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Desai R, Savkovic S, Handelsman DJ. Dried blood spot sampling of testosterone microdosing in healthy females. J Steroid Biochem Mol Biol 2024; 240:106496. [PMID: 38447904 DOI: 10.1016/j.jsbmb.2024.106496] [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: 01/15/2024] [Accepted: 03/03/2024] [Indexed: 03/08/2024]
Abstract
Capillary dried blood spot (DBS) analysis coupled with multi-analyte steroid liquid chromatography mass spectrometry (LCMS) is attractive for field studies, home-based self-sampling as well as clinical trials by eliminating costly and laborious sample processing involving venipuncture and frozen storage/shipping while providing multiple steroid measurements from a single small sample. We investigated steroid measurements in DBS samples stored for four years at room temperature prior to analysis compared with the original venipuncture serum samples. Healthy women (n=12) provided paired DBS and blood samples over two weeks run-in before seven days treatment with daily transdermal T gel (12.5 mg) and after the end of treatment on days 0, 1, 2, 4, 7 and 14. Compliance with treatment and sampling was high and no adverse effects were reported. Testosterone (T), androstenedione (A4), 17 hydroxyprogesterone (17OHP) and progesterone (P4) were measured in extracted DBS samples as whole blood concentrations with and without adjustment for hematocrit. Using the same LCMS methods, DBS T and A4 measurements had high correlation with minimal bias from prior serum measurements with DBS T displaying the same pattern as serum, with or without hematocrit adjustment. However, serial whole blood measurements of T without hematocrit adjustment provided the best fitting model compared with serum, urine, or hematocrit-adjusted whole blood T measurements. These finding facilitate and simplify DBS methodology for wider field and home-based self-sampling studies of reproductive steroids indicating the need for hematocrit adjustment may be superfluous.
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Affiliation(s)
- Reena Desai
- Andrology Department, Concord Hospital &, ANZAC Research Institute, University of Sydney, Sydney, NSW 2139, Australia
| | - Sasha Savkovic
- Andrology Department, Concord Hospital &, ANZAC Research Institute, University of Sydney, Sydney, NSW 2139, Australia
| | - David J Handelsman
- Andrology Department, Concord Hospital &, ANZAC Research Institute, University of Sydney, Sydney, NSW 2139, Australia.
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2
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Xiaoyong X, Xilin G, Guangfei W, Wei W, Xiaowen Z, Hong X, Huimin Z, Zhiping L. Reliability and feasibility of home-based dried blood spot in therapeutic drug monitoring: a systematic review and meta-analysis. Eur J Clin Pharmacol 2023; 79:183-193. [PMID: 36469108 DOI: 10.1007/s00228-022-03417-9] [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: 07/12/2022] [Accepted: 11/05/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE Dried blood spot (DBS) is one of promising home sampling methods for therapeutic drug monitoring (TDM). However, the associated reliability and feasibility (including yield, adherence, and preference), which are criteria for the promotion of home-based DBS, remain unknown. This systematic review and meta-analysis aimed to evaluate the reliability and feasibility of TDM using DBS sampling. METHODS In this study, a combination of MeSH and free terms for (dried blood spot*[title/abstract])AND ("Drug Monitoring"[Mesh])AND(home OR venous)was surveyed using EMBASE, PubMed, Cochrane Library, and Web of Science upon gathering published. we registered this study protocol with the International Prospective Registry of Systematic Reviews (CRD42021247559). RESULTS Approximately half (35/75) of the evaluations reported good agreement between DBS and plasma, and the results for drugs with poor agreement may be improved using a haematocrit-based physiological equation. The yield and adherence to home-based DBS exceeded 87%, and questionnaire-based preference for DBS was 77%. CONCLUSIONS DBS may be a reliable and feasible home sampling method; however, it requires intricate design and evaluation before implementation.
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Affiliation(s)
- Xu Xiaoyong
- Department of Clinical Pharmacy, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Shanghai, 201102, China
| | - Ge Xilin
- Department of Clinical Pharmacy, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Shanghai, 201102, China
| | - Wang Guangfei
- Department of Clinical Pharmacy, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Shanghai, 201102, China
| | - Wu Wei
- Department of Clinical Pharmacy, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Shanghai, 201102, China
| | - Zhai Xiaowen
- Department of Hematology and Oncology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, China
| | - Xu Hong
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, China
| | - Zhang Huimin
- Department of Pharmaceutics, China Pharmaceutical University, Nanjing, 210009, People's Republic of China
| | - Li Zhiping
- Department of Clinical Pharmacy, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Shanghai, 201102, China.
