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Cedergren Weber G, Odin P. Diagnostic work up: Laboratory and biomarkers. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 162:53-96. [PMID: 35397789 DOI: 10.1016/bs.irn.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This chapter will focus on the diagnostic work around sexual dysfunction in Parkinson's disease, especially laboratory tests and biomarkers. A number of methods to analyze if sexual dysfunction is caused by neural pathology, vascular dysfunction or other mechanisms are now available. Other methods can be used to differentiate between psychogenic/functional reasons behind sexual dysfunction and organic ones. The role of biomarkers for diagnosis, but also for understanding the reason behind and for counteracting sexual dysfunction is becoming more evident. There is also a rich and increasing number of scales and other instruments available for detecting and quantifying sexual hypo- and hyperactivity. When investigating the reason behind sexual dysfunction in patients with Parkinson's disease comorbidities should also be considered. Finally, early and pronounced sexual dysfunction might in some cases be an indication that differential diagnosis, like Multisystem Atrophy, should be thought about. All these aspects of the diagnostic procedures around sexual dysfunction in Parkinson's disease will be covered in this chapter.
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Affiliation(s)
- Gustav Cedergren Weber
- Division of Neurology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
| | - Per Odin
- Division of Neurology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
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Deger M, Ozmen C, Akdogan N, Tepe O, Yucel SP, Izol V. The Relationship Between Gensini Score and Erectile Dysfunction in Patients with Chronic Coronary Syndrome. Sex Med 2021; 9:100376. [PMID: 34090241 PMCID: PMC8240327 DOI: 10.1016/j.esxm.2021.100376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/30/2021] [Accepted: 04/03/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction In previous studies, the relationship between atherosclerosis and erectile dysfunction (ED) was examined, but the relationship and correlation between Gensini score which evaluates the extent and severity of chronic coronary syndrome (CCS), and ED severity were not investigated. Aim To evaluate the relationship between Gensini score and ED in patients with CCS. Methods We included 142 consecutive male patients with the diagnosed CCS and underwent an elective coronary angiography between January 2019 and March 2020. Main Outcome Measure Correlation analysis demonstrated that Gensini score significantly negatively correlated with the International Index Erectile Function - 5 (IIEF-5) score (r = -0.417, P < .001). Results Severe ED was present in 48 (33.8%) patients, moderate ED in 31 (21.8%) patients, and mild ED in 22 (15.5%) patients. 41(28.9%) patients did not have ED. Both the No ED and Mild ED groups were statistically significantly lower than the Severe ED group in terms of the Gensini score (P < .05). When the recommended optimal cut-off point and accuracy measurements were made for the Gensini score, the area under curve (AUC) value in predicting ED was 0.806 (95% CI: 0.732-0.880, P < .001). Multivariate logistic regression analysis demonstrated that independent predictors for ED were Gensini score and age (P < .001, and P = .026, respectively). Every 1 unit increase in Gensini score resulted in a 6% increase in the occurrence of ED (OR = 1.06, CI:1.03-1.10, P < .001). Conclusion ED can be caused by endothelial dysfunction. Patients with severe CSS and high Gensini score should be evaluted for ED. ED may be a sign of severe CCS and a high Gensini score. It is also necessary to evaluate cardiological in patients with ED. Deger M, Ozmen C, Akdogan N, et al. The Relationship Between Gensini Score and Erectile Dysfunction in Patients with Chronic Coronary Syndrome. Sex Med 2021;9:100376.
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Affiliation(s)
- Mutlu Deger
- Department of Urology, Faculty of Medicine, Çukurova University, Adana, Turkey.
| | - Caglar Ozmen
- Department of Cardiology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Nebil Akdogan
- Department of Urology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Omer Tepe
- Department of Cardiology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Sevinc Puren Yucel
- Department of Biostatistics, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Volkan Izol
- Department of Urology, Faculty of Medicine, Çukurova University, Adana, Turkey
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Kutikhin AG, Feenstra L, Kostyunin AE, Yuzhalin AE, Hillebrands JL, Krenning G. Calciprotein Particles: Balancing Mineral Homeostasis and Vascular Pathology. Arterioscler Thromb Vasc Biol 2021; 41:1607-1624. [PMID: 33691479 PMCID: PMC8057528 DOI: 10.1161/atvbaha.120.315697] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 03/01/2021] [Indexed: 12/12/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Anton G. Kutikhin
- Laboratory for Vascular Biology, Division of Experimental and Clinical Cardiology, Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russian Federation (A.G.K., A.E.K., A.E.Y.)
