predictor of CV events. METHODS We used gas chromatography/mass spectrometry to analyze baseline levels of testosterone in the prospective population-based MrOS (Osteoporotic Fractures in Men) Sweden study (2,416 men, age 69 to 81 years). SHBG was measured by immunoradiometric assay. CV clinical outcomes were obtained from central Swedish registers. RESULTS During a median 5-year follow-up, 485 CV events occurred. Both total testosterone and SHBG levels were inversely associated with the risk of CV events (trend over quartiles: p = 0.009 and p = 0.012, respectively). Men in the highest quartile of testosterone (≥550 ng/dl) had a lower risk of CV events compared with men in the 3 lower quartiles (hazard ratio: 0.70, 95% confidence interval: 0.56 to 0.88). This association remained after adjustment for traditional CV risk factors and was not materially changed in analyses excluding men with known CV disease at baseline (hazard ratio: 0.71, 95% confidence interval: 0.53 to 0.95). In models that included both testosterone and SHBG, testosterone but not SHBG predicted CV risk. CONCLUSIONS High serum testosterone predicted a reduced 5-year risk of CV events in elderly men.
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Affiliation(s)
- Claes Ohlsson
- Centre for Bone and Arthritis Research, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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Cheung AS, Pattison D, Bretherton I, Hoermann R, Lim Joon D, Ho E, Jenkins T, Hamilton EJ, Bate K, Chan I, Zajac JD, Grossmann M. Cardiovascular risk and bone loss in men undergoing androgen deprivation therapy for non-metastatic prostate cancer: implementation of standardized management guidelines. Andrology 2013; 1:583-9. [PMID: 23686896 DOI: 10.1111/j.2047-2927.2013.00093.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 03/22/2013] [Accepted: 04/02/2013] [Indexed: 11/30/2022]
Abstract
Our objective was to evaluate the effectiveness of implementing standardized guidelines to mitigate metabolic and bone side effects of androgen deprivation therapy (ADT) in men with non-metastatic prostate cancer. We conducted a 2-year prospective cohort study at a tertiary referral teaching hospital. Overall, 236 men (mean age 69.8 ± 7.1) commencing ADT for non-metastatic prostate cancer attended a baseline clinic visit between 2007 and 2011, and 153 men were eligible for follow-up after 2 years of continuous ADT. Of these, 113 men had data available for analysis at 2 years. At baseline, 87% of the men were overweight or obese, 61% had hypertension, 56% had hypercholesterolaemia, 27% prior cardiovascular disease, 11% osteoporosis and 40% osteopaenia. After 2 years of ADT, there was an increase in waist circumference (+2.8 ± 6.3 cm, p = 0.002), and, in men without diabetes, in HbA1c (+0.13 ± 0.34%, p = 0.019). Despite this, due to treatment, there were significant reductions in total cholesterol (-0.35 ± 1.00 mmol/L, p < 0.001), and blood pressure (systolic -7.6 ± 19.3 mmHg; diastolic -4.7 ± 11.6 mmHg, p < 0.001). After 2 years, men not receiving anti-resorptive therapy experienced a significant decline in lumbar spine (-0.042 ± 0.134 g/cm(2) , p = 0.012) and total hip bone mineral density (BMD) (-0.026 ± 0.036 g/cm(2) , p < 0.001), whereas bisphosphonate treatment maintained stable BMD. Prevalence of anaemia increased from 13.8 to 32.5%. Older age independently predicted a greater drop in haemoglobin (p = 0.005). We conclude that a structured approach to assess and treat men undergoing ADT effectively improves cardiovascular risk factors and prevents bone decay. Larger studies are needed to determine effects on cardiovascular outcomes, fracture prevention and survival.
