1
|
Chen XJ. Analysis of Sex Hormones, Insulin Dosage, and Risk Factors Associated With Male Diabetic Patients. Am J Mens Health 2024; 18:15579883241235062. [PMID: 38554046 PMCID: PMC10981860 DOI: 10.1177/15579883241235062] [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: 09/13/2023] [Revised: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 04/01/2024] Open
Abstract
The purpose of this study is to assess the influence of sex hormones and other indicators on risk factors for hypercoagulable states in male patients with type 2 diabetes mellitus. Ninety-two diabetic patients were divided into two groups based on testosterone levels: T1 group (testosterone <12 mmol/L) and T2 group (testosterone >12 mmol/L). Fifty-four non-diabetic patients were used as the control group. Sex hormone index, glucose, insulin, C-peptide, 24-h urinary free cortisol, thromboelastography, and insulin resistance index were measured by radioimmunoassay. Testosterone was lower in the diabetic men than in the control group (12.02 vs 14.77, p < .05), and was inversely related to blood coagulation status, blood glucose level, and cortisol level. Body mass index was positively correlated with estradiol and insulin resistance index. Testosterone was independently associated with the clotting process after controlling for age. Low testosterone is a risk factor for hypercoagulable state in diabetic men. Elevated estradiol and insulin resistance are influential factors for increased body mass index.
Collapse
Affiliation(s)
- Xiao-Jun Chen
- Department of Endocrinology, Chongming Branch, Shanghai Tenth People’s Hospital, Shanghai, China
| |
Collapse
|
2
|
Nguyen Hoai B, Hoang L, Nguyen Cao T, Pham Minh Q, A Jannini E. Testosterone and aging male, a perspective from a developing country. Aging Male 2023; 26:2223712. [PMID: 37335039 DOI: 10.1080/13685538.2023.2223712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/19/2023] [Accepted: 06/06/2023] [Indexed: 06/21/2023] Open
Abstract
PURPOSE Hypogonadism is associated with a wide range of physical and psychological symptoms that can affect the overall health of men. However, in a developing country, there are several imposing challenges in the diagnosis and treatment of hypogonadism, including a lack of awareness and understanding of the condition among healthcare providers and patients, limited resources and the high cost of treatment. This review aimed to examine the potential benefits and risks of testosterone replacement therapy (TRT) and provides a perspective of a developing country on the topic. MATERIALS AND METHODS A comprehensive literature review was conducted to gather relevant information on the impact of testosterone deficiency on ageing males and the effectiveness of TRT for treating hypogonadism. Published peer-reviewed articles were analyzed to evaluate the benefits and risks of TRT. Additionally, the unique challenges faced in the diagnosis and treatment of hypogonadism in a developing country were considered. RESULTS Testosterone replacement therapy has been shown to be an effective treatment for hypogonadism, particularly in symptomatic men with low testosterone levels. It offers potential benefits such as improvements in symptoms and overall quality of life. However, there are associated risks and side effects that need to be considered. In a developing country, challenges such as limited awareness and understanding of hypogonadism, resource constraints, and high treatment costs pose additional barriers to accessing TRT and comprehensive care. CONCLUSION In conclusion, TRT holds promise as a treatment for hypogonadism, but its implementation and accessibility face significant challenges in a developing country. Addressing these challenges, including raising awareness, allocating resources, and finding cost-effective solutions, is crucial for ensuring that men with hypogonadism in such settings receive appropriate diagnosis and treatment. Further research and efforts are needed to improve the management of hypogonadism in developing countries and optimize the potential benefits of TRT for affected individuals.