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3
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Figueiredo MG, Gagliano-Jucá T, Basaria S. Testosterone Therapy With Subcutaneous Injections: A Safe, Practical, and Reasonable Option. J Clin Endocrinol Metab 2022; 107:614-626. [PMID: 34698352 PMCID: PMC9006970 DOI: 10.1210/clinem/dgab772] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Injections with intramuscular (IM) testosterone esters have been available for almost 8 decades and not only result in predictable serum testosterone levels but are also the most inexpensive modality. However, they are difficult to self-administer and associated with some discomfort. Recently, subcutaneous (SC) administration of testosterone esters has gained popularity, as self-administration is easier with this route. Available data, though limited, support the feasibility of this route. Here we review the pharmacokinetics and safety of SC testosterone therapy with both long- and ultralong-acting testosterone esters. In addition, we provide guidance for clinicians on how to counsel and manage their patients who opt for the SC route. EVIDENCE ACQUISITION Systematic review of available literature on SC testosterone administration including clinical trials, case series, and case reports. We also review the pharmacology of testosterone absorption after SC administration. EVIDENCE SYNTHESIS Available evidence, though limited, suggests that SC testosterone therapy in doses similar to those given via IM route results in comparable pharmacokinetics and mean serum testosterone levels. With appropriate training, patients should be able to safely self-administer testosterone esters SC with relative ease and less discomfort compared with the IM route. CONCLUSION Although studies directly comparing the safety of SC vs IM administration of testosterone esters are desirable, clinicians should consider discussing the SC route with their patients because it is easier to self-administer and has the potential to improve patient adherence.
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Affiliation(s)
| | | | - Shehzad Basaria
- Correspondence: Shehzad Basaria, MD, Research Program in Men’s Health: Aging and Metabolism, Brigham and Women’s Hospital, Harvard Medical School, 221 Longwood Ave, BLI 541, Boston, MA 02115, USA.
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4
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Abstract
A series of dried blood spot (DBS) detection methods for doping agents have been developed in the last two decades. The DBS technique minimizes invasiveness and reduces storage and shipping costs. Recently, the World Anti-Doping Agency announced the use of DBS for the 2022 Beijing Winter Olympic Games and Paralympic Games owing to the advantages of the DBS application in routine doping control. Therefore the further development of detection methods for doping agents in DBS is important and urgent. This review summarizes five aspects of DBS application in doping analysis: sample collection, storage conditions, pretreatment, instrumentation and validation according to the Prohibited List issued by the World Anti-Doping Agency, and proposes some suggestions for future studies of DBS in doping analysis.
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5
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Determination of anabolic steroids in dried blood using microsampling and gas chromatography-tandem mass spectrometry: Application to a testosterone gel administration study. J Chromatogr A 2020; 1628:461445. [DOI: 10.1016/j.chroma.2020.461445] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/28/2020] [Accepted: 07/31/2020] [Indexed: 12/18/2022]
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6
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Turner L, Ly LP, Desai R, Singh GKS, Handelsman TD, Savkovic S, Fennell C, Jayadev V, Conway A, Handelsman DJ. Pharmacokinetics and Acceptability of Subcutaneous Injection of Testosterone Undecanoate. J Endocr Soc 2019; 3:1531-1540. [PMID: 31384715 DOI: 10.1210/js.2019-00134] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 05/22/2019] [Indexed: 12/23/2022] Open
Abstract
Context Can injectable testosterone undecanoate (TU) be administered effectively and acceptably by the subcutaneous (SC) route? Objective To investigate the acceptability and pharmacokinetics (PK) of SC injection of TU. Design Randomized sequence, crossover clinical study of SC vs IM TU injections. Setting Ambulatory clinic of an academic andrology center. Participants Twenty men (11 hypogonadal, 9 transgender men) who were long-term users of TU. injections. Intervention: Injection of 1000 mg TU (in 4 mL castor oil vehicle) by SC or IM route. Main Outcome Measures: Patient-reported pain, acceptability, and preference scales. PK by measurement of serum testosterone, dihydrotestosterone (DHT), and estradiol (E2) concentrations with application of population PK methods and dried blood spot (DBS) sampling. Results Pain was greater after SC compared with IM injection 24 hours (but not immediately) after injection but both routes were equally acceptable. Ultimately 11 preferred IM, 6 preferred SC, and 3 had no preference. The DBS-based PK analysis of serum testosterone revealed a later time of peak testosterone concentration after SC vs IM injection (8.0 vs 3.3 days) but no significant route differences in model-predicted peak testosterone concentration (8.4 vs 9.6 ng/mL) or mean resident time (183 vs 110 days). The PK of venous serum testosterone, DHT, and E2 did not differ according to route of injection. Conclusions We conclude that SC TU injection is acceptable but produces greater pain 24 hours after injection that may contribute to the overall majority preference for the IM injection. The PK of testosterone, DHT, or E2 did not differ substantially between SC and IM routes. Hence whereas further studies are required, the SC route represents an alternative to IM injections without a need to change dose for men for whom IM injection is not desired or recommended.
