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Li T, Jiang Y, Bai Y, Jiang K, Du G, Chen P, Luo C, Li L, Qiao J, Shen J. A review for the impacts of circadian disturbance on urological cancers. Sleep Biol Rhythms 2024; 22:163-180. [PMID: 38524168 PMCID: PMC10959858 DOI: 10.1007/s41105-023-00500-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/18/2023] [Indexed: 03/26/2024]
Abstract
Circadian rhythm is an internal timing system and harmonizes a variety of cellular, behavioral, and physiological processes to daily environment. Circadian disturbance caused by altered life style or disrupted sleep patterns inevitably contributes to various disorders. As the rapidly increased cancer occurrences and subsequent tremendous financial burdens, more researches focus on reducing the morbidity rather than treating it. Recently, many epidemiologic studies demonstrated that circadian disturbance was tightly related to the occurrence and development of cancers. For urinary system, numerous clinical researches observed the incidence and progress of prostate cancer were influenced by nightshift work, sleep duration, chronotypes, light exposure, and meal timing, this was also proved by many genetic and fundamental findings. Although the epidemiological studies regarding the relationship between circadian disturbance and kidney/bladder cancers were relative limited, some basic researches still claimed circadian disruption was closely correlated to these two cancers. The role of circadian chemotherapy on cancers of prostate, kidney, and bladder were also explored, however, it has not been regularly recommended considering the limited evidence and poor standard protocols. Finally, the researches for the impacts of circadian disturbance on cancers of adrenal gland, penis, testis were not found at present. In general, a better understanding the relationship between circadian disturbance and urological cancers might help to provide more scientific work schedules and rational lifestyles which finally saving health resource by reducing urological tumorigenesis, however, the underlying mechanisms are complex which need further exploration.
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Affiliation(s)
- Tao Li
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
- Department of Urology, Guizhou Provincial People’s Hospital, Guiyang, China
| | - Yiting Jiang
- Department of Otorhinolaryngology, The Ninth People’s Hospital of Chongqing, Chongqing, China
| | - Yunjin Bai
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Kehua Jiang
- Department of Urology, Guizhou Provincial People’s Hospital, Guiyang, China
| | - Guangshi Du
- Translational Medicine Research Center of Guizhou Medical University, Guiyang, China
| | - Peng Chen
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Chao Luo
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Lei Li
- Gastrointestinal Surgery Center, School of Medicine, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China
| | - Jun Qiao
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Jun Shen
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
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Li T, Jiang YT, Qi XZ, Chen P, Zhang JH, Luo F, Qiao J, Gu J, Du GS, Wang Q. Circadian disturbance induces erectile dysfunction by impairing endothelial function. Asian J Androl 2024; 26:205-211. [PMID: 38048170 PMCID: PMC10919418 DOI: 10.4103/aja202345] [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: 01/20/2023] [Accepted: 09/27/2023] [Indexed: 12/06/2023] Open
Abstract
In order to explore the impact of circadian disturbance on erectile function, we randomly divided 24 adult male rats into groups of control (light on at 8:00 a.m. and off at 8:00 p.m.), dark/dark (DD; constant dark), light/light (LL; constant light), and shift dark/light (DL; light off at 8:00 a.m. and on at 8:00 p.m.). Four weeks later, erectile function was measured and corpora cavernosa were harvested for analysis. The maximum intracavernous pressure (mICP) and mICP/mean arterial pressure (MAP) ratio in the DD, LL, and DL groups were significantly lower than that in the control group. The LL and DL groups showed significantly attenuated endothelial nitric oxide synthase (eNOS), while DD, LL, and DL showed reduced neuronal nitric oxide synthase (nNOS) at both mRNA and protein levels. The production of nitric oxide (NO) and cyclic guanosine monophosphate (cGMP) was inhibited by altered light/dark cycles to varying degrees. Circadian disturbance impaired endothelial function and contributed to erectile dysfunction. For the core circadian elements, mRNA expression of circadian locomotor output cycles kaput ( Clock ) and brain/muscle aryl-hydrocarbon receptor nuclear translocator-like protein 1 ( Bmal1 ) was elevated in the DL group, but their protein expression was not significantly changed. DD, LL, and DL increased period 1 ( Per1 ) and Per3 levels, while LL and DL increased PER1 levels. No significant difference was found for Per2 levels, and PER2 and PER3 concentrations were not significantly changed. Moreover, LL and DL significantly increased cryptochrome-1 (CRY1) and CRY2 at both mRNA and protein levels. The altered light/dark rat model showed that circadian disturbance contributed to erectile dysfunction probably by impairing endothelial function. Meanwhile, the core circadian elements were detected in the corpora cavernosa, but these were disrupted. However, which circadian element regulates erectile function and how it works need further analysis.
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Affiliation(s)
- Tao Li
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
- Department of Urology, Guizhou Provincial People’s Hospital, Guiyang 550002, China
| | - Yi-Ting Jiang
- Department of Otorhinolaryngology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
| | - Xin-Zhu Qi
- Guizhou Institute for Food and Drug Control, Guiyang 550004, China
| | - Peng Chen
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
| | - Jun-Hao Zhang
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
| | - Fu Luo
- Department of Reproductive Center, Guizhou Provincial People’s Hospital, Guiyang 550002, China
| | - Jun Qiao
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
| | - Jiang Gu
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
| | - Guang-Shi Du
- Translational Medicine Research Center of Guizhou Medical University, Guiyang 550025, China
| | - Qiang Wang
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
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Grossmann M, Jayasena CN, Anawalt BD. Approach to the Patient: The Evaluation and Management of Men ≥50 Years With Low Serum Testosterone Concentration. J Clin Endocrinol Metab 2023; 108:e871-e884. [PMID: 36995891 PMCID: PMC10438885 DOI: 10.1210/clinem/dgad180] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
Although testosterone replacement in men with classic hypogonadism due to an identified pathology of the hypothalamic-pituitary-testicular axis is uncontroversial, the role of testosterone treatment for men with age-related declines in circulating testosterone is unclear. This is due to the lack of large, long-term testosterone therapy trials assessing definitive clinical endpoints. However, men ≥50 years of age, particularly those who have a body mass index >25 kg/m2 and multiple comorbidities, commonly present with clinical features of androgen deficiency and low serum testosterone concentrations. Clinicians are faced with the question whether to initiate testosterone therapy, a difficult dilemma that entails a benefit-risk analysis with limited evidence from clinical trials. Using a case scenario, we present a practical approach to the clinical assessment and management of such men.
