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Ruiz-Ochoa D, Guerra-Ruiz AR, García-Unzueta MT, Muñoz-Cacho P, Rodriguez-Montalvan B, Amado-Diago CA, Lavín-Gómez BA, Cano-García ME, Pablo-Marcos D, Vázquez LA. Sex hormones and the total testosterone:estradiol ratio as predictors of severe acute respiratory syndrome coronavirus 2 infection in hospitalized men. Andrology 2024; 12:1381-1388. [PMID: 38212146 DOI: 10.1111/andr.13581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND The predictive ability of the early determination of sex steroids and the total testosterone:estradiol ratio for the risk of severe coronavirus disease 2019 or the potential existence of a biological gradient in this relationship has not been evaluated. OBJECTIVES To assess the relationship of sex steroid levels and the total testosterone:estradiol ratio with the risk of severe acute respiratory syndrome coronavirus 2 infection in men, defined as the need for intensive care unit admission or death, and the predictive ability of each biomarker. MATERIALS AND METHODS This was a prospective observational study. We included all consecutive adult men with severe acute respiratory syndrome coronavirus 2 infections in a single center admitted to a general hospital ward or to the intensive care unit. Sex steroids were evaluated at the centralized laboratory of our hospital. RESULTS We recruited 98 patients, 54 (55.1%) of whom developed severe coronavirus disease in 2019. Compared to patients with nonsevere coronavirus disease 2019, patients with severe coronavirus disease 2019 had significantly lower serum levels of total testosterone (111 ± 89 vs. 191 ± 143 ng/dL; p < 0.001), dehydroepiandrosterone (1.69 ± 1.26 vs. 2.96 ± 2.64 ng/mL; p < 0.001), and dehydroepiandrosterone sulfate (91.72 ± 76.20 vs. 134.28 ± 98.261 μg/dL; p = 0.009), significantly higher levels of estradiol (64.61 ± 59.35 vs. 33.78 ± 13.78 pg/mL; p = 0.001), and significantly lower total testosterone:estradiol ratio (0.28 ± 0.31 vs. 0.70 ± 0.75; p < 0.001). The lower the serum level of androgen and the lower the total testosterone:estradiol ratio values, the higher the likelihood of developing severe coronavirus disease 2019, with the linear trend in the adjusted analyses being statistically significant for all parameters except for androstenedione (p = 0.064). In the receiver operating characteristic analysis, better predictive performance was shown by the total testosterone:estradiol ratio, with an area under the curve of 0.77 (95% confidence interval 0.68-0.87; p < 0.001). DISCUSSION AND CONCLUSION Our results suggest that men with severe acute respiratory syndrome coronavirus 2 infection, decreased androgen levels and increased estradiol levels have a higher likelihood of developing an unfavorable outcome. The total testosterone:estradiol ratio showed the best predictive ability.
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Affiliation(s)
- David Ruiz-Ochoa
- Department of Endocrinology and Nutrition, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Armando-Raúl Guerra-Ruiz
- Department of Clinical Biochemistry, Marqués de Valdecilla University Hospital, Santander, Spain
- IDIVAL Health Research Institute, Santander, Spain
- University of Cantabria, Santander, Spain
| | - María-Teresa García-Unzueta
- Department of Clinical Biochemistry, Marqués de Valdecilla University Hospital, Santander, Spain
- IDIVAL Health Research Institute, Santander, Spain
- University of Cantabria, Santander, Spain
| | - Pedro Muñoz-Cacho
- IDIVAL Health Research Institute, Santander, Spain
- Department of Medicine and Psychiatry, Gerencia de Atención Primaria, Servicio Cántabro de Salud, Santander, Spain
| | | | - Carlos Antonio Amado-Diago
- IDIVAL Health Research Institute, Santander, Spain
- University of Cantabria, Santander, Spain
- Department of Pneumology, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Bernardo-Alio Lavín-Gómez
- Department of Clinical Biochemistry, Marqués de Valdecilla University Hospital, Santander, Spain
- IDIVAL Health Research Institute, Santander, Spain
| | - María-Eliecer Cano-García
- Department of Microbiology, Marqués de Valdecilla University Hospital, Servicio Cántabro de Salud, Santander, Spain
| | - Daniel Pablo-Marcos
- Department of Microbiology, Marqués de Valdecilla University Hospital, Servicio Cántabro de Salud, Santander, Spain
| | - Luis Alberto Vázquez
- Department of Endocrinology and Nutrition, Marqués de Valdecilla University Hospital, Santander, Spain
- IDIVAL Health Research Institute, Santander, Spain
- University of Cantabria, Santander, Spain
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Wang Q, Yu R, Fu C, Li M, Wang X, Zhu D. The relationship between male and female endogenous reproductive hormones levels and subjective cognitive decline score: A cross-sectional analysis of the Pingyin cohort study. Clin Endocrinol (Oxf) 2024. [PMID: 38952182 DOI: 10.1111/cen.15104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/01/2024] [Accepted: 06/03/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVE Reproductive hormones might impact disease course in cognitive decline. We examined the association between male and female endogenous reproductive hormones and subjective cognitive decline (SCD) score. DESIGN, PATIENTS AND MEASUREMENTS A cross-sectional study design was used with baseline data from the Pingyin cohort study, involving 1943 participants aged 45-70 years. Oestrogen (E2), testosterone, follicle stimulating hormone (FSH) and luteinizing hormone (LH) were measured in females and E2 and testosterone were measured in males. We categorised hormones into three levels of low, intermediate and high level. The 9-item subjective cognitive decline questionnaire (SCD-Q9) scores were collected to assess the symptoms of SCD. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence interval (CI) between categorised hormone levels and SCD status. Multivariable linear regression models were also used. RESULTS Overall, 1943 participants were involved and 1285 (66.1%) were female. The mean age at baseline was 59.1 (standard deviation 7.1) years. Women with high testosterone levels had a higher probability of having SCD compared with those with low testosterone levels (OR 1.43, 95% CI 1.01-2.05). Men with a high level of testosterone (0.59, 0.35-0.98) and high testosterone/E2 ratio (0.55, 0.33-0.90) were related to decreased chances of having SCD. Each one-unit increase of testosterone was linked to reduced SCD score in males [(β: -.029, 95% CI (-0.052, -0.007)]. CONCLUSION There was sex-specific relationship between hormone levels and SCD abnormal. Those with higher testosterone levels in females may increase likelihood of experiencing SCD. Males with higher testosterone levels and higher testosterone/E2 ratio may be associated with reduced likelihood of SCD. The roles of endogenous reproductive hormone levels and their dynamic changes in cognitive function need further investigation.