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Affiliation(s)
- Leo Turner
- Andrology Department, Concord Hospital, Sydney, NSW, Australia
| | - Lam P Ly
- Andrology Department, Concord Hospital, Sydney, NSW, Australia.,ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Reena Desai
- Andrology Department, Concord Hospital, Sydney, NSW, Australia.,ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Gurmeet K S Singh
- ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia.,Department of Pharmaceutical Life Sciences, Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam, Malaysia
| | - Timothy D Handelsman
- Andrology Department, Concord Hospital, Sydney, NSW, Australia.,ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Sasha Savkovic
- Andrology Department, Concord Hospital, Sydney, NSW, Australia.,ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Carolyn Fennell
- Andrology Department, Concord Hospital, Sydney, NSW, Australia
| | - Veena Jayadev
- Andrology Department, Concord Hospital, Sydney, NSW, Australia
| | - Ann Conway
- Andrology Department, Concord Hospital, Sydney, NSW, Australia.,ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia
| | - David J Handelsman
- Andrology Department, Concord Hospital, Sydney, NSW, Australia.,ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia
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Horstman AMH, Backx EMP, Smeets JSJ, Marzuca-Nassr GN, van Kranenburg J, de Boer D, Dolmans J, Snijders T, Verdijk LB, de Groot LCPGM, van Loon LJC. Nandrolone decanoate administration does not attenuate muscle atrophy during a short period of disuse. PLoS One 2019; 14:e0210823. [PMID: 30689637 PMCID: PMC6349315 DOI: 10.1371/journal.pone.0210823] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 12/23/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A few days of bed rest or immobilization following injury, disease, or surgery can lead to considerable loss of skeletal muscle mass and strength. It has been speculated that such short, successive periods of muscle disuse may be largely responsible for the age-related loss of muscle mass throughout the lifespan. OBJECTIVE To assess whether a single intramuscular injection of nandrolone decanoate prior to immobilization can attenuate the loss of muscle mass and strength in vivo in humans. DESIGN, SETTING AND PARTICIPANTS Thirty healthy (22 ± 1 years) men were subjected to 7 days of one-legged knee immobilization by means of a full leg cast with (NAD, n = 15) or without (CON, n = 15) prior intramuscular nandrolone decanoate injection (200 mg). MEASURES Before and immediately after immobilization, quadriceps muscle cross-sectional area (CSA) (by means of single-slice computed tomography (CT) scans of the upper leg) and one-legged knee extension strength (one-repetition maximum [1-RM]) were assessed for both legs. Furthermore, muscle biopsies from the immobilized leg were taken before and after immobilization to assess type I and type II muscle fiber cross-sectional area. RESULTS Quadriceps muscle CSA decreased during immobilization in both CON and NAD (-6 ± 1% and -6 ± 1%, respectively; main effect of time P<0.01), with no differences between the groups (time × treatment interaction, P = 0.59). Leg muscle strength declined following immobilization (-6 ± 2% in CON and -7 ± 3% in NAD; main effect of time, P<0.05), with no differences between groups (time × treatment interaction, P = 0.55). CONCLUSIONS This is the first study to report that nandrolone decanoate administration does not preserve skeletal muscle mass and strength during a short period of leg immobilization in vivo in humans.