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Affiliation(s)
- A S Cheung
- Department of Medicine Austin Health, The University of Melbourne, Heidelberg, Vic., Australia
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Fairweather D, Cooper LT, Blauwet LA. Sex and gender differences in myocarditis and dilated cardiomyopathy. Curr Probl Cardiol 2013; 38:7-46. [PMID: 23158412 DOI: 10.1016/j.cpcardiol.2012.07.003] [Citation(s) in RCA: 211] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Heart failure due to nonischemic dilated cardiomyopathy (DCM) contributes significantly to the global burden of cardiovascular disease. Myocarditis is, in turn, a major cause of acute DCM in both men and women. However, recent clinical and experimental evidence suggests that the pathogenesis and prognosis of DCM differ between the sexes. This seminar provides a contemporary perspective on the immune mediators of myocarditis, including interdependent elements of the innate and adaptive immune response. The heart's acute response to injury is influenced by sex hormones that appear to determine the subsequent risk of chronic DCM. Preliminary data suggest additional genetic variations may account for some of the differences in epidemiology, left ventricular recovery, and survival between men and women. We highlight the gaps in our knowledge regarding the management of women with acute DCM and discuss emerging therapies, including bromocriptine for the treatment of peripartum cardiomyopathy.
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Gonzales RJ. Androgens and the cerebrovasculature: modulation of vascular function during normal and pathophysiological conditions. Pflugers Arch 2013; 465:627-42. [DOI: 10.1007/s00424-013-1267-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 03/08/2013] [Indexed: 12/26/2022]
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Fehérvári M, Krepuska M, Csobay-Novák C, Lakatos P, Oláh Z, Acsády G, Szeberin Z. [Prevalence of osteoporosis in patients with severe peripheral artery disease]. Orv Hetil 2013; 154:369-75. [PMID: 23461977 DOI: 10.1556/oh.2013.29532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Recent studies highlighted a significant association between bone mineral density and atherosclerosis. Cardiovascular disease is the main cause of death in Western countries, while the prevalence of osteoporosis reached 9% in Hungary. AIM The aim of this study was to investigate the prevalence of osteoporosis among patients with peripheral vascular disease. METHODS In a cross-sectional study bone mineral density using dual-energy X-ray absorptiometry in 172 patients with lower limb ischemia was investigated. According to previous medical history and blood tests, risk factors of atherosclerosis were also assessed and serum markers of bone turnover and other factors that could influence osteoporosis were evaluated. RESULTS Prior to bone mineral density screening, osteoporosis was known in 9% of patients. Based on osteodensitometric evaluation, 37% of the patients were diagnosed as having osteopenia and 31% as having osteoporosis. According to risk factors, different patient groups were created. Significantly more female than male patients had osteoporosis, while smoking, age and body mass index failed to affect the prevalence of osteoporosis. CONCLUSION These results suggest that patients with severe atherosclerosis need to be regularly screened and, if necessary, treated for osteoporosis.
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Affiliation(s)
- Mátyás Fehérvári
- Semmelweis Egyetem, Általános Orvostudományi Kar, Szív- és Érsebészeti Klinika, Budapest.
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Huang CK, Tsai MY, Luo J, Kang HY, Lee SO, Chang C. Suppression of androgen receptor enhances the self-renewal of mesenchymal stem cells through elevated expression of EGFR. BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR CELL RESEARCH 2013; 1833:1222-34. [PMID: 23333872 DOI: 10.1016/j.bbamcr.2013.01.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 01/07/2013] [Accepted: 01/09/2013] [Indexed: 01/07/2023]
Abstract
Bone marrow derived mesenchymal stem cells (BM-MSCs) have been widely applied in several clinical trials of diseases, such as myocardial infarction, liver cirrhosis, neurodegenerative disease, and osteogenesis imperfecta. Although most studies demonstrated that transplantation of BM-MSCs did exert a temporary relief and short-term therapeutic effects, eventually all symptoms recur, therefore it is essential to improve the therapeutic efficacy of transplantation by either elevating the self-renewal of BM-MSCs or enhancing their survival rate. Herein we demonstrated that the BM-MSCs and adipocyte derived mesenchymal stem cells (ADSCs) isolated from the androgen receptor (AR) knockout mice have higher self-renewal ability than those obtained from the wild-type mice. Knockdown of AR in MSC cell lines exhibited similar results. Mechanistic dissection studies showed that the depletion of AR resulted in activation of Erk and Akt signaling pathways through epidermal growth factor receptor (EGFR) activation or pathway to mediate higher self-renewal of BM-MSCs. Targeting AR signals using ASC-J9® (an AR degradation enhancer), hydroxyflutamide (antagonist of AR), and AR-siRNA all led to enhanced self-renewal of MSCs, suggesting the future possibility of using these anti-AR agents in therapeutic approaches.