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Affiliation(s)
- Qi Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ruihong Yu
- Pingyin Center for Disease Control and Prevention, Jinan, Pingyin, China
| | - Chunying Fu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Meiling Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiaoyi Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Dongshan Zhu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Center for Clinical Epidemiology and Evidence-Based Medicine, Shandong University, Jinan, China
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3
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Asero V, Scornajenghi CM, Iaconis S, Sicignano E, Falcone A, Dinacci F, Pagano G, Carino D, Corvino R, Tresh A. Interplay between male gonadal function and overall male health. J Basic Clin Physiol Pharmacol 2024; 35:105-110. [PMID: 38830206 DOI: 10.1515/jbcpp-2024-0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 04/23/2024] [Indexed: 06/05/2024]
Abstract
The process-of-male reproduction is intricate, and various medical conditions-have the potential to disrupt spermatogenesis. Moreover, infertility in males can serve as an indicator of-potential future health issue. Numerous conditions with systemic implications have been identified, encompassing genetic factors (such as Klinefelter Syndrome), obesity, psychological stress, environmental factors, and others. Consequently, infertility assessment-presents an opportunity for comprehensive health counseling, extending-beyond discussions about reproductive goals. Furthermore, male infertility has been suggested as a harbinger of future health problems, as poor semen quality and a diagnosis of-male infertility are associated with an increased risk of hypogonadism, cardiometabolic disorders, cancer, and even mortality. This review explores the existing-literature on the relationship between systemic illnesses and male fertility, impacting both clinical-outcomes and semen parameters. The majority of the literature analyzed, which compared gonadal function with genetic, chronic, infectious or tumoral diseases, confirm the association between overall male health and infertility.
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Affiliation(s)
- Vincenzo Asero
- Department of Maternal Infant and Urologic Sciences, 9311 University of Rome La Sapienza , Rome, Lazio, Italy
| | - Carlo Maria Scornajenghi
- Department of Maternal Infant and Urologic Sciences, 9311 University of Rome La Sapienza , Rome, Lazio, Italy
| | - Salvatore Iaconis
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, 165474 Federico II University Hospital , Napoli, Italy
| | - Enrico Sicignano
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, 165474 Federico II University Hospital , Napoli, Italy
| | - Alfonso Falcone
- Department of Neurosciences, Science of Reproduction and Odontostomatology, 9307 University of Naples Federico II , Napoli, Campania, Italy
| | - Fabrizio Dinacci
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, 165474 Federico II University Hospital , Napoli, Campania, Italy
| | - Giovanni Pagano
- Department of Neurosciences, Science of Reproduction and Odontostomatology, 9307 University of Naples Federico II , Napoli, Italy
| | - Dalila Carino
- Department of Maternal Infant and Urologic Sciences, 9311 University of Rome La Sapienza , Rome, Italy
| | - Roberta Corvino
- Department of Maternal Infant and Urologic Sciences, 9311 University of Rome La Sapienza , Rome, Italy
| | - Anas Tresh
- Department of Urology, 10624 Stanford University School of Medicine , Stanford, CA, USA
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Glover F, Sullivan E, Mulloy E, Belladelli F, Del Giudice F, Eisenberg ML. The relationship between klotho, testosterone, and sexual health parameters among US adult men. J Endocrinol Invest 2024; 47:523-533. [PMID: 37648906 DOI: 10.1007/s40618-023-02163-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 07/24/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Klotho is a pleotropic hormone involved in a multitude of biological processes necessary for healthy aging, and affords protection from adverse events such as cardiovascular disease, inflammation, and various cancers. Emerging evidence suggests that klotho is also an important component of biochemical pathways that regulate hormone balance, which may include those pathways governing testosterone production and men's sexual health, though data are limited and results are mixed. OBJECTIVE Using a cohort of 767 men from the NHANES 2015-2016 survey cycle, we set out to quantify the association between serum klotho levels and serum testosterone levels, as well as clinical markers of men's sexual health (e.g., testosterone:estrogen ratio, bioavailable testosterone, and free testosterone). METHODS Multivariable linear and logistic regression models while controlling for potential confounders were constructed to quantify the relationship between serum klotho and testosterone, as well as between serum klotho and odds of low testosterone (serum testosterone < 300 ng/dL). RESULTS A positive association was observed between serum klotho and testosterone (β = 0.18, p = 0.04). Serum klotho levels were also stratified into quartiles, and we observed statistically significant increases in testosterone for increasing quartile level of klotho using the first quartile as the reference group (β = 90.51, p = 0.001, β = 106.93, p = 0.002, β = 95.33, p = 0.03 for quartiles 2, 3, and 4, respectively). The average testosterone values by quartiles of klotho were 306.9 ng/dL, 390 ng/dL, 409.3 ng/dL, and 436.6 ng/dL, respectively. We modeled important proxies for sexual health including bioavailable and free testosterone, the testosterone:estradiol ratio, and C-reactive protein. Men in the second quartile of klotho had a significantly lower odds of an abnormal testosterone:estradiol ratio compared to the first quartile [OR = 0.18, 95% CI = (0.03, 0.98)].We observed null associations between continuous serum klotho and odds of low testosterone [OR = 1.0, 95% CI = (1.0, 1.0)], and when stratified by quartile, we observed a significant decrease in the odds of low testosterone for individuals in the second quartile of klotho compared to the first quartile [OR = 0.21, 95% CI = (0.05, 0.91)]. In addition, C-reactive protein was inversely associated with testosterone in men (β = - 4.65, p = 0.001), and inversely associated with quartiles of klotho (β = - 2.28, p = 0.04, β = - 2.22, p = 0.04, β = - 2.28, p = 0.03, for quartiles 2, 3, and 4, respectively). CONCLUSION Our findings support previous studies suggesting a role for klotho in testosterone levels and sexual function among men. Future studies are warranted to corroborate these findings, determine clinical significance, and elucidate potential mechanisms underlying these associations.