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Affiliation(s)
- Astrid M. H. Horstman
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Evelien M. P. Backx
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Joey S. J. Smeets
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Gabriel N. Marzuca-Nassr
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Janneau van Kranenburg
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Douwe de Boer
- Department of Clinical Chemistry, Central Diagnostic Laboratory, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - John Dolmans
- Department of Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Tim Snijders
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Lex B. Verdijk
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | | | - Luc J. C. van Loon
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
- * E-mail:
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8
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Zakaria R, Allen KJ, Koplin JJ, Crinis N, De Rosa L, Roche P, Greaves RF. Determination of haemoglobin derivatives in aged dried blood spot to estimate haematocrit. ACTA ACUST UNITED AC 2019; 57:1026-1034. [DOI: 10.1515/cclm-2018-0753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 12/04/2018] [Indexed: 12/18/2022]
Abstract
Abstract
Introduction
Dried blood spot (DBS) sample applications now encompass analytes related to clinical diagnosis, epidemiological studies, therapeutic drug monitoring, pharmacokinetic and toxicokinetic studies. Haematocrit (Hct) and haemoglobin (Hb) at very high or low concentrations may influence the accuracy of measurement quantification of the DBS sample. In this study, we aimed to predict the Hct of the punched DBS through primary spectrophotometric estimation of its haemoglobin-derivative (Hb-drv) content.
Methods
Formic acid solution was used to elute Hb-drv content of 3.2 mm spotted blood from its dry matrix. Direct spectrometry measurement was utilised to scan the extracted Hb-drv in the visible spectrum range of 520–600 nm. The linear relationship between an individual’s Hct percentage and Hb-drv concentration was applied to estimate the Hct level of the blood spot. De-identified whole blood samples were used for the method development and evaluation studies.
Results
The Hb-drv estimation is valid in samples >2 months old. Method validation experiments DBS demonstrate linearity between 82.5 and 207.5 g/L, average coefficient of variation of 3.6% (intra-assay) and 7.7% (inter-assay), analytical recovery of 84%, and a high positive correlation (r=0.88) between Hb-drv and the original whole blood Hct. The Bland-Altman difference plot demonstrates a mean difference of 2.4% between the calculated DBS Hct and the directly measured Hct from fresh whole bloods.
Conclusions
We have successfully developed a simple Hb-drv method to estimate Hct in aged DBS samples. This method can be incorporated into DBS analytical work-flow for the in-situ estimation of Hct and subsequent correction of the analyte of interest as required.
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Affiliation(s)
- Rosita Zakaria
- School of Health and Biomedical Sciences , RMIT University , Bundoora, Victoria , Australia
- Murdoch Children’s Research Institute , Parkville, Victoria , Australia
| | - Katrina J. Allen
- Murdoch Children’s Research Institute , Parkville, Victoria , Australia
- Department of Paediatrics , University of Melbourne , Parkville, Victoria , Australia
- Department of Allergy and Clinical Immunology , Royal Children’s Hospital , Parkville, Victoria , Australia
| | | | - Nick Crinis
- Clinical Biochemistry, Austin Pathology , Heidelberg, Victoria , Australia
| | - Lidia De Rosa
- Core Laboratory, Pathology , The Royal Children’s Hospital , Parkville, Victoria , Australia
| | - Peter Roche
- School of Health and Biomedical Sciences , RMIT University , Bundoora, Victoria , Australia
| | - Ronda F. Greaves
- School of Health and Biomedical Sciences , RMIT University , Bundoora, Victoria , Australia
- Victorian Clinical Genetics Services, Murdoch Children’s Research Institute , Flemington Rd , Parkville, Victoria 3052 , Australia
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9
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Serum cortisol as a moderator of the relationship between serum testosterone and Olympic weightlifting performance in real and simulated competitions. Biol Sport 2018; 35:215-221. [PMID: 30449938 PMCID: PMC6224847 DOI: 10.5114/biolsport.2018.74632] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/24/2018] [Accepted: 03/01/2018] [Indexed: 01/06/2023] Open
Abstract