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Affiliation(s)
- Mathis Grossmann
- Department of Medicine (Austin Health), The University of Melbourne, Melbourne, Victoria 3084, Australia
- Department of Endocrinology, Austin Health, Heidelberg, Victoria 3084, Australia
| | - Channa N Jayasena
- Section of Investigative Medicine, Imperial College London, London SW7 2AZ, UK
| | - Bradley D Anawalt
- Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA
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Lyu X, Dunietz GL, O'Brien LM, Chervin RD, Koumpias A, Shedden K. Disparities in sleep-wake patterns by labor force status: Population-based findings. Chronobiol Int 2023; 40:1111-1122. [PMID: 37691398 DOI: 10.1080/07420528.2023.2253904] [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: 11/16/2022] [Revised: 06/01/2023] [Accepted: 08/25/2023] [Indexed: 09/12/2023]
Abstract
Sleep disturbances have been associated with unemployment, but variation in sleep-wake patterns by labor force status has rarely been examined. With a population-based sample, we investigated differences in sleep-wake patterns by labor force status (employed, unemployed, and not-in-the-labor-force) and potential disparities by sociodemographic variables. The analysis included 130,602 adults aged 25-60 y, who participated in the American Time Use Survey between 2003 and 2019. Individual sleep-wake pattern was extracted from time use logs in a strict 24-h period (04:00 h-03:59 h). Functional nonparametric regression models based on dimensionality reduction and neighborhood matching were applied to model the relationship between sleep-wake patterns and labor force status. Specifically, we predicted changes in intra-person sleep-wake patterns under hypothetical changes of labor force status from employed to unemployed or not-in-the-labor-force. We then studied moderations of this association by gender, race/ethnicity and educational attainment. In comparison to the employed state, unemployed and not-in-the-labor-force states were predicted to have later wake-times, later bedtimes, and higher tendency for taking midday naps. Changes in labor force status led to more apparent shifts in wake-times than in bedtimes. Additionally, sleep schedules of Hispanics and those with higher education level were more vulnerable to the change of labor force status from employed to unemployed.
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Affiliation(s)
- Xiru Lyu
- Department of Statistics, University of Michigan, Ann Arbor, Michigan, USA
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Galit Levi Dunietz
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Louise M O'Brien
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ronald D Chervin
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Antonios Koumpias
- Department of Social Sciences, University of Michigan, Dearborn, Michigan, USA
| | - Kerby Shedden
- Department of Statistics, University of Michigan, Ann Arbor, Michigan, USA
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Adami LNG, Fernandes GL, Carvalho RCD, Okada FK, Tufik S, Andersen ML, Bertolla RP. Effect of chronic sleep deprivation on acrosomal integrity and functional parameters of murine sperm. F&S SCIENCE 2023; 4:11-20. [PMID: 36565949 DOI: 10.1016/j.xfss.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/09/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the effect of chronic sleep deprivation on sperm function quality in mice. DESIGN Experimental study. SETTING Not applicable. ANIMALS Spermatozoa from twenty-four 10-week-old C57BL/6J male mice. INTERVENTION(S) The sleep deprivation group underwent gentle handling for 6 hours for 5 consecutive days. The mice in the sleep recovery group were allowed to sleep during the 24-hour period after the sleep deprivation protocol. MAIN OUTCOME MEASURE(S) After euthanasia, the spermatozoa were collected for analysis. Sperm motility was evaluated using computer-assisted sperm analyzer. Intracellular superoxide anion (O2-) activity, acrosome integrity, mitochondrial activity, and DNA fragmentation assays were conducted afterward. RESULT(S) Sleep deprivation and sleep recovery groups presented a lower percentage of spermatozoa with an intact acrosome, compared with the respective control groups. Regarding DNA fragmentation, a decreased proportion of spermatozoa with Comet I class intact DNA was observed in the sleep recovery group, compared with the recovery control group. Beat cross frequency was increased in the sleep recovery group. CONCLUSION(S) Sleep deprivation can reduce sperm quality, impairing acrosome integrity. Sleep recovery decreased DNA integrity and increased beat cross frequency.
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Affiliation(s)
- Luana Nayara Gallego Adami
- Disciplina de Urologia, Setor de Reprodução Humana, Departamento de Cirurgia, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Renata Cristina de Carvalho
- Disciplina de Urologia, Setor de Reprodução Humana, Departamento de Cirurgia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Fatima Kazue Okada
- Disciplina de Urologia, Setor de Reprodução Humana, Departamento de Cirurgia, Universidade Federal de São Paulo, São Paulo, Brazil; Laboratório de Biologia do Desenvolvimento, Departamento de Morfologia e Genética, Universidade Federal de São Paulo, São Paulo, Brazil.
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ricardo Pimenta Bertolla
- Disciplina de Urologia, Setor de Reprodução Humana, Departamento de Cirurgia, Universidade Federal de São Paulo, São Paulo, Brazil
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Abstract
In the absence of obesity, adverse lifestyle behaviours, and use of medication such as opioids serum testosterone concentrations decrease by only a minimal amount at least until very advanced age in most men. Obesity is heterogeneous in its phenotype, and it is the accumulation of excess adipose tissue viscerally associated with insulin resistance, dyslipidaemia, inflammation, hypothalamic leptin resistance and gliosis that underpins the functional hypogonadism of obesity. Both central (hypothalamic) and peripheral mechanisms are involved resulting in a low serum total testosterone concentration, while LH and FSH are typically in the normal range. Peripherally a decrease in serum sex hormone binding globulin (SHBG) concentration only partially explains the decrease in testosterone and there is increasing evidence for direct effects in the testis. Men with obesity associated functional hypogonadism and serum testosterone concentrations below 16 nmol/L are at increased risk of incident type 2 diabetes (T2D); high testosterone concentrations are protective. The magnitude of weight loss is linearly associated with an increase in serum testosterone concentration and with the likelihood of preventing T2D or reverting newly diagnosed disease; treatment with testosterone for 2 years increases the probability of a positive outcome from a lifestyle intervention alone by approximately 40%. Whether the additional favourable benefits of testosterone treatment on muscle mass and strength and bone density and quality in the long-term remains to be determined.
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Affiliation(s)
- Gary Wittert
- University of Adelaide, Adelaide, Australia.
- Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia.