| | - Lian Feenstra
- Department of Pathology and Medical Biology, Division of Pathology (L.F., J.-L.H.), University Medical Center Groningen, University of Groningen, the Netherlands
- Laboratory for Cardiovascular Regenerative Medicine, Department of Pathology and Medical Biology (L.F., G.K.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Alexander E. Kostyunin
- Laboratory for Vascular Biology, Division of Experimental and Clinical Cardiology, Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russian Federation (A.G.K., A.E.K., A.E.Y.)
| | - Arseniy E. Yuzhalin
- Laboratory for Vascular Biology, Division of Experimental and Clinical Cardiology, Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russian Federation (A.G.K., A.E.K., A.E.Y.)
| | - Jan-Luuk Hillebrands
- Department of Pathology and Medical Biology, Division of Pathology (L.F., J.-L.H.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Guido Krenning
- Laboratory for Cardiovascular Regenerative Medicine, Department of Pathology and Medical Biology (L.F., G.K.), University Medical Center Groningen, University of Groningen, the Netherlands
- Sulfateq B.V., Admiraal de Ruyterlaan 5, 9726 GN, Groningen, the Netherlands (G.K.)
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Ivanovski O, Nikolov IG, Davceva O, Petrushevska G. Calcification of the cavernosal bodies may be responsible for development of erectile dysfunction in uremic apolipoprotein E deficient (apoE-/-) mice. Rev Int Androl 2019; 19:25-33. [PMID: 31899189 DOI: 10.1016/j.androl.2019.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/30/2019] [Accepted: 08/08/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION AND OBJECTIVE Erectile dysfunction's physiopathology in uremia is complex and multifactorial, involving a combination of classical risk factors and specific uremia-related risk factors such as increased oxidative stress, endothelial dysfunction and inflammation. The aim of the study is to investigate the effect of chronic kidney disease (CKD) on vascular calcification and endothelial function of cavernosal bodies in apolipoprotein E deficient (apoE-/-) mice, a well known model of erectile dysfunction. MATERIALS AND METHODS Eight-week-old male apoE-/- mice were randomly assigned to the following 3 groups: (i) subtotally nephrectomised (SNX apoE-/-, 12 mice), (ii) uninephrectomised (UNX apoE-/-, 11 mice) or (iii) sham operated (sham-op apoE-/-, 15 mice). At 16 weeks after surgery, aortas and penile erectile tissues were harvested for histological studies to assess atherosclerosis, vascular calcification, nitrotyrosine staining, total collagen content and macrophage staining. RESULTS At sacrifice, SNX and UNX mice had significantly higher serum urea, total cholesterol, and triglyceride concentrations than sham-op controls. Atherosclerotic lesions in thoracic aorta were significantly larger in uremic apoE-/- mice than in controls. There were no atheromatous lesions in cavernosal bodies or penile artery observed in any group. However, SNX and UNX animals showed a significant increase in calcification score, collagen content and nitrotyrosine staining in cavernosal bodies when compared with controls. The degree of macrophage infiltration was comparable between the 3 groups. CONCLUSION In conclusion, even mild renal dysfunction, i.e., after uninephrectomy increases calcification score and aggravates endothelial function of cavernosal bodies in apoE-/- mice and this effect might be linked to increased oxidative stress in penile endothelium.
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Affiliation(s)
- Ognen Ivanovski
- University Clinic of Urology, Medical Faculty, University SS Cyril and Methodius, Skopje, Macedonia.