Some equivocality exists regarding the effect of testosterone (T) on competitive performance with cortisol (C) implicated as a moderating factor. This study investigated whether C is moderating the T relationship with Olympic weightlifting (OWL) performance during real and simulated competitions. We monitored 105 male athletes (age 19.3±3.7 years); 46 during real OWL competitions (e.g., national age championships) and 59 across simulated events (e.g., talent identification). Serum T and C were assessed before warming up and within 15 minutes of event completion. Performance was indexed by the total combined load across the snatch and clean and jerk exercises. Hierarchical linear regression and simple slopes were employed to test the hormone and performance relationships. Pre-competition T (pre-T) and C (pre-C) were unrelated to OWL performance when controlling for competition type, time of day, age, and body mass (model=75.6% variance). However, the pre-T × pre-C interaction was significant (model=77% variance). Upon exploring this interaction, different pre-T and performance relationships emerged for males with high pre-C (β=-9.96) and low pre-C levels (β=9.04), with diverging slopes (p=0.006). The assessment of T changes and pre-C produced similar results. The association between male T and performance during OWL competition was determined by C activity, which could explain conflicting reports of T as a correlate of competitive abilities. Our results imply that T and C are not strictly anabolic and catabolic biomarkers of performance, respectively, but rather they exert complementary actions that could depend on task, situational and environmental needs.
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10
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Iyer R, Mok SF, Savkovic S, Turner L, Fraser G, Desai R, Jayadev V, Conway AJ, Handelsman DJ. Pharmacokinetics of testosterone cream applied to scrotal skin. Andrology 2017; 5:725-731. [DOI: 10.1111/andr.12357] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 02/06/2017] [Accepted: 02/10/2017] [Indexed: 11/27/2022]
Affiliation(s)
- R. Iyer
- Andrology Department; Concord Hospital and ANZAC Research Institute; University of Sydney; Sydney NSW Australia
| | - S. F. Mok
- Andrology Department; Concord Hospital and ANZAC Research Institute; University of Sydney; Sydney NSW Australia
| | - S. Savkovic
- Andrology Department; Concord Hospital and ANZAC Research Institute; University of Sydney; Sydney NSW Australia
| | - L. Turner
- Andrology Department; Concord Hospital and ANZAC Research Institute; University of Sydney; Sydney NSW Australia
| | - G. Fraser
- Andrology Department; Concord Hospital and ANZAC Research Institute; University of Sydney; Sydney NSW Australia
| | - R. Desai
- Andrology Department; Concord Hospital and ANZAC Research Institute; University of Sydney; Sydney NSW Australia
| | - V. Jayadev
- Andrology Department; Concord Hospital and ANZAC Research Institute; University of Sydney; Sydney NSW Australia
| | - A. J. Conway
- Andrology Department; Concord Hospital and ANZAC Research Institute; University of Sydney; Sydney NSW Australia
| | - D. J. Handelsman
- Andrology Department; Concord Hospital and ANZAC Research Institute; University of Sydney; Sydney NSW Australia
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11
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Crewther BT, Obmiński Z, Orysiak J, Al-Dujaili EAS. The utility of salivary testosterone and cortisol concentration measures for assessing the stress responses of junior athletes during a sporting competition. J Clin Lab Anal 2017; 32. [PMID: 28295634 DOI: 10.1002/jcla.22197] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 02/13/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND This study examined the utility of salivary testosterone (T) and cortisol (C) concentration measures for assessing the acute stress responses of junior athletes during a sporting competition. METHODS Paired capillary blood and saliva samples were taken from 71 junior athletes (45 males, 26 females) before and after a simulated Olympic weightlifting competition. The concentration measures of salivary T and C were referenced against blood total T (TT) and C (TC) concentrations. All hormones were tested by immunoassay. RESULTS The competition promoted an increase in the blood TT concentrations of the male (10.1%±18.7%) and female (12.9%±19.9%) athletes (P<.05), with TC also rising in females (37.5%±69%) and tending to increase in males (23.2%±56.1%). No significant changes in salivary T or C were identified. Locally-weighted regression revealed that salivary T was strongly related to blood TT in males (r2 =.84), but not females (r2 =-.15), whereas salivary C was moderately related to blood TC in both sexes (r2 =.43, r2 =.48), respectively. CONCLUSIONS A short, high-intensity competition promoted a predictable stress-induced rise in blood TT and TC concentrations. We observed no hormonal stress responses in saliva under the current format, which could be explained by individual variability and blood-saliva differences in hormone kinetics. Still, the salivary T and C measures did show a moderate to strong ability to track individual blood TT (males only) and TC (both sexes) concentrations in a young athletic cohort across a broad physiological range. Recommendations for researchers and practitioners are presented.