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Affiliation(s)
- Chiung-Kuei Huang
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA
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Saad F. Androgen therapy in men with testosterone deficiency: can testosterone reduce the risk of cardiovascular disease? Diabetes Metab Res Rev 2012; 28 Suppl 2:52-9. [PMID: 23280867 DOI: 10.1002/dmrr.2354] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Obesity, hypertension, insulin resistance (IR), dyslipidaemia, impaired coagulation profile and chronic inflammation characterize cardiovascular risk factors in men. Adipose tissue is an active endocrine organ producing substances that suppress testosterone (T) production and visceral fat plays a key role in this process. Low T leads to further accumulation of fat mass, thus perpetuating a vicious circle. In this review, we discuss reduced levels of T and increased cardiovascular disease (CVD) risk factors by focusing on evidence derived from three different approaches. (i) epidemiological/ observational studies (without intervention); (ii) androgen deprivation therapy (ADT) studies (standard treatment in advanced prostate cancer); and (iii) T replacement therapy (TRT) in men with T deficiency (TD). In epidemiological studies, low T is associated with obesity, inflammation, atherosclerosis and the progression of atherosclerosis. Longitudinal epidemiological studies showed that low T is associated with an increased cardiovascular mortality. ADT brings about unfavourable changes in body composition, IR and dyslipidaemia. Increases in fibrinogen, plasminogen activator inhibitor 1 and C-reactive protein have also been observed. TRT in men with TD has consistently shown a decrease in fat mass and simultaneous increase in lean mass. T is a vasodilator and in long-term studies, it was shown to reduce blood pressure. There is increasing evidence that T treatment improves insulin sensitivity and lipid profiles. T may possess anti-inflammatory and anti-coagulatory properties and therefore TRT contributes to reduction of carotid intima media thickness. We suggest that T may have the potential to decrease CVD risk in men with androgen deficiency.
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Affiliation(s)
- Farid Saad
- Global Medical Affairs Men's Healthcare, Bayer Pharma AG, Muellerstrasse 178, Berlin, Germany.
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Yeap BB, Araujo AB, Wittert GA. Do low testosterone levels contribute to ill-health during male ageing? Crit Rev Clin Lab Sci 2012; 49:168-82. [PMID: 23094995 DOI: 10.3109/10408363.2012.725461] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Testosterone regulates male sexual development and body composition. In adult men, testosterone levels exhibit a gradual decline with increasing age. Whether it is age per se or health and behaviour related factors that are responsible for this decline, and the implications thereof for subsequent health remain controversial. Observational studies report associations of lower testosterone levels with poorer health outcomes in ageing men, including frailty, reduced sexual activity, insulin resistance and cardiovascular events and mortality. However, outcome data from randomised clinical trials of testosterone are limited, and are lacking for major endpoints such as cardiovascular events. The risks and benefits of testosterone intervention in older men require further clarification. This article will review the role of testosterone in men, discuss epidemiological and interventional data illuminating its potential role to preserve health during male ageing, consider the limitations of the evidence base and implications for clinical practice, and explore future directions for research in this topical area.
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Affiliation(s)
- Bu B Yeap
- School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia.