- South Australian Health and Medical Research Institute North Terrace Adelaide, 5000, SA, Adelaide, Australia.
| | - Mathis Grossmann
- Department of Medicine (Austin Health), The University of Melbourne, Heidelberg, Victoria4, Germany
- Department of Endocrinology, Austin Health, Heidelberg, VIC, Germany
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Abstract
Sleep serves important biological functions, and influences health and longevity through endocrine and metabolic related systems. Sleep debt, circadian misalignment and sleep disruption from obstructive sleep apnea is widespread in modern society and accumulates with life because recovery sleep is not completely restorative. Accumulated disordered sleep throughout life impacts the ageing process and the development of age-related diseases. When epidemiological and interventional studies are considered collectively, sleep loss and lower sleep duration are associated with lower morning, afternoon and 24-h testosterone; as well as higher afternoon, but not morning or 24-h cortisol. These reciprocal changes imbalances anabolic-catabolic signaling because testosterone and cortisol are respectively the main anabolic and catabolic signals in man. Fixing testosterone-cortisol balance by means of a novel dual-hormone clamp mitigates the induction of insulin resistance by sleep restriction and provided the first proof-of-concept that the metabolic harm from sleep loss can be ameliorated by approaches that do not require sleeping more. Obstructive sleep apnea is associated with lower testosterone, even after controlling for age and obesity whereas the conclusion that continuous positive airway pressure therapy has no effect on testosterone is premature because available studies are underpowered and better-quality studies suggest otherwise. High dose testosterone therapy induces OSA, but more physiological dosing may not; and this effect may be transient or may dissipate with longer term therapy. Studies investigating the origin of the diurnal testosterone rhythm, the effect of circadian misalignment on testosterone-cortisol balance, and methods to mitigate metabolic harm, are required.
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Affiliation(s)
- Peter Y Liu
- Division of Endocrinology, Metabolism and Nutrition, Department of Medicine, Harbor UCLA Medical Center and The Lundquist Institute, 1124 W Carson St., Box 446, Torrance, CA, 90502, USA.
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
| | - Radha T Reddy
- Division of Endocrinology, Metabolism and Nutrition, Department of Medicine, Harbor UCLA Medical Center and The Lundquist Institute, 1124 W Carson St., Box 446, Torrance, CA, 90502, USA
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8
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Associations of testosterone and cortisol concentrations with sleep quality in Japanese male workers. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2022; 12:100158. [PMID: 36148025 PMCID: PMC9485038 DOI: 10.1016/j.cpnec.2022.100158] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/29/2022] Open
Abstract
Low testosterone concentrations are associated with disrupted sleep, and high levels of cortisol, which is elevated in response to stress, lead to insomnia. This study aimed to investigate the associations of testosterone and cortisol concentrations with sleep quality and to examine potential interactions between them in Japanese working men. This study was a cross-sectional design, and testosterone and cortisol concentrations in blood were the exposure variables and sleep parameters were the outcome variables. The Japanese version of the Pittsburgh Sleep Quality Index was used to measure sleep quality, and it included the total duration of sleep, time in bed (TIB), and sleep efficacy. We included 178 men (mean age = 49.1 years, standard deviation = 9.0) who completed all components in the questionnaire related to sleep and provided blood samples. Testosterone and cortisol concentrations were negatively associated with TIB (standardized beta = −0.15 and −0.24, p < 0.05, respectively), while only testosterone concentrations were positively associated with sleep efficacy (standardized beta = 0.15, p < 0.05). An interaction effect of testosterone and cortisol was significant for TIB and sleep efficacy (standardized beta for interaction term = 0.40, p < 0.001 and −0.22, p = 0.012, respectively). When stratified by cortisol concentrations, the associations between testosterone concentrations and sleep parameters were modified. Our findings suggest that associations between testosterone concentrations and sleep parameters are stronger at low cortisol concentrations, but not at high cortisol concentrations. High cortisol concentrations may diminish associations between low testosterone concentrations and diminished sleep efficacy. Testosterone and cortisol levels were negatively associated with hours in bed. Testosterone concentrations were positively associated with sleep efficacy. Cortisol levels modified the associations between testosterone and sleep efficacy. Testosterone strongly associated with sleep efficacy in low cortisol levels. Cortisol levels may inhibit associations between testosterone and sleep efficacy.
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Kelly MR, Yuen F, Satterfield BC, Auchus RJ, Gaddameedhi S, Van Dongen HPA, Liu PY. Endogenous Diurnal Patterns of Adrenal and Gonadal Hormones During a 24-Hour Constant Routine After Simulated Shift Work. J Endocr Soc 2022; 6:bvac153. [PMID: 36330292 PMCID: PMC9620969 DOI: 10.1210/jendso/bvac153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Indexed: 01/12/2023] Open
Abstract
Context Night-shift work causes circadian misalignment, predicts the development of metabolic diseases, and complicates the interpretation of hormone measurements. Objective To investigate endogenous circadian rhythms, dissociated from behavioral and environmental confounds, in adrenal and gonadal steroids after simulated shift work. Methods Fourteen healthy adults (ages 25.8 ± 3.2 years) were randomized to 3 days of night or day (control) shift work followed by a constant routine protocol designed to experimentally unveil rhythms driven endogenously by the central circadian pacemaker. Blood was sampled every 3 hours for 24 hours during the constant routine to concurrently obtain 16 Δ4 steroid profiles by mass spectrometry. Cosinor analyses of these profiles provided mesor (mean abundance), amplitude (oscillation magnitude), and acrophase (peak timing). Results Night-shift work marginally increased cortisol by 1 μg/dL (P = 0.039), and inactive/weak derivatives cortisone (P = 0.003) and 18-hydroxycortisol (P < 0.001), but did not alter the mesor of potent androgens testosterone and 11-ketotestosterone. Adrenal-derived steroids, including 11-ketotestosterone (P < 0.01), showed robust circadian rhythmicity after either day- or night-shift work. In contrast, testosterone and progesterone showed no circadian pattern after both shift work conditions. Night-shift work did not alter the amplitude or acrophase of any of the steroid profiles. Conclusion Experimental circadian misalignment had minimal effects on steroidogenesis. Adrenal steroids, but not gonadal hormones, showed endogenous circadian regulation robust to prior shift schedule. This dichotomy may predispose night-shift workers to metabolic ill health. Furthermore, adrenal steroids, including cortisol and the main adrenal androgen 11-ketostosterone, should always be evaluated during the biological morning whereas assessment of gonadal steroids, particularly testosterone, is dependent on the shift-work schedule.