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Affiliation(s)
| | | | - Joanna Orysiak
- Institute of Sport-National Research Institute, Warsaw, Poland
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12
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Almeida M, Laurent MR, Dubois V, Claessens F, O'Brien CA, Bouillon R, Vanderschueren D, Manolagas SC. Estrogens and Androgens in Skeletal Physiology and Pathophysiology. Physiol Rev 2017; 97:135-187. [PMID: 27807202 PMCID: PMC5539371 DOI: 10.1152/physrev.00033.2015] [Citation(s) in RCA: 457] [Impact Index Per Article: 65.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Estrogens and androgens influence the growth and maintenance of the mammalian skeleton and are responsible for its sexual dimorphism. Estrogen deficiency at menopause or loss of both estrogens and androgens in elderly men contribute to the development of osteoporosis, one of the most common and impactful metabolic diseases of old age. In the last 20 years, basic and clinical research advances, genetic insights from humans and rodents, and newer imaging technologies have changed considerably the landscape of our understanding of bone biology as well as the relationship between sex steroids and the physiology and pathophysiology of bone metabolism. Together with the appreciation of the side effects of estrogen-related therapies on breast cancer and cardiovascular diseases, these advances have also drastically altered the treatment of osteoporosis. In this article, we provide a comprehensive review of the molecular and cellular mechanisms of action of estrogens and androgens on bone, their influences on skeletal homeostasis during growth and adulthood, the pathogenetic mechanisms of the adverse effects of their deficiency on the female and male skeleton, as well as the role of natural and synthetic estrogenic or androgenic compounds in the pharmacotherapy of osteoporosis. We highlight latest advances on the crosstalk between hormonal and mechanical signals, the relevance of the antioxidant properties of estrogens and androgens, the difference of their cellular targets in different bone envelopes, the role of estrogen deficiency in male osteoporosis, and the contribution of estrogen or androgen deficiency to the monomorphic effects of aging on skeletal involution.
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Affiliation(s)
- Maria Almeida
- Division of Endocrinology and Metabolism, Center for Osteoporosis and Metabolic Bone Diseases, University of Arkansas for Medical Sciences and the Central Arkansas Veterans Healthcare System, Little Rock, Arkansas; Departments of Cellular and Molecular Medicine and Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium; Center for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium; and Institut National de la Santé et de la Recherche Médicale UMR1011, University of Lille and Institut Pasteur de Lille, Lille, France
| | - Michaël R Laurent
- Division of Endocrinology and Metabolism, Center for Osteoporosis and Metabolic Bone Diseases, University of Arkansas for Medical Sciences and the Central Arkansas Veterans Healthcare System, Little Rock, Arkansas; Departments of Cellular and Molecular Medicine and Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium; Center for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium; and Institut National de la Santé et de la Recherche Médicale UMR1011, University of Lille and Institut Pasteur de Lille, Lille, France
| | - Vanessa Dubois
- Division of Endocrinology and Metabolism, Center for Osteoporosis and Metabolic Bone Diseases, University of Arkansas for Medical Sciences and the Central Arkansas Veterans Healthcare System, Little Rock, Arkansas; Departments of Cellular and Molecular Medicine and Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium; Center for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium; and Institut National de la Santé et de la Recherche Médicale UMR1011, University of Lille and Institut Pasteur de Lille, Lille, France
| | - Frank Claessens
- Division of Endocrinology and Metabolism, Center for Osteoporosis and Metabolic Bone Diseases, University of Arkansas for Medical Sciences and the Central Arkansas Veterans Healthcare System, Little Rock, Arkansas; Departments of Cellular and Molecular Medicine and Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium; Center for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium; and Institut National de la Santé et de la Recherche Médicale UMR1011, University of Lille and Institut Pasteur de Lille, Lille, France
| | - Charles A O'Brien