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Testosterone is negatively associated with the severity of coronary atherosclerosis in men. Asian J Androl 2012; 14:875-8. [PMID: 23042448 DOI: 10.1038/aja.2012.95] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This study aimed to determine whether plasma testosterone is associated with the severity of coronary atherosclerosis in a group of 803 men who underwent elective coronary angiography. Testosterone levels were measured in 803 male patients who were categorized into three groups according to testosterone level tertiles. All patients underwent elective coronary angiography, and the severity of coronary artery disease (CAD) was determined by the Gensini score. Moreover, patients were classified into two groups according to Gensini scores (score ≤26 and score >26) using the median values as cutoff points. The plasma testosterone levels were measured by an ELISA kit. The level of testosterone was negatively associated with the Gensini score (r=-0.188; P=0.000). A multiple linear regression analysis revealed that testosterone was an independent risk factor for the Gensini score (β=-0.110; P=0.002) after adjusting for confounding covariates. In a multivariate logistic regression model, the severity of CAD was shown to be significantly lower in the third tertile (highest) of testosterone compared to the first tertile (lowest) of testosterone (odds ratio (OR)=0.465; 95% confidence interval (CI): 0.327-0.662; P=0.000). In this study, patients with lower testosterone levels had higher Gensini scores in a group of 803 men who underwent elective coronary angiography. Additional studies are needed to clarify the direction of causality and possible underlying mechanisms.
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Yeap BB. Hormones and health outcomes in aging men. Exp Gerontol 2012; 48:677-81. [PMID: 22884846 DOI: 10.1016/j.exger.2012.07.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2012] [Revised: 07/24/2012] [Accepted: 07/24/2012] [Indexed: 01/07/2023]
Abstract
Increasing age is a predictor of ill-health and mortality related to cardiovascular disease and to frailty, a syndrome characterized by deterioration of multiple organ systems leading to loss of physiological reserve, diminished capacity to cope with stressors, and increased risk of disability and death. As men grow older, their levels of testosterone decline while the prevalence of ill-health increases. Observational studies have linked lower testosterone levels with cardiovascular disease and mortality in middle-aged and older men. More recently, lower testosterone has been shown to predict reduced sexual activity and frailty in aging men. Additional studies are needed to determine whether lower testosterone is a biomarker or a potentially treatable risk factor for poorer health outcomes in older men. During aging, the response of the pituitary-thyroid axis alters to manifest higher thyrotropin levels. The presences of subclinical hypo- and hyper-thyroidism predict adverse cardiovascular outcomes. Newer results indicate that in euthyroid older men, differences in free thyroxine levels within the normal range predict specific health outcomes including frailty. Clarification of the roles of endogenous testosterone and thyroxine in the genesis of ill-health during male aging offers the prospect of future intervention to preserve health and well-being in this growing population.
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Affiliation(s)
- Bu B Yeap
- School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia.
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45
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Current world literature. Curr Opin Endocrinol Diabetes Obes 2012; 19:233-47. [PMID: 22531108 DOI: 10.1097/med.0b013e3283542fb3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Horstman AM, Dillon EL, Urban RJ, Sheffield-Moore M. The role of androgens and estrogens on healthy aging and longevity. J Gerontol A Biol Sci Med Sci 2012; 67:1140-52. [PMID: 22451474 DOI: 10.1093/gerona/gls068] [Citation(s) in RCA: 230] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Aging is associated with a loss of sex hormone in both men (andropause) and women (menopause). In men, reductions in testosterone can trigger declines in muscle mass, bone mass, and in physical function. In women, the impact of the loss of sex hormones, such as estradiol, on bone is well elucidated, but evidence is limited on whether the loss of estradiol negatively affects muscle mass and physical function. However, deficiencies in multiple anabolic hormones have been shown to predict health status and longevity in older persons. Thus, consideration should be given as to whether targeted hormone replacement therapies may prove effective at treating clinical conditions, such as age-related sarcopenia, cancer cachexia, and/or acute or chronic illnesses. If initiated carefully in the appropriate clinical population, hormone replacement therapies in men and women may prevent and reverse muscle and bone loss and functional declines and perhaps promote healthy aging and longevity.