| | - Igor G Nikolov
- University Clinic of Nephrology, Medical Faculty, University SS Cyril and Methodius, Skopje, Macedonia
| | - Olivera Davceva
- University Clinic of Clinical Biochemistry, Medical Faculty, University SS Cyril and Methodius, Skopje, Macedonia
| | - Gordana Petrushevska
- Institute of Pathology, Medical Faculty, University SS Cyril and Methodius, Skopje, Macedonia
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Karabakan M, Bozkurt A, Saylam B, Kucuksu Z, Hirik E, Kagan Aktas B. A new proof for the relationship between erectile dysfunction and atherosclerosis: fragmented QRS? Int J Impot Res 2019; 32:302-307. [PMID: 31243353 DOI: 10.1038/s41443-019-0166-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 04/10/2019] [Accepted: 05/28/2019] [Indexed: 11/09/2022]
Abstract
In patients with coronary artery disease (CAD), fragmented QRS (fQRS) is a practical marker of myocardial ischemia evaluated on electrocardiography (ECG).The current study investigated the connection between FQRS and erectile dysfunction (ED), which is commonly accepted as an early sign and independent predictor of CAD. The study consisted of a 190 ED patients; 47 of them having severe, 44 moderate, 49 mild-to-moderate, and 50 mild ED, and a control group of 51 otherwise healthy adult men. None of the participants had a history of cardiac disease. There was a significant difference among the groups in terms of fQRS; severe, moderate, and mild-to-moderate ED groups had significantly higher rates of fQRS presence on ECG (27.5%, 23.5%, and 22.5%, respectively) in comparison with those of mild ED and the control groups (13.7% and 12.7%, respectively) (p < 0.001). In patients presenting with ED complaints, a fQRS finding on a simple ECG recording may serve as a first sign of the presence of CAD. As far as we know, the present study is the first in the literature assessing the possible relationship between ED and fQRS. On the ECG, the existence of fQRS was considered to be connected with ED; thus, including this basic parameter into the clinical decisions for ED patients may initiate an extensive diagnostic approach for their underlying cardiovascular diseases.
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Affiliation(s)
- Mehmet Karabakan
- Department of Urology, Mersin Toros State Hospital, Mersin, Turkey.
| | - Aliseydi Bozkurt
- Department of Urology, Erzincan University Mengucek Gazi Research and Training Hospital, Erzincan, Turkey
| | - Barıs Saylam
- Department of Urology, Mersin Research and Training Hospital, Mersin, Turkey
| | - Zafer Kucuksu
- Department of Cardiology, Erzincan University Mengucek Gazi Research and Training Hospital, Erzincan, Turkey
| | - Erkan Hirik
- Department of Urology, Erzincan University Mengucek Gazi Research and Training Hospital, Erzincan, Turkey
| | - Binhan Kagan Aktas
- Department of Urology, Ankara Numune Research and Training Hospital, Ankara, Turkey
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Usefulness of serum fetuin-A level as a marker of erectile dysfunction. Int J Impot Res 2017; 29:189-193. [PMID: 28424505 DOI: 10.1038/ijir.2017.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 03/06/2017] [Accepted: 03/29/2017] [Indexed: 02/06/2023]
Abstract
This study aimed to evaluate the correlation between serum levels of fetuin-A and the presence and severity of erectile dysfunction (ED) in Egyptian population. The study was performed on 60 ED patients and 20 age-matched healthy controls. A comprehensive medical history and complete physical examination were obtained and performed in all participants. ED and its severity were assessed via International Index of Erectile Function (IIEF-5). Doppler ultrasound, fasting blood glucose level, complete lipid profile, serum total testosterone (TT) and serum fetuin-A were performed. Our results revealed that there were no statistically significant differences between the ED group and the controls regarding body mass index, fetal bovine serum, cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglyceride (TG). However, IIEF-5 and serum TT levels were significantly lower in ED patients than controls. Regarding serum fetuin-A, our data demonstrated that ED patients had significantly lower serum fetuin-A levels than controls. In addition, patients with severe ED had lower fetuin-A levels than moderate and mild ED (P<0.001). Serum fetuin-A levels are positively correlated with cholesterol, LDL, TG and IIEF-5 and negatively correlated with HDL. In conclusion, serum fetuin-A level could be a potentially useful and sensitive biomarker for ED diagnosis.