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Affiliation(s)
- Monica R Kelly
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- VA Greater Los Angeles Healthcare System, Geriatric Research, Education and Clinical Center, North Hills, CA, USA
| | - Fiona Yuen
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Division of Endocrinology, Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Brieann C Satterfield
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Richard J Auchus
- Division of Metabolism, Diabetes, and Endocrinology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Pharmacology, University of Michigan, Ann Arbor, MI, USA
| | - Shobhan Gaddameedhi
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
| | - Hans P A Van Dongen
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Peter Y Liu
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Division of Endocrinology, Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
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10
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Winters SJ. Hypogonadism in Males With Genetic Neurodevelopmental Syndromes. J Clin Endocrinol Metab 2022; 107:e3974-e3989. [PMID: 35913018 DOI: 10.1210/clinem/dgac421] [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: 04/07/2022] [Indexed: 11/19/2022]
Abstract
Genetic syndromes that affect the nervous system may also disrupt testicular function, and the mechanisms for these effects may be interrelated. Most often neurological signs and symptoms predominate and hypogonadism remains undetected and untreated, while in other cases, a thorough evaluation of a hypogonadal male reveals previously unrecognized ataxia, movement disorder, muscle weakness, tremor, or seizures, leading to a syndromic diagnosis. Androgen deficiency in patients with neurological diseases may aggravate muscle weakness and fatigue and predispose patients to osteoporosis and obesity. The purpose of this mini review is to provide a current understanding of the clinical, biochemical, histologic, and genetic features of syndromes in which male hypogonadism and neurological dysfunction may coexist and may be encountered by the clinical endocrinologist.
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Affiliation(s)
- Stephen J Winters
- Division of Endocrinology, Metabolism & Diabetes, University of Louisville, Louisville, KY, USA
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11
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Wu FCW. Ageing male (part 2): Management of functional hypogonadism in older men, a patient-centric holistic approach. Best Pract Res Clin Endocrinol Metab 2022; 36:101626. [PMID: 35461757 DOI: 10.1016/j.beem.2022.101626] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The diagnosis of functional hypogonadism should prompt a thorough assessment and optimization of general health, including lifestyle changes, weight reduction, care of comorbidities and cessation of offending medications, some of which can lead to meaningful gains in endogenous testosterone (T) concentrations. Having excluded or addressed reversible causes and contra-indications, patients with functional hypogonadism can be offered a trial of testosterone replacement therapy (TRT) after full discussion on the anticipated benefits and potential risks. T treatment improves libido but may be less effective for erectile dysfunction (ED). T treatment can also have modest positive effects on insulin resistance, bone strength, some measures of physical strength, and mild depressive symptoms but the clinical significance of these relatively short-term improvements remain uncertain in terms of longer-term patient-important outcomes. Initiation of TRT is a joint decision between patient and clinician since longer-term benefits and risks have not been adequately defined.
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Affiliation(s)
- Frederick C W Wu
- Division of Endocrinology, Diabetes & Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9WL, UK.
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12
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Risk of Infertility in Males with Obstructive Sleep Apnea: A Nationwide, Population-Based, Nested Case‒Control Study. J Pers Med 2022; 12:jpm12060933. [PMID: 35743718 PMCID: PMC9224853 DOI: 10.3390/jpm12060933] [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: 03/21/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 02/04/2023] Open
Abstract
Obstructive sleep apnea (OSA) yields intermittent hypoxia, hypercapnia, and sleep fragmentation. OSA is associated with chronic medical conditions such as cardiovascular diseases, metabolic syndrome, and neurocognitive dysfunction. However, the risk of infertility in OSA remains unclear due to limited data and lack of long-term population-based studies. The study aims to assess the risk of infertility in obstructive sleep apnea (OSA) by means of a population-based cohort study. The data was utilized from the Taiwan National Health Insurance Research Database (NHIRD) to conduct a population-based cohort study (1997–2013). Compared with the Non-OSA group, the male with OSA and surgery group has the OR (odds ratio) of infertility of 2.70 (95% CI, 1.46–4.98, p = 0.0015), but no significance exists in females with OSA. When the data was stratified according to age and gender, some associations in the specific subgroups were significant. Respectively, males aged 20–35 years old and aged 35–50 years old with a history of OSA and surgery both had a positive association with infertility. (aOR: 3.19; 95% CI, 1.18–8.66, p = 0.0227; aOR: 2.57; 95% CI, 1.18–5.62 p = 0.0176). Male patients with OSA suffer from reduced fertility, but no significant difference was noted in females with OSA. The identification of OSA as a risk factor for male infertility will aid clinicians to optimize long-term medical care. Furthermore, more studies will be encouraged to clarify the effect of OSA on female fertility.
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Zhang F, Xiong Y, Qin F, Yuan J. Short Sleep Duration and Erectile Dysfunction: A Review of the Literature. Nat Sci Sleep 2022; 14:1945-1961. [PMID: 36325277 PMCID: PMC9621223 DOI: 10.2147/nss.s375571] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022] Open
Abstract
The meaning of sleep has puzzled people for millennia. In modern society, short sleep duration is becoming a global problem. It has been established that short sleep duration can increase the risk of several diseases, such as cardiovascular and metabolic diseases. Currently, a growing body of research has revealed a possible link between sleep disorders and erectile dysfunction (ED). However, the mechanisms linking short sleep duration and ED are largely unknown. Thus, we provide a review of clinical trials and animal studies. In this review, we propose putative pathways connecting short sleep duration and ED, including neuroendocrine pathways and molecular mechanisms, aiming to pave the way for future research. Meanwhile, the assessment and improvement of sleep quality should be recommended in the diagnosis and treatment of ED patients.
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Affiliation(s)
- Fuxun Zhang
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, People's Republic of China.,Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yang Xiong
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, People's Republic of China.,Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Feng Qin
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Jiuhong Yuan
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, People's Republic of China.,Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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14
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Li T, Bai Y, Jiang Y, Jiang K, Tian Y, Wang Z, Ban Y, Liang X, Luo G, Sun F. Potential Effect of the Circadian Clock on Erectile Dysfunction. Aging Dis 2022; 13:8-23. [PMID: 35111358 PMCID: PMC8782551 DOI: 10.14336/ad.2021.0728] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 07/28/2021] [Indexed: 12/03/2022] Open
Abstract
The circadian rhythm is an internal timing system, which is generated by circadian clock genes. Because the circadian rhythm regulates numerous cellular, behavioral, and physiological processes, organisms have evolved with intrinsic biological rhythms to adapt the daily environmental changes. A variety of pathological events occur at specific times, while disturbed rhythms can lead to metabolic syndrome, vascular dysfunction, inflammatory disorders, and cancer. Therefore, the circadian clock is considered closely related to various diseases. Recently, accumulated data have shown that the penis is regulated by the circadian clock, while erectile function is impaired by an altered sleep-wake cycle. The circadian rhythm appears to be a novel therapeutic target for preventing and managing erectile dysfunction (ED), although research is still progressing. In this review, we briefly summarize the superficial interactions between the circadian clock and erectile function, while focusing on how disturbed rhythms contribute to risk factors of ED. These risk factors include NO/cGMP pathway, atherosclerosis, diabetes mellitus, lipid abnormalities, testosterone deficiency, as well as dysfunction of endothelial and smooth muscle cells. On the basis of recent findings, we discuss the potential role of the circadian clock for future therapeutic strategies on ED, although further relevant research needs to be performed.