Collapse
Affiliation(s)
- Bac Nguyen Hoai
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Long Hoang
- Department of Urology, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Thang Nguyen Cao
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Quan Pham Minh
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Emmanuele A Jannini
- Chair of Endocrinology and Sexual Medicine (ENDOSEX), University of Rome Tor Vergata, Rome, Italy
| |
Collapse
|
3
|
Jayasena CN, Anderson RA, Llahana S, Barth JH, MacKenzie F, Wilkes S, Smith N, Sooriakumaran P, Minhas S, Wu FCW, Tomlinson J, Quinton R. Society for Endocrinology guidelines for testosterone replacement therapy in male hypogonadism. Clin Endocrinol (Oxf) 2022; 96:200-219. [PMID: 34811785 DOI: 10.1111/cen.14633] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 10/25/2021] [Accepted: 10/28/2021] [Indexed: 12/15/2022]
Abstract
Male hypogonadism (MH) is a common endocrine disorder. However, uncertainties and variations in its diagnosis and management exist. There are several current guidelines on testosterone replacement therapy that have been driven predominantly by single disciplines. The Society for Endocrinology commissioned this new guideline to provide all care providers with a multidisciplinary approach to treating patients with MH. This guideline has been compiled using expertise from endocrine (medical and nursing), primary care, clinical biochemistry, urology and reproductive medicine practices. These guidelines also provide a patient perspective to help clinicians best manage MH.
Collapse
Affiliation(s)
- Channa N Jayasena
- Section of Investigative Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | | | - Sofia Llahana
- School of Health Sciences, City, University of London, London & Department of Endocrinology & Diabetes, University College London Hospitals (UCLH) NHS Foundation Trust, London, UK
| | - Julian H Barth
- Specialist Laboratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Finlay MacKenzie
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Scott Wilkes
- School of Medicine, University of Sunderland, Sunderland, UK
| | | | - Prasanna Sooriakumaran
- Department of Uro-oncology, UCLH NHS Foundation Trust, London & Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Sukhbinder Minhas
- Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Frederick C W Wu
- Division of Endocrinology, Diabetes & Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Jeremy Tomlinson
- Oxford Centre for Diabetes, Endocrinology & Metabolism, University of Oxford, Oxford, UK
| | - Richard Quinton
- Department of Endocrinology, Diabetes & Metabolism, Newcastle-upon-Tyne Hospitals NHS Foundation Trust & Translational & Clinical Research Institute, University of Newcastle-upon-Tyne, UK
| |
Collapse
|
4
|
Oguz A, Sahin M, Ulgen C, Uyan M, Gul K. Overt hypogonadism is a cardiovascular risk factor in type 2 diabetic males: An observational study. Andrologia 2021; 54:e14271. [PMID: 34632609 DOI: 10.1111/and.14271] [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: 08/31/2021] [Revised: 09/25/2021] [Accepted: 09/28/2021] [Indexed: 11/30/2022] Open
Abstract
We aimed to evaluate the effects of hypogonadism on metabolic and chronic complications in type 2 diabetic males. 261 nonobese males with type 2 diabetes aged 18-70 were involved in the study. Hypononadal males were divided into 2 groups as overt hypogonadism (total testosterone≤230 ng/dl) and borderline hypogonadism (230-345 ng/dl). The control group involved eugonadal diabetic males. Micro-macrovascular complications were recorded. 101 patients had hypogonadism (38.7%), and 160 patients were eugonadal (61.3%). Microvascular complication rate was not different, but macrovascular complication rate was significantly higher in hypogonadal males (42.6%/31.3%, p = 0.042). Optimal glycosylated haemoglobin (HbA1c) achievement(<7%) was significantly lower in hypogonadal patients (20.8%/31.3%, p = 0.043). Poor glycaemic control (HbA1c≥7%), presence of microvascular complication and increased triglyceride levels were independent risk factors for hypogonadism (OR: 1.5, p = 0.044;OR:3.89,p = 0.025 and OR: 1.0, p = 0.016 respectively). Overt hypogonadism, hypertension, hypercholesterolaemia and severe hypoglycaemia were independent risk factors for macrovascular complications (OR: 1.0, p = 0.027; OR:2.6, p = 0.002; OR: 1.8, p = 0.047 and OR: 1.0, p = 0.007 respectively), diabetes duration (≥5 years) and poor glycaemic control for microvascular complication (OR: 1.0, p = 0.031 and OR:2.0, p = 0.028). As a result, hypogonadism is frequent among diabetic males and poor glycaemic control may be an important contributing factor. Furthermore overt hypogonadism is an important cardiovascular risk marker. Therefore, ensuring eugonadism in diabetic patients may positively affect both glycaemic control and complications.