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Affiliation(s)
- F Glover
- Emory University School of Medicine, Atlanta, GA, 30322, USA.
| | - E Sullivan
- Pharmacology Department, Emory University, Atlanta, GA, 30322, USA
| | - E Mulloy
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - F Belladelli
- Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy
| | - F Del Giudice
- Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy
| | - M L Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
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Kim D, Manikat R, Cholankeril G, Ahmed A. Endogenous sex hormones and nonalcoholic fatty liver disease in US adults. Liver Int 2024; 44:460-471. [PMID: 38010926 DOI: 10.1111/liv.15786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND AND AIMS Sex steroid hormones and sex hormone-binding globulin (SHBG) have a role in predisposing individuals to nonalcoholic fatty liver disease (NAFLD), but their effects are known to differ between men and women. The testosterone-to-estradiol ratio (T/E2 ratio) and free androgen index (FAI) were known biomarkers for the hormonal milieu. We investigated whether sex steroid hormones, T/E2 ratio, FAI, and SHBG were associated with NAFLD in US adults. METHODS A cross-sectional analysis using the 2013-2016 National Health and Nutrition Examination Survey (NHANES) was performed. NAFLD was defined by utilizing the Hepatic Steatosis Index (HSI) and the US fatty liver index (USFLI) without other causes of chronic liver disease. RESULTS Out of 8687 subjects (49.5% male), low total testosterone levels were associated with progressively higher odds of NAFLD in men. Increasing T/E2 ratio was inversely associated with higher odds of NAFLD in men. Low serum SHBG levels were independently associated with an increased risk of NAFLD regardless of sex and menopausal status. Increasing FAI was independently associated with NAFLD. When we additionally adjusted for SHBG, T/E2 ratio, not total testosterone, was inversely associated with NAFLD in a dose-dependent manner. Increasing FAI was associated with higher odds of NAFLD in premenopausal women and marginally associated with NAFLD in postmenopausal women. CONCLUSION The T/E2 ratio and SHBG were inversely associated with an increased risk of NAFLD in men. In women, increasing FAI was associated with NAFLD, whereas SHBG was inversely associated with NAFLD.
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Affiliation(s)
- Donghee Kim
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA
| | - Richie Manikat
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA
| | - George Cholankeril
- Liver Center, Division of Abdominal Transplantation, Michael E DeBakey Department of General Surgery, Baylor College of Medicine, Houston, Texas, USA
- Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Aijaz Ahmed
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA
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Kusters CDJ, Paul KC, Lu AT, Ferruci L, Ritz BR, Binder AM, Horvath S. Higher testosterone and testosterone/estradiol ratio in men are associated with decreased Pheno-/GrimAge and DNA-methylation based PAI1. GeroScience 2024; 46:1053-1069. [PMID: 37369886 PMCID: PMC10828310 DOI: 10.1007/s11357-023-00832-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/18/2023] [Indexed: 06/29/2023] Open
Abstract
Sex hormones are hypothesized to drive sex-specific health disparities. Here, we study the association between sex steroid hormones and DNA methylation-based (DNAm) biomarkers of age and mortality risk including Pheno Age Acceleration (AA), Grim AA, and DNAm-based estimators of Plasminogen Activator Inhibitor 1 (PAI1), and leptin concentrations. We pooled data from three population-based cohorts, the Framingham Heart Study Offspring Cohort, the Baltimore Longitudinal Study of Aging, and the InCHIANTI Study, including 1,062 postmenopausal women without hormone therapy and 1,612 men of European descent. Sex-stratified analyses using a linear mixed regression were performed, with a Benjamini-Hochberg (BH) adjustment for multiple testing. Sex Hormone Binding Globulin (SHBG) was associated with a decrease in DNAm PAI1 among men (per 1 standard deviation (SD): -478 pg/mL; 95%CI: -614 to -343; P:1e-11; BH-P: 1e-10), and women (-434 pg/mL; 95%CI: -589 to -279; P:1e-7; BH-P:2e-6). The testosterone/estradiol (TE) ratio was associated with a decrease in Pheno AA (-0.41 years; 95%CI: -0.70 to -0.12; P:0.01; BH-P: 0.04), and DNAm PAI1 (-351 pg/mL; 95%CI: -486 to -217; P:4e-7; BH-P:3e-6) among men. In men, testosterone was associated with a decrease in DNAm PAI1 (-481 pg/mL; 95%CI: -613 to -349; P:2e-12; BH-P:6e-11). SHBG was associated with lower DNAm PAI1 among men and women. Higher testosterone and testosterone/estradiol ratio were associated with lower DNAm PAI and a younger epigenetic age in men. A decrease in DNAm PAI1 is associated with lower mortality and morbidity risk indicating a potential protective effect of testosterone on lifespan and conceivably cardiovascular health via DNAm PAI1.
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Affiliation(s)
- Cynthia D J Kusters
- Department of Human Genetics, David Geffen School of Medicine, Los Angeles, CA, USA.
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
- Department of Epidemiology, Fielding School of Public Health at UCLA, Box 708822, 650 Charles E. Young Drive South, CA, 90095-7088, Los Angeles, USA.