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Affiliation(s)
- Tao Li
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
| | - Yunjin Bai
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Yiting Jiang
- Department of Otorhinolaryngology, The Ninth People’s Hospital of Chongqing, Chongqing, China
| | - Kehua Jiang
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
| | - Ye Tian
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
| | - Zhen Wang
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
| | - Yong Ban
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
| | - Xiangyi Liang
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
| | - Guangheng Luo
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
- Correspondence should be addressed to: Dr. Fa Sun, Department of Urology, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China. .
| | - Fa Sun
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
- Correspondence should be addressed to: Dr. Fa Sun, Department of Urology, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China. .
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15
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Li T, Bai Y, Jiang Y, Jiang K, Tian Y, Gu J, Sun F. The potential impacts of circadian rhythm disturbances on male fertility. Front Endocrinol (Lausanne) 2022; 13:1001316. [PMID: 36277693 PMCID: PMC9582279 DOI: 10.3389/fendo.2022.1001316] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
A circadian rhythm is an internalized timing system that synchronizes the cellular, behavioral, and physiological processes of organisms to the Earth's rotation. Because all physiological activities occur at a specific time, circadian rhythm disturbances can lead to various pathological disorders and diseases. Growing evidence has shown that the circadian clock is tightly connected to male fertility, and circadian perturbations contribute to infertility. The night shiftwork, insufficient sleep, and poor sleep quality are common causes of circadian disturbances, and many studies have reported that they impair sperm quality and increase the risk of male infertility. However, research on the impacts of light, body temperature, and circadian/circannual rhythms is relatively lacking, although some correlations have been demonstrated. Moreover, as the index of sperm quality was diverse and study designs were non-uniform, the conclusions were temporarily inconsistent and underlying mechanisms remain unclear. A better understanding of whether and how circadian disturbances regulate male fertility will be meaningful, as more scientific work schedules and rational lifestyles might help improve infertility.
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Affiliation(s)
- Tao Li
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Yunjin Bai
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yiting Jiang
- Department of Otorhinolaryngology, The Ninth People’s Hospital of Chongqing, Chongqing, China
| | - Kehua Jiang
- Department of Urology, Guizhou Provincial People’s Hospital, Guiyang, China
| | - Ye Tian
- Department of Urology, Guizhou Provincial People’s Hospital, Guiyang, China
| | - Jiang Gu
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
- *Correspondence: Fa Sun, ; Jiang Gu,
| | - Fa Sun
- Department of Urology, Guizhou Provincial People’s Hospital, Guiyang, China
- *Correspondence: Fa Sun, ; Jiang Gu,
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16
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Su L, Zhang SZ, Zhu J, Wu J, Jiao YZ. Effect of partial and total sleep deprivation on serum testosterone in healthy males: a systematic review and meta-analysis. Sleep Med 2021; 88:267-273. [PMID: 34801825 DOI: 10.1016/j.sleep.2021.10.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/20/2021] [Accepted: 10/25/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Currently, there is no consensus on the effect of sleep deprivation on male serum testosterone. This systematic review and meta-analysis aimed to determine the association between partial/total sleep deprivation and male serum testosterone level. METHODS The literature related to sleep deprivation and male serum testosterone in the PubMed, Embase, and Cochrane Library databases were searched from their inception to July 15, 2021. Data were pooled using the Stata 15 software. The results were presented as standard mean differences (SMDs) with their 95% confidence intervals (CIs). RESULTS Eighteen studies involving 252 men were included in the systematic review and meta-analysis. The findings revealed that short-term partial sleep deprivation had no significant effect on male serum testosterone (SMD = -0.22; 95% CI: -0.5, 0.06; P = 0.13), while total sleep deprivation reduced the male testosterone levels (SMD = -0.64; 95% CI: -0.87, -0.42; P < 0.001). According to the intervention duration of total sleep deprivation, subgroup analysis was conducted by a fixed-effects model. The results revealed that the serum testosterone was significantly decreased after 24 h total sleep deprivation (SMD = - 0.67; 95% CI = - 0.93, -0.42, P < 0.001), as well as 40-48 h total sleep deprivation (SMD = - 0.74; 95% CI = - 1.22, -0.26, P = 0.002). CONCLUSIONS This meta-analysis revealed that total sleep deprivation (more than or equal to 24 h) reduces the male testosterone levels, while short-term partial sleep deprivation has no significant effect on male serum testosterone. Sleep duration plays a pivotal role in maintaining male serum testosterone levels.
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Affiliation(s)
- Liang Su
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Si-Zheng Zhang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jian Zhu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jie Wu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Yong-Zheng Jiao
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
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17
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Su L, Meng YH, Zhang SZ, Cao Y, Zhu J, Qu H, Jiao YZ. Association between obstructive sleep apnea and male serum testosterone: A systematic review and meta-analysis. Andrology 2021; 10:223-231. [PMID: 34536053 DOI: 10.1111/andr.13111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 08/12/2021] [Accepted: 09/08/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Currently, there is no consensus on the effect of obstructive sleep apnea on male serum testosterone levels. This systematic review and meta-analysis aimed to determine the association between obstructive sleep apnea and male serum testosterone level. METHODS The literature related to obstructive sleep apnea and male serum testosterone in the PubMed, Embase, and Cochrane Library databases were searched from their inception to June 10, 2021. Data were pooled using the Stata 15 software. We performed a subgroup analysis of studies after matching the age and body mass index, as well as according to the severity of obstructive sleep apnea. RESULTS Eighteen studies involving 1823 men were included in the systematic review and meta-analysis. A significant inverse association between obstructive sleep apnea and male serum testosterone (SMD = -0.76; 95% CI: -1.18, -0.33; p = 0.001) was found. After adjusting for age and body mass index, this inverse association still existed (SMD = -0.8; 95% CI = -1.41, -0.18, p = 0.012). According to the subgroup analysis of obstructive sleep apnea severity, our results showed that serum testosterone was not significantly decreased in mild (SMD = -0.58; 95% CI = -1.88, 0.73, p = 0.386) and moderate obstructive sleep apnea patients (SMD = -0.94; 95% CI = -2.04, 0.15, p = 0.092), whereas it was significantly reduced in patients with severe obstructive sleep apnea (SMD = -1.21; 95% CI = -2.02, -0.41, p = 0.003). CONCLUSIONS Obstructive sleep apnea is inversely associated with male serum testosterone levels, independent of body mass index and age. Notably, the severity of obstructive sleep apnea is also correlated with male serum testosterone, which is significantly reduced in patients with severe obstructive sleep apnea.