Collapse
Affiliation(s)
- Ayten Oguz
- Department of Endocrinology and Metabolism, Faculty of Medicine, Istinye University, İstanbul, Turkey
| | - Murat Sahin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Cansu Ulgen
- Department of Internal Medicine, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Merve Uyan
- Department of Internal Medicine, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Kamile Gul
- Gaziantep Liv Hospital, Endocrinology and Metabolism, Gaziantep, Turkey
| |
Collapse
|
5
|
Kalra S, Kalhan A, Dhingra A, Kapoor N. Management of late-onset hypogonadism: person-centred thresholds, targets, techniques and tools. J R Coll Physicians Edinb 2021; 51:79-84. [PMID: 33877144 DOI: 10.4997/jrcpe.2021.121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Late-onset hypogonadism (LOH) is a complex and highly debatable syndrome in ageing men, which is characterised by reduced testosterone levels associated with classical symptoms of androgen deficiency. This article discusses the complex issues surrounding its management related to patient-centric thresholds and therapeutic targets. It specifically highlights the need to consider symptoms as the starting point, the key milestones in the management and the target of treatment, while ensuring safety at all times. The diagnosis of LOH requires a high index of suspicion and early identification of symptoms followed by appropriate investigations. The threshold for initiation of treatment has to be person centric and requires individualised decisions. The dose, preparation, route and follow up after testosterone initiation also may vary among different people. A person-centred approach is key to the successful management of this complex, nebulous yet debilitating disease.
Collapse
Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital and BRIDE, Karnal, India,
| | - Atul Kalhan
- Department of Diabetes and Endocrinology, Royal Glamorgan Hospital, Llantrisant, UK
| | - Atul Dhingra
- Department of Endocrinology, Gangaram Bansal Hospital, Sri Ganganagar, Rajasthan, India
| | - Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College & Hospital, Vellore, Tamil Nadu, India; Non communicable disease unit, Faculty of Medicine, Dentistry and Health Science, The University of Melbourne, Australia
| |
Collapse
|
6
|
Insulin resistance and testosterone level in Indonesian young adult males. ACTA ACUST UNITED AC 2021; 58:93-98. [PMID: 32134740 DOI: 10.2478/rjim-2020-0004] [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] [Received: 01/17/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Central obesity is characterized by the accumulation of abdominal fat which may lead to several diseases including insulin resistance. The prevalence of central obesity is higher in male and the incidence in young adult males is increased. Central obesity is also related to low testosterone levels. The research aimed to assess the relationship between the testosterone levels and insulin resistance of young adult males with central obesity. METHODS This was a cross-sectional study, the subjects were young adult males of 18 to 25 years old. The central obesity consisted of 50 samples and non-central obesity comprised 70 samples. The examination of testosterone and insulin was performed by the ECLIA method, glucose used the enzymatic method, the insulin resistance was calculated by using the HOMA-IR index. RESULTS The mean of the testosterone level in central obesity was lower than non-central obesity (5.24 + 1.17 vs 7.18 + 1.54 ng/mL, p < 0.001). HOMA-IR index in central obesity was higher than non-central obesity (4.29 + 2.23 vs 2.46 + 1.72, p < 0.001). Testosterone levels had negative correlation with HOMA-IR (r = -0.470, p < 0.001). There was significant difference in HOMA-IR among the quartiles of testosterone levels. CONCLUSION There is negative correlation between testosterone level with HOMA-IR, the lower the testosterone level the higher the insulin resistance in young adult males.
Collapse
|
7
|
Al-Sharefi A, Quinton R. Current National and International Guidelines for the Management of Male Hypogonadism: Helping Clinicians to Navigate Variation in Diagnostic Criteria and Treatment Recommendations. Endocrinol Metab (Seoul) 2020; 35:526-540. [PMID: 32981295 PMCID: PMC7520594 DOI: 10.3803/enm.2020.760] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/23/2020] [Accepted: 07/27/2020] [Indexed: 12/19/2022] Open
Abstract
Male hypogonadism-rebadged by some as testosterone deficiency syndrome-is a clinical and biochemical diagnosis of increasing worldwide interest. Organic male hypogonadism-usually permanent-is well-established, but aging men may also exhibit lower serum testosterone levels; principally due to burden of extra-gonadal comorbidities such as obesity, diabetes and metabolic syndrome, but with an underlying intact hypothalamo-pituitary-testicular (HPT) axis capable of springing back into operation once comorbidities are addressed. Despite encouraging observational data and plausible theoretical underpinning, evidence for efficacy and safety of testosterone in this "aging" group of men is lacking; addressing comorbid illnesses remains the key priority instead. Nevertheless, in recent years, accumulation of misleading information online has triggered a global tsunami of testosterone prescriptions. Despite this, many men with organic hypogonadism remain undiagnosed or untreated; many more face a diagnostic odyssey before achieving care by the appropriate specialist. As testosterone therapy is not without risk several clinical practice guidelines have been published specialist societies to guide physicians on best practice. However, these are heterogeneous in key areas, reflecting divergent approaches to the same evidence basis. Herein, we navigate the major clinical practice guidelines on male hypogonadism and test their respective recommendations against current best evidence.