| | - Kimberly C Paul
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Ake T Lu
- Department of Human Genetics, David Geffen School of Medicine, Los Angeles, CA, USA
- Altos Labs, San Diego, USA
| | - Luigi Ferruci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute On Aging, National Institutes of Health, Baltimore, USA
| | - Beate R Ritz
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA
- Department of Environmental Health, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Alexandra M Binder
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Steve Horvath
- Department of Human Genetics, David Geffen School of Medicine, Los Angeles, CA, USA
- Altos Labs, San Diego, USA
- Department of Biostatistics, School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
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Belladelli F, Boeri L, Fallara G, Pozzi E, Corsini C, Cilio S, Capogrosso P, D'Arma A, Eisenberg ML, Montorsi F, Salonia A. Hyperestrogenism is associated with sexual function impairment in men-findings from a cross-sectional, real-life study. Andrology 2024; 12:179-185. [PMID: 37261881 DOI: 10.1111/andr.13470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/08/2023] [Accepted: 05/26/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Hyperestrogenism is believed to be harmful to male sexuality. We aimed to investigate the prevalence of and the impact of hyperestrogenism on sexual functioning in a cohort of men seeking medical attention for new-onset erectile dysfunction. MATERIALS AND METHODS Data from 547 men seeking first medical help for new-onset erectile dysfunction at a single andrology center were analyzed. Patients were assessed with a thorough medical and sexual history. Comorbidities were scored with the Charlson comorbidity index. All patients completed the International index of erectile function; the International index of erectile function-erectile function domain was categorized according to Cappelleri's criteria. Circulating hormones were measured in every patient. Hyperestrogenism was defined as estradiol levels >42.6 pg/mL (Tan et al., 2015). Descriptive statistics and logistic/linear regression models tested the association between hyperestrogenism and International index of erectile function domains score. RESULTS Overall, 96 (17.6%) participants had serum estrogen levels suggestive of hyperestrogenism. Men with hyperestrogenism were older (median [interquartile range]: 46 [35-59] vs. 44 [31-56] years; p < 0.001), had a higher rate of comorbidities (Charlson comorbidity index ≥1: 26.0% vs. 7.4%; p < 0.001), and higher serum total testosterone values (5.4 [5.2-8.0] vs. 4.3 [4.1-5.7] ng/mL; p = 0.01) than those with normal estradiol values. A higher prevalence of severe erectile dysfunction (135 [29.9%] vs. 47 [48.9%] men; p = 0.01) and of hypogonadism (22 [4.8%] vs. 6 [6.3%] men; p = 0.004) were found in men with hyperestrogenism. Serum estradiol levels were positively correlated with total testosterone levels (β = 0.26, p < 0.001) but negatively correlated with International index of erectile function-orgasmic function (β = -0.24, p = 0.002) and International index of erectile function-erectile function scores (β = -0.03, p < 0.001). When International index of erectile function scores was used to stratify erectile dysfunction patients, hyperestrogenism (odds ratio 2.44, p = 0.02) was associated with severe erectile dysfunction. CONCLUSIONS One out of five men seeking first medical help for erectile dysfunction showed elevated serum estradiol values suggestive of hyperestrogenism. Hyperestrogenism was associated with health-significant comorbidities, orgasmic function impairment, and erectile dysfunction severity.
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Affiliation(s)
- Federico Belladelli
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Luca Boeri
- Department of Urology, Foundation IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Fallara
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Edoardo Pozzi
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Christian Corsini
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Simone Cilio
- Vita-Salute San Raffaele University, Milan, Italy
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Napoli, Italy
| | - Paolo Capogrosso
- ASST Sette Laghi-Circolo e Fondazione Macchi Hospital, Varese, Italy
| | - Alessia D'Arma
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Michael L Eisenberg
- Department of Urology, School of Medicine, Stanford University, Stanford, California, USA
| | - Francesco Montorsi
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Salonia
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
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8
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Kusters CDJ, Paul KC, Lu AT, Ferrucci L, Ritz BR, Binder AM, Horvath S. Higher testosterone and testosterone/estradiol ratio in men are associated with better epigenetic estimators of mortality risk. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.02.16.23285997. [PMID: 36865294 PMCID: PMC9980235 DOI: 10.1101/2023.02.16.23285997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Introduction Sex hormones are hypothesized to drive sex-specific health disparities. Here, we study the association between sex steroid hormones and DNA methylation-based (DNAm) biomarkers of age and mortality risk including Pheno Age Acceleration (AA), Grim AA, and DNAm-based estimators of Plasminogen Activator Inhibitor 1 (PAI1), and leptin concentrations. Methods We pooled data from three population-based cohorts, the Framingham Heart Study Offspring Cohort (FHS), the Baltimore Longitudinal Study of Aging (BLSA), and the InCHIANTI Study, including 1,062 postmenopausal women without hormone therapy and 1,612 men of European descent. Sex hormone concentrations were standardized with mean 0 and standard deviation of 1, for each study and sex separately. Sex-stratified analyses using a linear mixed regression were performed, with a Benjamini-Hochberg (BH) adjustment for multiple testing. Sensitivity analysis was performed excluding the previously used training-set for the development of Pheno and Grim age. Results Sex Hormone Binding Globulin (SHBG) is associated with a decrease in DNAm PAI1 among men (per 1 standard deviation (SD): -478 pg/mL; 95%CI: -614 to -343; P:1e-11; BH-P: 1e-10), and women (-434 pg/mL; 95%CI: -589 to -279; P:1e-7; BH-P:2e-6). The testosterone/estradiol (TE) ratio was associated with a decrease in Pheno AA (-0.41 years; 95%CI: -0.70 to -0.12; P:0.01; BH-P: 0.04), and DNAm PAI1 (-351 pg/mL; 95%CI: -486 to -217; P:4e-7; BH-P:3e-6) among men. In men, 1 SD increase in total testosterone was associated with a decrease in DNAm PAI1 (-481 pg/mL; 95%CI: -613 to -349; P:2e-12; BH-P:6e-11). Conclusion SHBG was associated with lower DNAm PAI1 among men and women. Higher testosterone and testosterone/estradiol ratio were associated with lower DNAm PAI and a younger epigenetic age in men. A decrease in DNAm PAI1 is associated with lower mortality and morbidity risk indicating a potential protective effect of testosterone on lifespan and conceivably cardiovascular health via DNAm PAI1.