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Affiliation(s)
- Liang Su
- Department of Andrology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yu-Hang Meng
- Department of rehabilitation medicine, The Northern Medical District of Chinese PLA General Hospital, Beijing, China
| | - Si-Zheng Zhang
- Department of Andrology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yan Cao
- Department of Andrology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jian Zhu
- Department of Andrology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hua Qu
- Department of Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yong-Zheng Jiao
- Department of Andrology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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18
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Pastuszak AW, Gittelman M, Tursi JP, Jaffe JS, Schofield D, Miner MM. Pharmacokinetics of testosterone therapies in relation to diurnal variation of serum testosterone levels as men age. Andrology 2021; 10:209-222. [PMID: 34510812 PMCID: PMC9293229 DOI: 10.1111/andr.13108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/09/2021] [Accepted: 08/24/2021] [Indexed: 12/18/2022]
Abstract
Background To improve symptoms associated with testosterone deficiency, many testosterone therapies are available that aim to restore serum testosterone (T) levels to the normal physiologic range. The magnitude, frequency, and duration between peak and trough T concentrations vary with route of administration, and none reflect normal endogenous daily diurnal T variations. Objective To compare pharmacokinetic profiles of serum T from approved T formulations with endogenous diurnal T variations in young and older men, and to consider whether there may be value in mimicking the diurnal T rhythmicity with exogenous testosterone therapies as men age. Materials and methods A literature search of studies examining the diurnal variation of endogenous T in healthy men and men with testosterone deficiency was performed using PubMed in January 2020. Additional searches for serum T pharmacokinetic profiles of various testosterone therapy formulations were also conducted. Prescribing information for various T formulations was also reviewed. Discussion and conclusion Endogenous diurnal T variation is well described and appears to be blunted naturally as men age. Men with testosterone deficiency lack diurnal T variation and exhibit a flatter T profile compared with eugonadal men. Some T replacement options provide intraday T level variations similar to normal circadian secretion, and others provide a flatter exposure profile reflective of depot release. Others provide profiles that exceed the frequency and physiologic range of the natural diurnal variation of T. All exogenous T replacement dosing targets an increase in average T levels to within the normal physiologic range and improves symptoms associated with low T, but no single testosterone therapy can exactly mimic the normal diurnal T patterns seen in younger men and the blunted circadian T secretion of older men.
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Affiliation(s)
| | - Marc Gittelman
- 21st Century Oncology, Uro-Medix/GenesisCare, Aventura, Florida, USA
| | | | | | | | - Martin M Miner
- Men's Health Center, Miriam Hospital, Providence, Rhode Island, USA
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19
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Liu PY, Lawrence-Sidebottom D, Piotrowska K, Zhang W, Iranmanesh A, Auchus RJ, Veldhuis JD, Van Dongen HPA. Clamping Cortisol and Testosterone Mitigates the Development of Insulin Resistance during Sleep Restriction in Men. J Clin Endocrinol Metab 2021; 106:e3436-e3448. [PMID: 34043794 PMCID: PMC8660069 DOI: 10.1210/clinem/dgab375] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Indexed: 01/04/2023]
Abstract
CONTEXT Sleep loss in men increases cortisol and decreases testosterone, and sleep restriction by 3 to 4 hours/night induces insulin resistance. OBJECTIVE We clamped cortisol and testosterone and determined the effect on insulin resistance. METHODS This was a randomized double-blind, in-laboratory crossover study in which 34 healthy young men underwent 4 nights of sleep restriction of 4 hours/night under 2 treatment conditions in random order: dual hormone clamp (cortisol and testosterone fixed), or matching placebo (cortisol and testosterone not fixed). Fasting blood samples, and an additional 23 samples for a 3-hour oral glucose tolerance test (OGTT), were collected before and after sleep restriction under both treatment conditions. Cytokines and hormones were measured from the fasting samples. Overall insulin sensitivity was determined from the OGTT by combining complementary measures: homeostasis model assessment of insulin resistance of the fasting state; Matsuda index of the absorptive state; and minimal model of both fasting and absorptive states. RESULTS Sleep restriction alone induced hyperinsulinemia, hyperglycemia, and overall insulin resistance (P < 0.001 for each). Clamping cortisol and testosterone alleviated the development of overall insulin resistance (P = 0.046) and hyperinsulinemia (P = 0.014) by 50%. Interleukin-6, high-sensitivity C-reactive protein, peptide YY, and ghrelin did not change, whereas tumor necrosis factor-α and leptin changed in directions that would have mitigated insulin resistance with sleep restriction alone. CONCLUSION Fixing cortisol-testosterone exposure mitigates the development of insulin resistance and hyperinsulinemia, but not hyperglycemia, from sustained sleep restriction in men. The interplay between cortisol and testosterone may be important as a mechanism by which sleep restriction impairs metabolic health.