Collapse
Affiliation(s)
- Ahmed Al-Sharefi
- Department of Endocrinology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, UK
| | - Richard Quinton
- Department of Endocrinology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, UK
- Translational & Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, UK
| |
Collapse
|
8
|
Kirlangic OF, Yilmaz-Oral D, Kaya-Sezginer E, Toktanis G, Tezgelen AS, Sen E, Khanam A, Oztekin CV, Gur S. The Effects of Androgens on Cardiometabolic Syndrome: Current Therapeutic Concepts. Sex Med 2020; 8:132-155. [PMID: 32201216 PMCID: PMC7261691 DOI: 10.1016/j.esxm.2020.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 01/31/2020] [Accepted: 02/11/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Cardiometabolic syndrome (CMS), as a bunch of metabolic disorders mainly characterized by type 2 diabetes mellitus (T2DM), hypertension, atherosclerosis, central adiposity, and abdominal obesity triggering androgen deficiency, is one of the most critical threats to men. Although many significant preclinical and clinical findings explain CMS, new approaches toward common pathophysiological mechanisms and reasonable therapeutic targets are lacking. AIM To gain a further understanding of the role of androgen levels in various facets of CMS such as the constellation of cardiometabolic risk factors including central adiposity, dyslipidemia, insulin resistance, diabetes, and arterial hypertension and to define future directions for development of effective therapeutic modalities. METHODS Clinical and experimental data were searched through scientific literature databases (PubMed) from 2009 to October 2019. MAIN OUTCOME MEASURE Evidence from basic and clinical research was gathered with regard to the causal impact and therapeutic roles of androgens on CMS. RESULTS There are important mechanisms implicated in androgen levels and the risk of CMS. Low testosterone levels have many signs and symptoms on cardiometabolic and glycometabolic risks as well as abdominal obesity in men. CLINICAL IMPLICATIONS The implications of the findings can shed light on future improvements in androgen levels and add potentially predictive risk for CMS, as well as T2DM, abdominal obesity to guide clinical management in the early stage. STRENGTHS & LIMITATIONS This comprehensive review refers to the association between androgens and cardiovascular health. A limitation of this study is the lack of large, prospective population-based studies that analyze the effects of testosterone treatment on CMS or mortality. CONCLUSION Low testosterone levels have several common features with metabolic syndrome. Thus, testosterone may have preventive role in the progress of metabolic syndrome and subsequent T2DM, abdominal obesity, and cardiovascular disease and likely affect aging men's health mainly through endocrine and vascular mechanisms. Further studies are necessary to evaluate the therapeutic interventions directed at preventing CMS in men. Kirlangic OF, Yilmaz-Oral D, Kaya-Sezginer E, et al. The Effects of Androgens on Cardiometabolic Syndrome: Current Therapeutic Concepts. Sex Med 2020;8:132-155.
Collapse
Affiliation(s)
- Omer Faruk Kirlangic
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Medical Biochemistry, Ankara, Turkey
| | - Didem Yilmaz-Oral
- Cukurova University, Faculty of Pharmacy, Department of Pharmacology, Adana, Turkey
| | - Ecem Kaya-Sezginer
- Ankara University, Faculty of Pharmacy, Department of Biochemistry, Ankara, Turkey
| | - Gamze Toktanis
- Ankara University, Faculty of Pharmacy, Department of Pharmacology, Ankara, Turkey
| | | | - Ekrem Sen
- Ankara University, Faculty of Pharmacy, Department of Pharmacology, Ankara, Turkey
| | - Armagan Khanam
- Ankara University, Faculty of Pharmacy, Department of Pharmacology, Ankara, Turkey
| | - Cetin Volkan Oztekin
- Department of Urology, Faculty of Medicine, University of Kyrenia, Girne, Turkish Republic of North Cyprus, Mersin 10, Turkey
| | - Serap Gur
- Ankara University, Faculty of Pharmacy, Department of Pharmacology, Ankara, Turkey.