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Affiliation(s)
- Cynthia DJ Kusters
- Department of Human Genetics, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Kimberly C Paul
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Ake T Lu
- Department of Human Genetics, David Geffen School of Medicine, Los Angeles, CA, USA
- Altos Labs, San Diego, USA
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, USA
| | - Beate R Ritz
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Department of Environmental Health, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Alexandra M Binder
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Steve Horvath
- Department of Human Genetics, David Geffen School of Medicine, Los Angeles, CA, USA
- Altos Labs, San Diego, USA
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
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9
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Chehab O, Shabani M, Varadarajan V, Wu CO, Watson KE, Yeboah J, Post WS, Ambale-Venkatesh B, Bluemke DA, Michos E, Lima JA. Endogenous Sex Hormone Levels and Myocardial Fibrosis in Men and Postmenopausal Women. JACC. ADVANCES 2023; 2:100320. [PMID: 37691970 PMCID: PMC10489298 DOI: 10.1016/j.jacadv.2023.100320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 02/06/2023] [Accepted: 02/28/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Sex hormone (SH) imbalances have been linked to a higher risk of heart failure in both sexes. However, mechanisms that underlie this relationship remain unclear. We examined the association of baseline SH with interstitial and replacement myocardial fibrosis in the MESA (Multi-Ethnic Study of Atherosclerosis) using cardiac magnetic resonance (CMR) T1 mapping and late gadolinium enhancement (LGE). OBJECTIVES The purpose of this study was to assess the link between baseline sex hormone levels and myocardial fibrosis in the MESA cohort using CMR. METHODS A total of 2,324 participants (men and postmenopausal women [PMW]) were included in the MESA with SH measured at baseline and had underwent CMR 10 years later. All analyses were stratified by sex and age. Regression models were constructed to assess the associations of baseline SH with extracellular volume (ECV)% and native T1 time and with LGE. Higher native T1 time and ECV% are interpreted as evidence of increasing interstitial myocardial fibrosis (IMF). Given the limited number of myocardial scars present in PMW, analysis of LGE was limited to men. RESULTS Among older men (age ≥65 years), a 1-SD increment higher free testosterone was significantly associated with 2.45% lower ECV% and 21.5% lower native T1 time, while a 1-SD increment higher bioavailable testosterone was associated with 12.5% lower native T1 time. A 1-SD increment greater sex hormone-binding globulin level was associated with 1% higher ECV%. Among PMW of 55 to 64 years, a 1-SD increment higher total testosterone was associated with 9.5% lower native T1 time. Higher levels of estradiol in older men were independently associated with higher odds of having a myocardial scar (OR: 4.10; 95% CI: 1.35-12.40; P = 0.01). CONCLUSIONS Among older men, SH imbalances at initial evaluation were independently associated with CMR defined IMF and replacement fibrosis, respectively; while increasing total testosterone in middle-aged PMW was associated with lesser marker of IMF. (JACC Adv 2023;2:100320) Published by Elsevier on behalf of the American College of Cardiology Foundation.
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Affiliation(s)
- Omar Chehab
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Mahsima Shabani
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Vinithra Varadarajan
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Collin O. Wu
- Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Karol E. Watson
- Division of Cardiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Joseph Yeboah
- Section of Cardiology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Wendy S. Post
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - David A. Bluemke
- Department of Radiology, University of Wisconsin School of Medicine and Public Heath, Madison, Wisconsin, USA
| | - Erin Michos
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - João A.C. Lima
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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10
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Caceres S, Crespo B, Alonso-Diez A, de Andrés PJ, Millan P, Silván G, Illera MJ, Illera JC. Long-Term Exposure to Isoflavones Alters the Hormonal Steroid Homeostasis-Impairing Reproductive Function in Adult Male Wistar Rats. Nutrients 2023; 15:nu15051261. [PMID: 36904260 PMCID: PMC10005734 DOI: 10.3390/nu15051261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
The consumption of isoflavones is gaining popularity worldwide due to their beneficial effects on health. However, isoflavones are considered to be endocrine disruptors and cause deleterious effects on hormone-sensitive organs, especially in males. Therefore, this study aimed to determine if a continuous and prolonged exposure to isoflavones in adult males altered the endocrine axis effect of testicular function. For this purpose, seventy-five adult male rats were administered with low and high mixtures of isoflavones (genistein and daidzein) for 5 months. The determination of steroid hormones (progesterone, androstenedione, dehydroepiandrosterone, testosterone, dihydrotestosterone, 17β-estradiol, and estrone sulphate) was carried out in serum and testicular homogenate samples. Sperm quality parameters and testicular histology were also determined. The results revealed that low and high doses of isoflavones promote a hormonal imbalance in androgen and estrogen production, resulting in a decrease in circulating and testicular androgen levels and an increase in estrogen levels. These results are associated with a reduction in the sperm quality parameters and a reduction in the testicular weight, both in the diameter of the seminiferous tubules and the height of the germinal epithelium. Altogether, these results suggest that a continuous exposure to isoflavones in adult male rats causes a hormonal imbalance in the testes that disrupts the endocrine axis, causing defects in testicular function.
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Affiliation(s)
- Sara Caceres
- Department of Physiology, Veterinary Medicine School, Complutense University of Madrid, 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-913943865
| | - Belén Crespo
- Department of Physiology, Veterinary Medicine School, Complutense University of Madrid, 28040 Madrid, Spain
| | - Angela Alonso-Diez
- Department of Animal Medicine, Surgery and Pathology, Veterinary Medicine School, Complutense University of Madrid, 28040 Madrid, Spain
| | - Paloma Jimena de Andrés
- Department of Animal Medicine, Surgery and Pathology, Veterinary Medicine School, Complutense University of Madrid, 28040 Madrid, Spain
| | - Pilar Millan
- Department of Physiology, Veterinary Medicine School, Complutense University of Madrid, 28040 Madrid, Spain
| | - Gema Silván
- Department of Physiology, Veterinary Medicine School, Complutense University of Madrid, 28040 Madrid, Spain
| | - María José Illera
- Department of Physiology, Veterinary Medicine School, Complutense University of Madrid, 28040 Madrid, Spain
| | - Juan Carlos Illera
- Department of Physiology, Veterinary Medicine School, Complutense University of Madrid, 28040 Madrid, Spain
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11
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Appiah D, Luitel S, Nwabuo CC, Ebong I, Winters SJ. Low endogenous estradiol levels are associated with elevated risk of cardiovascular disease mortality in young and middle-aged men in the United States. Atherosclerosis 2022; 361:34-40. [PMID: 36210243 DOI: 10.1016/j.atherosclerosis.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/18/2022] [Accepted: 09/14/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS Evidence for the association of total estradiol (E2) with cardiovascular disease (CVD) in young men is limited. We investigated the association of total E2 or free estradiol (FE2) and CVD mortality in a nationally representative multiracial sample of young and middle-aged men in the United States. METHODS Data were from 954 men without CVD, cancer, diabetes and not on androgen therapy or taking anabolic steroids, who participated in the National Health and Nutrition Examination Survey (1988-1991), for whom E2 was measured, and were followed for mortality through to 2015. Fasting serum levels of E2 were measured using competitive electrochemiluminescence immunoassays. Free estradiol was estimated from the levels of estradiol, sex hormone binding globulin, and albumin. International Classification of Diseases codes were used to define CVD mortality. Cox regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI). RESULTS The average age of participants at baseline was 35.7 ± 11.6 years, with 11% and 6% reporting Black and Hispanic race and ethnicity, respectively. During a median follow-up of 25.2 years, 40 CVD deaths were recorded. Controlling for baseline demographic and CVD risk factors, and total testosterone levels, a 1 standard deviation decrement in log E2 (HR: 2.33, 95%CI: 1.11-5.00) or FE2 (HR: 1.89, 95%CI: 1.01-3.57) was associated with elevated risk of CVD mortality. This elevated risk was largely limited to non-Hispanic White men. CONCLUSIONS In this study, low levels of E2 or FE2 were associated with elevated risk of CVD mortality.