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Affiliation(s)
- Peter Y Liu
- Division of Endocrinology, The Lundquist Institute at Harbor UCLA Medical Center, Torrance, CA, USA
- David Geffen School of Medicine, University of California—Los Angeles, Los Angeles, CA, USA
| | - Darian Lawrence-Sidebottom
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA
- Neuroscience Graduate Program, Washington State University, Pullman, WA, USA
| | - Katarzyna Piotrowska
- Division of Endocrinology, The Lundquist Institute at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Wenyi Zhang
- Division of Endocrinology, The Lundquist Institute at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Ali Iranmanesh
- Endocrinology Service, VA Medical Center, Salem, VA, USA
| | - Richard J Auchus
- Division of Metabolism, Diabetes, and Endocrinology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Pharmacology, University of Michigan, Ann Arbor, MI, USA
| | - Johannes D Veldhuis
- Endocrine Research Unit, Mayo School of Graduate Medical Education, Center for Translational Science Activities, Mayo Clinic, Rochester, MN, USA
| | - Hans P A Van Dongen
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
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20
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Tančić-Gajić M, Vukčević M, Ivović M, Marina LV, Arizanović Z, Soldatović I, Stojanović M, Đogo A, Kendereški A, Vujović S. Obstructive Sleep Apnea Is Associated With Low Testosterone Levels in Severely Obese Men. Front Endocrinol (Lausanne) 2021; 12:622496. [PMID: 34381420 PMCID: PMC8350060 DOI: 10.3389/fendo.2021.622496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 06/16/2021] [Indexed: 11/16/2022] Open
Abstract
Background Disrupted sleep affects cardio-metabolic and reproductive health. Obstructive sleep apnea syndrome represents a major complication of obesity and has been associated with gonadal axis activity changes and lower serum testosterone concentration in men. However, there is no consistent opinion on the effect of obstructive sleep apnea on testosterone levels in men. Objective The aim of this study was to determine the influence of obstructive sleep apnea on total and free testosterone levels in severely obese men. Materials and methods The study included 104 severely obese (Body Mass Index (BMI) ≥ 35 kg/m2) men, aged 20 to 60, who underwent anthropometric, blood pressure, fasting plasma glucose, lipid profile, and sex hormone measurements. All participants were subjected to polysomnography. According to apnea-hypopnea index (AHI) patients were divided into 3 groups: <15 (n = 20), 15 - 29.9 (n = 17) and ≥ 30 (n = 67). Results There was a significant difference between AHI groups in age (29.1 ± 7.2, 43.2 ± 13.2, 45.2 ± 10.2 years; p < 0.001), BMI (42.8 ± 5.9, 43.2 ± 5.9, 47.1 ± 7.8 kg/m2; p = 0.023), the prevalence of metabolic syndrome (MetS) (55%, 82.4%, 83.6%, p = 0.017), continuous metabolic syndrome score (siMS) (4.01 ± 1.21, 3.42 ± 0.80, 3.94 ± 1.81, 4.20 ± 1.07; p = 0.038), total testosterone (TT) (16.6 ± 6.1, 15.2 ± 5.3, 11.3 ± 4.44 nmol/l; p < 0.001) and free testosterone (FT) levels (440.4 ± 160.8, 389.6 ± 162.5, 294.5 ± 107.0 pmol/l; p < 0.001). TT level was in a significant negative correlation with AHI, oxygen desaturation index (ODI), BMI, MetS and siMS. Also, FT was in a significant negative correlation with AHI, ODI, BMI, age, MetS and siMS. The multiple regression analysis revealed that both AHI and ODI were in significant correlation with TT and FT after adjustment for age, BMI, siMS score and MetS components. Conclusion Obstructive sleep apnea is associated with low TT and FT levels in severely obese men.
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Affiliation(s)
- Milina Tančić-Gajić
- Department for Obesity, Reproductive and Metabolic Disorders, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Miodrag Vukčević
- Department of Pulmonology, Clinical Hospital Centre Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Miomira Ivović
- Department for Obesity, Reproductive and Metabolic Disorders, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ljiljana V. Marina
- Department for Obesity, Reproductive and Metabolic Disorders, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Zorana Arizanović
- Department for Obesity, Reproductive and Metabolic Disorders, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivan Soldatović
- Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Miloš Stojanović
- Department for Obesity, Reproductive and Metabolic Disorders, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Aleksandar Đogo
- Department of Endocrinology, Clinical Center of Montenegro, Podgorica, Montenegro
| | - Aleksandra Kendereški
- Department for Obesity, Reproductive and Metabolic Disorders, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Svetlana Vujović
- Department for Obesity, Reproductive and Metabolic Disorders, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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21
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O'Byrne NA, Yuen F, Butt WZ, Liu PY. Sleep and Circadian Regulation of Cortisol: A Short Review. CURRENT OPINION IN ENDOCRINE AND METABOLIC RESEARCH 2021; 18:178-186. [PMID: 35128146 DOI: 10.1016/j.coemr.2021.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The central circadian pacemaker (CCP) located in the suprachiasmatic nucleus (SCN) of the hypothalamus drives the 24-hour pattern in cortisol, which functions as the main central synchronizing signal that coordinates peripheral clocks in organs that control whole body metabolism. A superimposed pulsatile pattern of cortisol allows rapid responses that fine tune the body's reaction to changes in the environment. In addition to coordinating metabolic processes to predictable environmental events, cortisol is the main catabolic signal which acts with testosterone, the quintessential male anabolic hormone, to maintain catabolic-anabolic homeostasis in men. Sleep restriction, when sufficiently substantial, increases late afternoon/early evening cortisol, but does not alter 24-hour cortisol; whereas even maximal acute circadian misalignment only slightly delays the cortisol rhythm. Prolonged circadian misalignment decreases overall cortisol exposure. The implications of these regulatory changes on health and disease requires further evaluation.
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Affiliation(s)
- Nora A O'Byrne
- The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA
| | - Fiona Yuen
- The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA
| | - Waleed Z Butt
- The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA
| | - Peter Y Liu
- The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA.,Department of Medicine, Division of Endocrinology, David Geffen School of Medicine at UCLA
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22
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Wang Y, Zeng Y, Zhang X, Meng Q, Mi F, Wang S, Xu F, Sun Y, Feng Y, Yin J. Daytime Napping Duration Is Positively Associated With Risk of Hyperuricemia in a Chinese Population. J Clin Endocrinol Metab 2021; 106:e2096-e2105. [PMID: 33507274 DOI: 10.1210/clinem/dgab043] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Loss of sleep or disturbance of sleep-wake cycles has been related to metabolic impairments. However, few studies have investigated the association between daily sleep duration and hyperuricemia. OBJECTIVE We investigated daily sleep duration (daytime napping and nocturnal sleep) with hyperuricemia risk. METHODS We cross-sectionally analyzed data from the China Multi-Ethnic Cohort (CMEC), Yunnan region. A total of 22 038 participants aged 30 to 79 years were recruited in 2018. Hyperuricemia was defined as serum uric acid (SUA) above 7.0 mg/dL in men and above 6.0 mg/dL in women. Outcomes were associations between daily sleep duration and hyperuricemia. RESULTS We found that the longest daytime napping duration was associated with a higher risk of hyperuricemia in the crude model (odds ratio [OR] [95% CI], 2.22 [1.88-2.61], P < .001) and in a multivariable adjustment model (OR, 1.69; 95% CI, 1.41-2.01, P < .001) after adjusting for demographic, sleep habits, and metabolic risk factors. The association was moderately attenuated with additionally adjusted for serum creatinine (OR, 1.54; 95% CI, 1.28-1.86, P < .001). Longer daytime napping duration was also related to higher risk of hyperuricemia combined with metabolic syndrome (MetS). Respondents in the group with daytime napping duration greater than or equal to 90 minutes presented with a higher risk of hyperuricemia combined with MetS (OR, 1.39; 95% CI, 1.06-1.79; P < .001) in the fully adjusted model. We did not observe any relation between nocturnal sleep duration and risk of hyperuricemia in the study. CONCLUSION Longer daytime napping duration (but not nocturnal sleep duration) was independently associated with risk of hyperuricemia in a Chinese population.