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Karabakan M, Bozkurt A, Akdemir S, Gunay M, Keskin E. Significance of serum endothelial cell specific molecule-1 (Endocan) level in patients with erectile dysfunction: a pilot study. Int J Impot Res 2017; 29:175-178. [PMID: 28424502 DOI: 10.1038/ijir.2017.19] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 02/25/2017] [Accepted: 03/29/2017] [Indexed: 12/13/2022]
Abstract
This study aimed to measure the serum endocan level of patients with erectile dysfunction (ED) and to investigate the possible association between the Endothelial-specific molecule-1 (Endocan) level and ED. Twenty healthy and sixty-four male patients included in the study were divided into four groups: severe ED (19 patients), moderate ED (24 patients), mild ED (21 patients) and control group (20 healthy men). The erectile function of all the patients was evaluated using the International Index of Erectile Function-5 (IIEF-5) questionnaire. The body mass index (BMI) of each participant was determined, together with levels of fasting blood glucose, total testosterone, low- and high-density lipoprotein cholesterol, triglyceride and endocan in serum samples. No significant difference was found between the three ED groups and the control group in terms of the mean age, BMI and the levels of cholesterol and fasting blood glucose (P>0.05). The mean serum endocan level was found to 1.076±0.5, 0.674±0.40 and 0.671±0.3 ng ml-1 in the severe, moderate and mild ED groups, respectively. This indicated that the highest value was obtained from the severe ED group, and the difference between the severe ED group and the other groups was statistically significant. In the control group, the serum endocan level was 0.73±0.46 ng ml-1, which was significantly higher compared to the moderate and mild ED groups (P<0.05). The significant difference between the control and ED groups in terms of the serum endocan level can assist in the evaluation of endothelial pathologies in the etiology ED.
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Affiliation(s)
- M Karabakan
- Department of Urology, Mersin Toros State Hospital, Mersin, Turkey
| | - A Bozkurt
- Department of Urology, Erzincan University, Mengucek Gazi Research and Training Hospital, Erzincan, Turkey
| | - S Akdemir
- Department of Urology, Faculty of Medicine, İzmir University, İzmir, Turkey
| | - M Gunay
- Department of Chemistry, Erzincan University Mengucek Gazi Research and Training Hospital, Erzincan, Turkey
| | - E Keskin
- Department of Urology, Erzincan University, Mengucek Gazi Research and Training Hospital, Erzincan, Turkey
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Prystupa A, Dąbrowska A, Sak JJ, Tarach J, Toruń-Jurkowska A, Lachowska-Kotowska P, Dzida G. Concentrations of fetuin-A, osteoprotegerin and α-Klotho in patients with alcoholic liver cirrhosis. Exp Ther Med 2016; 12:3464-3470. [PMID: 27882180 PMCID: PMC5103841 DOI: 10.3892/etm.2016.3754] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 07/26/2016] [Indexed: 12/15/2022] Open
Abstract
The aim of the present study was to evaluate the concentrations of fetuin-A, osteoprotegerin (OPG) and α-Klotho protein in patients with alcoholic cirrhosis at different stages of the disease, and to demonstrate that fetuin-A, osteoprotegin and α-Klotho may be used as markers of the severity of cirrhosis. A total of 54 patients with alcoholic liver cirrhosis treated in various hospitals in the Lublin region of Poland were randomly enrolled. The control group consisted of 18 healthy individuals without liver disease, who did not drink alcohol. Serum levels of fetuin-A, OPG and α-Klotho were measured by ELISA kits. Levels of fetuin-A were significantly reduced in patients with alcoholic liver cirrhosis compared with the control group. OPG levels were higher in patients with alcoholic liver cirrhosis than in the controls, whereas the levels of α-Klotho were comparable in the cirrhosis and control groups. No statistically significant differences in the concentrations of fetuin-A, OPG and α-Klotho protein were demonstrated according to type of liver cirrhosis. The findings of the present study revealed a significant negative correlation between the level of α-Klotho protein and C-reactive protein in the patients with alcoholic liver cirrhosis. Concentrations of fetuin-A were lower, whereas those of OPG were higher, in the alcoholic liver cirrhosis group compared with the control group. Fetuin-A, OPG and α-Klotho may not be good indicators of liver cirrhosis severity. In conclusion, fetuin-A and OPG may be used in the diagnosis of liver cirrhosis.
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Affiliation(s)
- Andrzej Prystupa
- Department of Internal Medicine, Medical University of Lublin, 20-059 Lublin, Poland
| | - Anna Dąbrowska
- Department of Endocrinology, Medical University of Lublin, 20-059 Lublin, Poland
| | - Jarosław Jerzy Sak
- Department of Nephrology, Medical University of Lublin, 20-059 Lublin, Poland; Department of Ethics and Human Philosophy, Medical University of Lublin, 20-059 Lublin, Poland
| | - Jerzy Tarach
- Department of Endocrinology, Medical University of Lublin, 20-059 Lublin, Poland
| | - Anna Toruń-Jurkowska
- Department of Mathematics and Medical Biostatistics, Medical University of Lublin, 20-059 Lublin, Poland
| | | | - Grzegorz Dzida
- Department of Internal Medicine, Medical University of Lublin, 20-059 Lublin, Poland
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