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Affiliation(s)
- Duke Appiah
- Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
| | - Sujata Luitel
- Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Chike C Nwabuo
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Imo Ebong
- Division of Cardiovascular Sciences, University of California, Davis, Sacramento, CA, USA
| | - Stephen J Winters
- Division of Endocrinology, Metabolism and Diabetes, University of Louisville, Louisville, KY, USA
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12
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Xu N, An Q. Correlation between dietary score and depression in cancer patients: Data from the 2005–2018 National Health and Nutrition Examination Surveys. Front Psychol 2022; 13:978913. [PMID: 36186370 PMCID: PMC9523136 DOI: 10.3389/fpsyg.2022.978913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
Abstract
AimTo investigate the correlation between dietary score and depression in patients with cancer.MethodsIn this cross-sectional study, data were collected from the National Health and Nutrition Examination Survey (NHANES) 2005–2018, a cross-sectional and nationally representative database, to compare 322 patients with depression to 2,868 with no depression. Mediterranean (MEDS) diet, Dietary Approaches to Stop Hypertension (DASH) diet, and the Healthy Eating Index 2015 (HEI-2015) score were calculated. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Weighted logistic regression models were used to explore the relationship between dietary scores and depression in patients with cancer. Subgroup analysis was performed by sleep disorders, sex, cancer type, number of tumors, and pain relief prescription treatment.ResultsThe final study sample included 3,190 adults, with 56.94% of them being women, representing 2,177 (86.51%) non-Hispanic white adults. After multivariable adjustment, the MEDS score was correlated with a reduced risk of depression in patients with cancer [odds ratio (OR): 0.90, 95% confidence interval (CI): 0.82–0.97, p = 0.010]. Moreover, the MEDS score was correlated with depression in cancer patients with sleep disorders (OR: 0.84, 95% CI: 0.76–0.93, p = 0.001), in female patients with cancer (OR: 0.83, 95% CI: 0.74–0.92, p < 0.001), particularly in female cancer reproductive system patients (OR: 0.69, 95% CI: 0.57–0.82, p < 0.001). MEDS score also showed a decreased risk of depression in patients with 1 cancer (OR: 0.90, 95% CI: 0.82–0.98, p = 0.019). MEDS score (OR: 0.86, 95% CI: 0.86–0.98, p = 0.024) and DASH (OR: 0.91, 95% CI: 0.84–0.98, p = 0.015) score were related to a decreased risk of depression in patients with cancer using pain relief prescription.ConclusionGood diet quality is significantly correlated with decreased risk of depression in patients with cancer. Aligning with the Dietary Guidelines, such as the MEDS diet, may be beneficial to the reduced risk of depression in patients with cancer.
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Affiliation(s)
- Nan Xu
- Department of Traditional Chinese Medicine, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Qing An
- Department of Traditional Chinese Medicine, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Qing An
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13
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Androgen Annihilation Versus Advanced Androgen Blockage as First Line Treatment for Metastatic Castration Resistant Prostate Cancer: a systematic review and meta-analysis. Crit Rev Oncol Hematol 2022; 179:103801. [PMID: 36031173 DOI: 10.1016/j.critrevonc.2022.103801] [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: 05/18/2022] [Revised: 07/26/2022] [Accepted: 08/23/2022] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Despite recent advances in the treatments of metastatic castration resistant prostate cancer (mCRPC), patients' prognosis remains suboptimal and novel treatment combinations are under scrutiny. On this matter, the recent ACIS trial tested the role of abiraterone plus apalutamide (androgen annihilation) in addition to androgen deprivation therapy, versus abiraterone plus androgen deprivation therapy. Herein, we performed a meta-analysis to compare overall survival (OS) and progression free survival (PFS) among patients who received androgen annihilation versus advanced androgen blockage (abiraterone or enzalutamide), in addition to conventional androgen deprivation therapy. METHODS A comprehensive search for all published phase III randomized control trials on first line mCRPC that evaluated advanced androgen blockage (COU-AA-302, PREVAIL) or androgen annihilation (ACIS) was conducted PubMed, EMBASE, Web of Science, and Scopus databases up to 31/12/2021. We reconstructed survival data from published Kaplan-Meier curves on overall survival (OS) and progression free survival (PFS) and meta-analyzed androgen annihilation versus advanced androgen blockage (grouping together abiraterone and enzalutamide) versus androgen deprivation therapy. The outcomes of interest were assessed using difference in restricted mean survival time (ΔRMST) at different time points. RESULTS Three trials were included involving 3787 patients. Overall, patients receiving androgen annihilation exhibited similar OS compared to advanced androgen blockage: ΔRMST at 36 months of -0.2 (95%CI: -1.1, 0.8, p=0.8). At 36 months, relatively to ADT alone, patients receiving androgen annihilation or advanced androgen blockage exhibited longer OS: ΔRMST of 1.6 (95%CI: 0.6, 2.7, p=0.002) and 1.8 months (95%CI: 1.1, 2.5, p<0.001), respectively. Patients receiving androgen annihilation exhibited better PFS compared to advanced androgen blockage: ΔRMST at 36 months of 2.4 months (95%CI: 1.0, 3.8, p=0.001). CONCLUSION We found no OS benefit for patients with mCRPC treated with androgen annihilation compared to advanced androgen blockage. This might be ascribed to an increased rate of other cause mortality that might determine the absence of an OS benefit or to the efficacy of second line therapies. Optimal treatment sequence and patient selection for androgen annihilation remain open points. However, a PFS benefit was found in case of combination therapy, whose clinical meaning is not yet clear.