| |
Collapse
|
9
|
Chen C, Zhai H, Cheng J, Weng P, Chen Y, Li Q, Wang C, Xia F, Wang N, Lu Y. Causal Link Between Vitamin D and Total Testosterone in Men: A Mendelian Randomization Analysis. J Clin Endocrinol Metab 2019; 104:3148-3156. [PMID: 30896763 DOI: 10.1210/jc.2018-01874] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 03/15/2019] [Indexed: 12/11/2022]
Abstract
CONTEXT Low circulating vitamin D levels have been associated with lower total testosterone levels. These epidemiological associations, if true, would have public health importance because vitamin D deficiency is common and correctable. We tested whether genetically lowered vitamin D levels were associated with lower total testosterone (T), using Mendelian randomization (MR) methodology. DESIGN AND SETTING A total of 4254 men were enrolled from the Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China) study, which was performed at 23 sites in eastern China during 2014 to 2016. Using four single-nucleotide polymorphisms strongly associated with 25-hydroxyvitamin D [25(OH)D] levels, we created a genetic risk score (GRS) as an instrumental variable to estimate the effect of genetically lowered 25(OH)D on total T. MAIN OUTCOME MEASURE Total T was detected by chemiluminescence assay. RESULTS Lower 25(OH)D levels were associated with lower total T (β, 0.40; 95% CI, 0.23 to 0.58) after multivariable adjustment. Per-SD increase in the vitamin D GRS (VD_GRS) was significantly associated with 25(OH)D (β, -1.64; 95% CI, -2.04 to -1.24) and with total T (β, -0.19; 95% CI, -0.37 to -0.02). Using VD_GRS as the instrumental variable in the MR analysis, the causal regression coefficient of genetically determined per-SD increase for 25(OH)D on total T was 0.12 (95% CI, 0.02 to 0.22). CONCLUSION We provide evidence for the biologically plausible causal effects of 25(OH)D on total T using MR analysis. Whether vitamin D supplementation can raise androgen levels merits further investigation in long-term, randomized controlled trials.
Collapse
Affiliation(s)
- Chi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai University School of Medicine, Shanghai, China
| | - Hualing Zhai
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai University School of Medicine, Shanghai, China
| | - Jing Cheng
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai University School of Medicine, Shanghai, China
| | - Pan Weng
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai University School of Medicine, Shanghai, China
| | - Yi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai University School of Medicine, Shanghai, China
| | - Qin Li
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai University School of Medicine, Shanghai, China
| | - Chiyu Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai University School of Medicine, Shanghai, China
| | - Fangzhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai University School of Medicine, Shanghai, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai University School of Medicine, Shanghai, China
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai University School of Medicine, Shanghai, China
| |
Collapse
|
10
|
Osadnik T, Pawlas N, Osadnik K, Bujak K, Góral M, Lejawa M, Fronczek M, Reguła R, Czarnecka H, Gawlita M, Strzelczyk JK, Gonera M, Gierlotka M, Poloński L, Gąsior M. High progesterone levels are associated with family history of premature coronary artery disease in young healthy adult men. PLoS One 2019; 14:e0215302. [PMID: 30986240 PMCID: PMC6464341 DOI: 10.1371/journal.pone.0215302] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 03/29/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND & AIMS The offspring of patients with premature coronary artery disease (P-CAD) are at higher risk for cardiovascular disease, compared with subjects without a family history (FH) of P-CAD. The increased risk for cardiovascular disease in subjects with FH of early-onset CAD results from unfavorable genetic variants as well as social, behavioral and environmental factors, which are more prevalent in this group. Previous studies have shown that specific sex hormone levels may be associated with the risk of cardiovascular disease. The aim of this study was to compare wide range of biochemical marker levels including i.e. the levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), progesterone, estradiol, testosterone and sex-hormone binding globulin (SHBG) between young healthy male adults with and without FH of P-CAD. METHODS The study group consisted of young healthy Polish male adults enrolled in a MAGNETIC case-control study, who were recruited between July 2015 and October 2017. The inclusion criteria were as follows: male sex, age ≥18 and ≤35 years old, FH of P-CAD (cases) or no P-CAD in first-degree relatives (controls). The comparison of continuous and categorical variables was performed