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Affiliation(s)
- Astrid M Horstman
- Division of Endocrinology and Metabolism, Department of Internal Medicine, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-1060, USA.
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Zwadlo C, Borlak J. Dihydrotestosterone--a culprit in left ventricular hypertrophy. Int J Cardiol 2012; 155:452-6. [PMID: 22264871 DOI: 10.1016/j.ijcard.2011.12.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2011] [Revised: 12/14/2011] [Accepted: 12/17/2011] [Indexed: 10/14/2022]
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Fahed AC, Gholmieh JM, Azar ST. Connecting the Lines between Hypogonadism and Atherosclerosis. Int J Endocrinol 2012; 2012:793953. [PMID: 22518131 PMCID: PMC3296205 DOI: 10.1155/2012/793953] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Accepted: 11/09/2011] [Indexed: 11/18/2022] Open
Abstract
Epidemiological studies show that atherosclerotic cardiovascular disease is a leading cause of morbidity and mortality worldwide and point to gender differences with ageing males being at highest risk. Atherosclerosis is a complex process that has several risk factors and mediators. Hypogonadism is a commonly undiagnosed disease that has been associated with many of the events, and risk factors leading to atherosclerosis. The mechanistic relations between testosterone levels, atherosclerotic events, and risk factors are poorly understood in many instances, but the links are clear. In this paper, we summarize the research journey that explains the link between hypogonadism, each of the atherosclerotic events, and risk factors. We look into the different areas from which lessons could be learned, including epidemiological studies, animal and laboratory experiments, studies on androgen deprivation therapy patients, and studies on testosterone-treated patients. We finish by providing recommendations for the clinician and needs for future research.
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Affiliation(s)
- Akl C. Fahed
- Department of Genetics, Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA 02115, USA
| | - Joanna M. Gholmieh
- School of Pharmacy, Lebanese American University, P.O. Box 36, Byblos, Lebanon
| | - Sami T. Azar
- Department of Internal Medicine, American University of Beirut, Bliss Street, P.O. Box 11-0236, Beirut, Lebanon
- *Sami T. Azar:
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Brodacki B, Chalimoniuk M, Wesołowska J, Staszewski J, Chrapusta SJ, Stępień A, Langfort J. cGMP level in idiopathic Parkinson's disease patients with and without cardiovascular disease - A pilot study. Parkinsonism Relat Disord 2011; 17:689-92. [PMID: 21802341 DOI: 10.1016/j.parkreldis.2011.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 06/17/2011] [Accepted: 07/06/2011] [Indexed: 11/26/2022]
Abstract
We have previously found that average serum cGMP level in unselected patients with Parkinson's disease (PD), particularly in patients treated with a combination of l-DOPA and the dopamine agonist pergolide mesylate, is markedly higher than that in healthy controls. Here we compared serum cGMP and total testosterone levels between l-DOPA/pergolide mesylate-treated male idiopathic PD patients without and with cardiovascular disease (iPD, n = 10, and iPD-CVD, n = 10, respectively) and age-matched healthy volunteers (n = 10). There was no difference in PD-related disability between the two patient groups as assessed by UPDRS motor score and Hoehn-Yahr staging. Whereas none of the patients showed hypoandrogenemia, PD patients compared to controls revealed significantly lower serum testosterone levels, and iPD-CVD patients showed significantly lower levels than iPD patients. Serum cGMP levels were but moderately while significantly higher in the two groups of PD patients than in the controls, and were the highest in the iPD-CVD group. For all study groups combined, there was a high negative correlation between total testosterone level and cGMP level. Our data indicate that blood total testosterone level is negatively correlated with general health status in PD patients, whereas the reverse is true for blood cGMP level.
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Affiliation(s)
- Bogdan Brodacki
- Neurology Clinic, Military Institute of Medicine, 128 Szaserów St., 04-141 Warsaw, Poland
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Affiliation(s)
- Bu B Yeap
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA
- Department of Endocrinology and Diabetes, Fremantle Hospital, Fremantle, WA
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