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14
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Fallara G, Pozzi E, Belladelli F, Corsini C, Boeri L, Capogrosso P, Montorsi F, Salonia A. Cardiovascular Morbidity and Mortality in Men – Findings From a Meta-analysis on the Time-related Measure of Risk of Exogenous Testosterone. J Sex Med 2022; 19:1243-1254. [DOI: 10.1016/j.jsxm.2022.05.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/22/2022] [Accepted: 05/27/2022] [Indexed: 11/26/2022]
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15
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Belladelli F, Fallara G, Pozzi E, Corsini C, Cilio S, Raffo M, d'Arma A, Boeri L, Capogrosso P, Eisenberg M, Montorsi F, Salonia A. Effects of recreational cannabis on testicular function in primary infertile men. Andrology 2022; 10:1172-1180. [PMID: 35868833 DOI: 10.1111/andr.13235] [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: 05/18/2022] [Revised: 07/07/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Male factor contributes to up to 50% of cases of couples experiencing infertility. Cannabis is one of the most commonly used recreational drugs and its effects on the reproductive system have been largely debated in the literature. OBJECTIVES The aim of this study is to evaluate the effect of recreational cannabis use on total T (tT) levels, gonadal status, and sperm parameters in a cohort of primary infertile non-Finnish, white-European men. MATERIALS AND METHODS Data of 2074 white-European men visited for primary couple's infertility were analyzed. Lifestyle factors and cannabis use were investigated in all participants. Semen analyses were based on the 2010 WHO reference criteria. Serum hormones were evaluated, and patients were subdivided based on their gonadal status. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Descriptive statistics and linear regression analyses were used to test the association between cannabis use, sperm parameters, and hormonal levels. Logistic regression analyses tested potential predictors for abnormal sperm parameters and gonadal status. RESULTS Of 2074, 225 (10.9%) patients reported cannabis use in their lifetime. Total Testosterone levels were lower in cannabis users compared to non-users (p = 0.03). In a multivariable linear regression analysis, cannabis use was inversely associated with tT levels (ß = -0.372 ng/mL; p = 0.005) but not with FSH nor with LH levels. Conversely, at multivariable logistic regression model cannabis use was not associated with the type of hypogonadism. At multivariable linear regression analysis, cannabis use was inversely associated with sperm morphology (p = 0.007), while not with both sperm concentration and sperm motility. Similarly, at adjusted logistic regression analysis cannabis use resulted associated with teratozoospermia (p = 0.039), but not with oligo-, astheno- and azoospermia. CONCLUSIONS Infertile men using cannabis are at higher risk of having lower testosterone levels and altered sperm morphology as compared with non-users. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Federico Belladelli
- University Vita-Salute San Raffaele.,Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele
| | - Giuseppe Fallara
- University Vita-Salute San Raffaele.,Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele
| | - Edoardo Pozzi
- University Vita-Salute San Raffaele.,Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele
| | - Christian Corsini
- University Vita-Salute San Raffaele.,Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele
| | - Simone Cilio
- University Vita-Salute San Raffaele.,Azienda Ospedaliera Universitaria, Federico II, Naples, Italy
| | - Massimiliano Raffo
- University Vita-Salute San Raffaele.,Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele
| | | | - Luca Boeri
- Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico
| | | | - Michael Eisenberg
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Francesco Montorsi
- University Vita-Salute San Raffaele.,Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele
| | - Andrea Salonia
- University Vita-Salute San Raffaele.,Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele
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16
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Lao Y, Li X, He L, Guan X, Li R, Wang Y, Li Y, Wang Y, Li X, Liu S, Dong Z. Association Between Alcohol Consumption and Risk of Bladder Cancer: A Dose-Response Meta-Analysis of Prospective Cohort Studies. Front Oncol 2021; 11:696676. [PMID: 34604033 PMCID: PMC8479110 DOI: 10.3389/fonc.2021.696676] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 08/10/2021] [Indexed: 12/30/2022] Open
Abstract
Background Controversial results of the association between alcohol consumption and risk of bladder cancer were reported by the previous meta-analyses. Objective To quantitatively investigate the association between alcohol consumption and risk of bladder cancer based on prospective cohort studies, and explore whether there is potential dose-response relation. Method PubMed, EMBASE, the Cochrane Library databases, China Biology Medicine disc (CBM), and Chinese National Knowledge Infrastructure (CNKI) were searched for relevant studies. Categorical meta-analysis was performed for risk estimates of any alcohol consumers versus non-drinkers as well as different drinking degrees (light, moderate, and heavy) versus none. And two-stage generalized least-squares regression and restricted cubic spline, as well as fixed-effects dose-response models, were used for linear and nonlinear dose-response relation exploration. Results 9 prospective cohort studies including 1,971,396 individuals were finally included. We did not observe a significant association between alcohol intake and the risk of bladder cancer in the entire population. Linear association was detected in those who consumed alcohol from liquor or spirits (P linear=0.02). One drink increment each day of alcohol could elevate the risk of bladder cancer by 9% (RR=1.09; 95%CI: 1.01-1.17). Alcohol was a risk factor of bladder cancer for male drinkers (RR=1.23; 95%CI: 1.13-1.35; I2=3.7%), while none linear or nonlinear relation was found. Conclusion No significant association between alcohol consumption and bladder cancer risk was found in the entire population, but there was a linear dose-response relation in those who consume alcohol from liquor or spirits. Alcohol may elevate the risk of bladder cancer in males in a dose-independent way. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, PROSPERO (CRD42020216195).