using the Student's t-test or the U-Mann-Whitney test, and Fisher's exact test, respectively. The correlations between FSH, LH, testosterone, progesterone, SHBG and other laboratory parameters were assessed using the Spearman rank correlation test. Both univariable and multivariable logistic regression analyses were performed to assess the association between analyzed variables and FH of P-CAD. RESULTS A total of 411 subjects (223 cases and 188 controls) were included in the study. There was a higher prevalence of major cardiovascular risk factors in subjects with FH of P-CAD (smoking, higher total and LDL cholesterol levels, higher body mass index and lower HDL cholesterol level). Moreover, the offspring of patients with P-CAD had lower SHBG level, and higher LH and progesterone levels in the crude comparison, compared with individuals without FH of P-CAD. After adjustment for confounding variables, progesterone and LH were determined to be independently associated with FH of P-CAD. CONCLUSION Progesterone and LH levels are significantly associated with FH of P-CAD, independent of traditional risk factors for CAD.
Collapse
Affiliation(s)
- Tadeusz Osadnik
- 2nd Department of Cardiology and Angiology, Silesian Center for Heart Diseases, Zabrze, Poland
- Chair and Department of Pharmacology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Natalia Pawlas
- Chair and Department of Pharmacology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
- Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland
| | - Kamila Osadnik
- Chair and Department of Pharmacology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Kamil Bujak
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Marta Góral
- Students’ Scientific Society, 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Mateusz Lejawa
- Chair and Department of Pharmacology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Martyna Fronczek
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Rafał Reguła
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Hanna Czarnecka
- Clinical Laboratory, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Marcin Gawlita
- Department of Environmental Medicine and Epidemiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Joanna Katarzyna Strzelczyk
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Małgorzata Gonera
- Regional Specialized Hospital No. 4, Anesthesiology and Intensive Care Unit, Bytom, Poland
| | - Marek Gierlotka
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
- Department of Cardiology, University Hospital in Opole, Faculty of Natural Sciences and Technology, Institute of Medicine, University of Opole, Opole, Poland
| | - Lech Poloński
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| |
Collapse
|
11
|
Dimopoulou C, Goulis DG, Corona G, Maggi M. The complex association between metabolic syndrome and male hypogonadism. Metabolism 2018; 86:61-68. [PMID: 29656047 DOI: 10.1016/j.metabol.2018.03.024] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 03/26/2018] [Accepted: 03/27/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND The complex association between metabolic syndrome (MetS) and male hypogonadism is well established. A number of observational studies show that low testosterone is associated with insulin resistance and an increased risk for diabetes mellitus and MetS in men. AIMS To elucidate the association between MetS and male hypogonadism, present epidemiological data on the co-existence of the two comorbidities, enlighten the underlying pathophysiology and appraise the effects of testosterone supplementation therapy (TTh) and lifestyle modifications on MetS and body composition in men. MATERIALS AND METHODS Systematic search to PubMed and Medline databases for publications reporting data on association between MetS and male hypogonadism. RESULTS Both MetS and male hypogonadism have a high prevalence in the general population and are frequently co-existing e.g. in males with diabetes. Accumulating evidence from animal and human studies suggests that MetS is involved in the pathogenesis of hypogonadism in males as well as the other way around. On the other hand, there is evidence for a favorable effect of testosterone supplementation in testosterone deficient men with MetS and/or diabetes mellitus. CONCLUSIONS Studies with superior methodological characteristics are needed in order to establish a role for testosterone supplementation in men with MetS and/or diabetes mellitus.
Collapse
Affiliation(s)
- Christina Dimopoulou
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece.
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece
| | - Giovanni Corona
- Endocrinology Unit, Medical Department, Azienda Usl Bologna Maggiore Hospital, Bologna, Italy
| | - Mario Maggi
- Andrology and Sexual Medicine Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Italy
| |
Collapse
|