- Division of Endocrinology and Metabolism, Center for Osteoporosis and Metabolic Bone Diseases, University of Arkansas for Medical Sciences and the Central Arkansas Veterans Healthcare System, Little Rock, Arkansas; Departments of Cellular and Molecular Medicine and Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium; Center for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium; and Institut National de la Santé et de la Recherche Médicale UMR1011, University of Lille and Institut Pasteur de Lille, Lille, France
| | - Roger Bouillon
- Division of Endocrinology and Metabolism, Center for Osteoporosis and Metabolic Bone Diseases, University of Arkansas for Medical Sciences and the Central Arkansas Veterans Healthcare System, Little Rock, Arkansas; Departments of Cellular and Molecular Medicine and Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium; Center for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium; and Institut National de la Santé et de la Recherche Médicale UMR1011, University of Lille and Institut Pasteur de Lille, Lille, France
| | - Dirk Vanderschueren
- Division of Endocrinology and Metabolism, Center for Osteoporosis and Metabolic Bone Diseases, University of Arkansas for Medical Sciences and the Central Arkansas Veterans Healthcare System, Little Rock, Arkansas; Departments of Cellular and Molecular Medicine and Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium; Center for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium; and Institut National de la Santé et de la Recherche Médicale UMR1011, University of Lille and Institut Pasteur de Lille, Lille, France
| | - Stavros C Manolagas
- Division of Endocrinology and Metabolism, Center for Osteoporosis and Metabolic Bone Diseases, University of Arkansas for Medical Sciences and the Central Arkansas Veterans Healthcare System, Little Rock, Arkansas; Departments of Cellular and Molecular Medicine and Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium; Center for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium; and Institut National de la Santé et de la Recherche Médicale UMR1011, University of Lille and Institut Pasteur de Lille, Lille, France
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Karavolos S, Reynolds M, Panagiotopoulou N, McEleny K, Scally M, Quinton R. Male central hypogonadism secondary to exogenous androgens: a review of the drugs and protocols highlighted by the online community of users for prevention and/or mitigation of adverse effects. Clin Endocrinol (Oxf) 2015; 82:624-32. [PMID: 25333666 DOI: 10.1111/cen.12641] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 09/23/2014] [Accepted: 10/17/2014] [Indexed: 11/28/2022]
Abstract
Androgen- or anabolic steroid-induced hypogonadism (ASIH) is no longer confined to professional athletes; its prevalence amongst young men and teenagers using androgens and/or anabolic steroids (AASs) is rising fast, and those affected can experience significant symptoms. Clinicians are increasingly encountering demanding, well-informed men affected by ASIH, yet lacking authoritative information on the subject may struggle to project a credible message. In this article, we overview the methods and drugs that men use in an attempt to counteract ASIH (with a view to either preventing its onset, or reversing it once it has developed) and summarize the scientific evidence underpinning these. The main channel for obtaining these drugs is the Internet, where they can be readily sourced without a valid prescription. An Internet search using relevant terms revealed a huge number of websites providing advice on how to buy and use products to counteract ASIH. Drugs arising repeatedly in our search included human chorionic gonadotrophin (hCG), selective oestrogen receptor modulators (SERMs) and aromatase inhibitors (AIs). The quality and accuracy of the online information was variable, but review of medical literature also highlighted a lack of scientific data to guide clinical practice. It is important for clinicians to be aware of the AAS user's self-treatment strategies with regard to ASIH side-effect mitigation. By ensuring that they are well-informed, clinicians are more likely to retain the credibility and trust of AAS users, who will in turn likely be more open to engage with appropriate management.
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Affiliation(s)
- Stamatios Karavolos
- Newcastle Fertility Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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Li W, Doherty J, Moench P, Flarakos J, Tse FL. LC–MS/MS bioanalysis of loratadine (Claritin) in dried blood spot (DBS) samples collected by subjects in a clinical research study. J Chromatogr B Analyt Technol Biomed Life Sci 2015; 983-984:117-24. [DOI: 10.1016/j.jchromb.2014.12.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 12/28/2014] [Accepted: 12/30/2014] [Indexed: 11/28/2022]
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