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Affiliation(s)
- Yongfeng Lao
- Second Clinical Medical College, Lanzhou University, Lanzhou, China.,Department of Urology, Lanzhou University Second Hospital, Lanzhou, China.,Key Laboratory of Gansu Province for Urological Diseases, Gansu Nephro-Urological Clinical Center, Lanzhou, China.,Institute of Urology, Lanzhou University Second Hospital, Lanzhou, China
| | - Xiaolong Li
- Second Clinical Medical College, Lanzhou University, Lanzhou, China.,Department of Urology, Lanzhou University Second Hospital, Lanzhou, China.,Key Laboratory of Gansu Province for Urological Diseases, Gansu Nephro-Urological Clinical Center, Lanzhou, China.,Institute of Urology, Lanzhou University Second Hospital, Lanzhou, China
| | - Lijuan He
- Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Xin Guan
- Second Clinical Medical College, Lanzhou University, Lanzhou, China.,Department of Urology, Lanzhou University Second Hospital, Lanzhou, China.,Key Laboratory of Gansu Province for Urological Diseases, Gansu Nephro-Urological Clinical Center, Lanzhou, China.,Institute of Urology, Lanzhou University Second Hospital, Lanzhou, China
| | - Rongxin Li
- Second Clinical Medical College, Lanzhou University, Lanzhou, China.,Department of Urology, Lanzhou University Second Hospital, Lanzhou, China.,Key Laboratory of Gansu Province for Urological Diseases, Gansu Nephro-Urological Clinical Center, Lanzhou, China.,Institute of Urology, Lanzhou University Second Hospital, Lanzhou, China
| | - Yanan Wang
- Second Clinical Medical College, Lanzhou University, Lanzhou, China.,Department of Urology, Lanzhou University Second Hospital, Lanzhou, China.,Key Laboratory of Gansu Province for Urological Diseases, Gansu Nephro-Urological Clinical Center, Lanzhou, China.,Institute of Urology, Lanzhou University Second Hospital, Lanzhou, China
| | - Yanyou Li
- Second Clinical Medical College, Lanzhou University, Lanzhou, China.,Department of Urology, Lanzhou University Second Hospital, Lanzhou, China.,Key Laboratory of Gansu Province for Urological Diseases, Gansu Nephro-Urological Clinical Center, Lanzhou, China.,Institute of Urology, Lanzhou University Second Hospital, Lanzhou, China
| | - Yunchang Wang
- Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Xu Li
- Second Clinical Medical College, Lanzhou University, Lanzhou, China.,Department of Urology, Lanzhou University Second Hospital, Lanzhou, China.,Key Laboratory of Gansu Province for Urological Diseases, Gansu Nephro-Urological Clinical Center, Lanzhou, China.,Institute of Urology, Lanzhou University Second Hospital, Lanzhou, China
| | - Shuai Liu
- Second Clinical Medical College, Lanzhou University, Lanzhou, China.,Department of Urology, Lanzhou University Second Hospital, Lanzhou, China.,Key Laboratory of Gansu Province for Urological Diseases, Gansu Nephro-Urological Clinical Center, Lanzhou, China.,Institute of Urology, Lanzhou University Second Hospital, Lanzhou, China
| | - Zhilong Dong
- Second Clinical Medical College, Lanzhou University, Lanzhou, China.,Department of Urology, Lanzhou University Second Hospital, Lanzhou, China.,Key Laboratory of Gansu Province for Urological Diseases, Gansu Nephro-Urological Clinical Center, Lanzhou, China.,Institute of Urology, Lanzhou University Second Hospital, Lanzhou, China
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17
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Salciccia S, Eisenberg ML, Maggi M, Lai S, Mastroianni CM, Pasculli P, Ciardi MR, Canale V, Ferro M, Busetto GM, De Berardinis E, Ricciuti GP, Sciarra A, Del Giudice F. Modeling the Contribution of Male Testosterone Levels to the Duration of Positive COVID Testing among Hospitalized Male COVID-19 Patients. Diagnostics (Basel) 2021; 11:581. [PMID: 33804969 PMCID: PMC8063957 DOI: 10.3390/diagnostics11040581] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/13/2021] [Accepted: 03/18/2021] [Indexed: 12/23/2022] Open
Abstract
Background: A growing body of evidence is emerging suggesting testosterone can affect all cells involved in the immune response to both bacterial and viral infections, and the testosterone effect on the immune response could explain the greater susceptibility of men to infections including COVID-19. We aimed to explore the predictive role of male serum total testosterone (TT) levels on the time till viral negativity testing among hospitalized COVID-19 patients. Methods: The univariate effect of risk factors for the duration of COVID-19 viral positivity was evaluated using the log-rank test and Kaplan-Meier estimates. A multivariable Cox regression model was developed to test the role of TT levels and the subsequent odds for shorter viral positivity intervals. Results: Increasing serum TT levels and the need for an oxygen administration strategy were independently predictive for respectively reduced and increased days to negativization (Hazard Ratio [HR]: 1.39, 95% CI: 0.95-2.03 and HR: 0.19, 95% CI: 0.03-1.18). Conclusion: Baseline higher TT levels for male COVID-19 patients at hospital admission are associated with shorter durations of positive COVID-19 testing and thus viral clearance. Our preliminary findings might play a relevant to help pandemic control strategies if these will be verified in future larger multicentric and possibly randomized trials.
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Affiliation(s)
- Stefano Salciccia
- Department of Maternal-Infant and Urological Sciences, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (S.S.); (M.M.); (V.C.); (E.D.B.); (G.P.R.); (A.S.); (F.D.G.)
| | - Michael L. Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA 94305, USA;
| | - Martina Maggi
- Department of Maternal-Infant and Urological Sciences, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (S.S.); (M.M.); (V.C.); (E.D.B.); (G.P.R.); (A.S.); (F.D.G.)
| | - Silvia Lai
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy;
| | - Claudio Maria Mastroianni
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (C.M.M.); (P.P.); (M.R.C.)
| | - Patrizia Pasculli
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (C.M.M.); (P.P.); (M.R.C.)
| | - Maria Rosa Ciardi
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (C.M.M.); (P.P.); (M.R.C.)
| | - Vittorio Canale
- Department of Maternal-Infant and Urological Sciences, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (S.S.); (M.M.); (V.C.); (E.D.B.); (G.P.R.); (A.S.); (F.D.G.)
| | - Matteo Ferro
- Department of Urology, European Institute of Oncology (IEO), IRCCS, 20141 Milan, Italy
| | - Gian Maria Busetto
- Department of Urology and Organ Transplantation, University of Foggia, 71122 Foggia, Italy;
| | - Ettore De Berardinis
- Department of Maternal-Infant and Urological Sciences, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (S.S.); (M.M.); (V.C.); (E.D.B.); (G.P.R.); (A.S.); (F.D.G.)
| | - Gian Piero Ricciuti
- Department of Maternal-Infant and Urological Sciences, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (S.S.); (M.M.); (V.C.); (E.D.B.); (G.P.R.); (A.S.); (F.D.G.)
| | - Alessandro Sciarra
- Department of Maternal-Infant and Urological Sciences, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (S.S.); (M.M.); (V.C.); (E.D.B.); (G.P.R.); (A.S.); (F.D.G.)
| | - Francesco Del Giudice
- Department of Maternal-Infant and Urological Sciences, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (S.S.); (M.M.); (V.C.); (E.D.B.); (G.P.R.); (A.S.); (F.D.G.)
- Department of Urology, Stanford University School of Medicine, Stanford, CA 94305, USA;
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