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Affiliation(s)
- Yanjiao Wang
- School of Public Health, Kunming Medical University, Chenggong District, Kunming, China
| | - Yongli Zeng
- School of Public Health, Kunming Medical University, Chenggong District, Kunming, China
| | - Xuehui Zhang
- School of Public Health, Kunming Medical University, Chenggong District, Kunming, China
| | - Qiong Meng
- School of Public Health, Kunming Medical University, Chenggong District, Kunming, China
| | - Fei Mi
- School of Public Health, Kunming Medical University, Chenggong District, Kunming, China
| | - Songmei Wang
- School of Public Health, Kunming Medical University, Chenggong District, Kunming, China
| | - Fang Xu
- School of Public Health, Kunming Medical University, Chenggong District, Kunming, China
| | - Yan Sun
- Department of Ultrasound, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yuemei Feng
- School of Public Health, Kunming Medical University, Chenggong District, Kunming, China
| | - Jianzhong Yin
- School of Public Health, Kunming Medical University, Chenggong District, Kunming, China
- Baoshan College of Traditional Chinese Medicine, Baoshan, China
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23
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Liu PY, Takahashi PY, Yang RJ, Iranmanesh A, Veldhuis JD. Age and time-of-day differences in the hypothalamo-pituitary-testicular, and adrenal, response to total overnight sleep deprivation. Sleep 2021; 43:5717179. [PMID: 31993665 DOI: 10.1093/sleep/zsaa008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/08/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES In young men, sleep restriction decreases testosterone (Te) and increases afternoon cortisol (F), leading to anabolic-catabolic imbalance, insulin resistance, and other andrological health consequences. Age-related differences in the hypothalamo-pituitary-testicular/adrenal response to sleep restriction could expose older individuals to greater or lesser risk. We aimed to evaluate and compare the 24-h and time-of-day effect of sleep restriction on F, luteinizing hormone (LH), and Te in young and older men. METHODS Thirty-five healthy men, aged 18-30 (n = 17) and 60-80 (n =18) years, underwent overnight sleep deprivation (complete nighttime wakefulness) or nighttime sleep (10 pm to 6 am) with concurrent 10-min blood sampling in a prospectively randomized crossover study. F, LH, and Te secretion were calculated by deconvolution analysis. RESULTS Sleep deprivation had multiple effects on 24-h Te secretion with significant reductions in mean concentrations, basal, total and pulsatile secretion, and pulse frequency (each p < 0.05), in the absence of detectable changes in LH. These effects were most apparent in older men and differed according to age for some parameters: pulsatile Te secretion (p = 0.03) and Te pulse frequency (p = 0.02). Time-of-day analyses revealed that sleep restriction significantly reduced Te in the morning and afternoon, reduced LH in the morning in both age groups, and increased F in the afternoon in older men. CONCLUSIONS These data suggest a time-of-day dependent uncoupling of the regulatory control of the testicular axis and of F secretion. Future studies will need to directly verify these regulatory possibilities specifically and separately in young and older men. CLINICAL TRIAL Not applicable.
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Affiliation(s)
- Peter Y Liu
- Department of Medicine, Division of Endocrinology, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Paul Y Takahashi
- Department of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN
| | - Rebecca J Yang
- Endocrine Research Unit, Mayo School of Graduate Medical Education, Center for Translational Science Activities, Mayo Clinic, Rochester, MN
| | - Ali Iranmanesh
- Endocrine Service, Salem Veterans Affairs Medical Center, Salem, VA
| | - Johannes D Veldhuis
- Endocrine Research Unit, Mayo School of Graduate Medical Education, Center for Translational Science Activities, Mayo Clinic, Rochester, MN
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24
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Abstract
Disordered sleep impairs neurocognitive performance, and is now recognized to cause metabolic ill-health. This review assesses the nascent relationship between insufficient, misaligned, and disrupted sleep with andrological health. High-quality cohort studies show a reduced sperm count in men with sleep disturbances. Well-designed interventional studies show a reduction in testosterone with sleep restriction. Studies of long-term shift workers show no effect of misaligned sleep on mean testosterone concentrations. Men with obstructive sleep apnea (OSA) and more severe hypoxemia have lower testosterone levels, although it is unknown if this relationship is entirely explained by concomitant obesity, or is reversible. Nevertheless, erectile dysfunction, which is common in men with OSA, is clinically improved when OSA is properly treated. Few studies manipulating sleep have been performed in older men, in whom the accumulation of sleep disturbances over decades of life may contribute to age-related illnesses. Improving sleep could ameliorate the development of these disorders.
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Affiliation(s)
- Nora A O'Byrne
- The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA
| | - Fiona Yuen
- The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA
| | - Warda Niaz
- The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA
| | - Peter Y Liu
- The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA.,Department of Medicine, Division of Endocrinology, David Geffen School of Medicine at UCLA
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25
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Analysis of Brain Functions in Men with Prostate Cancer under Androgen Deprivation Therapy: A One-Year Longitudinal Study. Life (Basel) 2021; 11:life11030227. [PMID: 33802213 PMCID: PMC8000211 DOI: 10.3390/life11030227] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/07/2021] [Accepted: 03/09/2021] [Indexed: 12/24/2022] Open
Abstract
The relationship between cognitive decline and androgen deprivation therapy (ADT) under luteinizing hormone-releasing hormone (LHRH) analogues is unclear, and there is a scarcity of longitudinal studies considering the interaction between cognition, depressive symptoms and sleep quality in men with prostate cancer (PCa) treated with ADT. This study aimed to determine if there were differences in the scores obtained in cognitive assessment, depressive symptoms, and sleep quality after one year of ADT and determine the interrelations between sleep, mood, and cognitive status. A prospective longitudinal observational study was designed, in which a cohort of men (mean age was 70.8 years) newly treated with androgen-deprivation therapy was assessed in the first six months of treatment and 12 months later. Analysis of cognitive function by the Mini-Mental State Examination (MMSE) scores indicated a significant (p < 0.05) increase after one year of treatment and by the Brief Scale for Cognitive Evaluation (BCog) scores indicated no changes in the scores before and after one year of treatment. Analysis of depressive symptoms with the Geriatric Depression Scale and sleep quality with the Athens Insomnia Scale (AIS) scores showed significant (p < 0.05) changes after one year of treatment with ADT, with men describing more depressive symptoms and more sleep disturbances. No statistically significant differences were found in the cognitive performance between men with impaired sleep or depression results and those without them. Our study showed no clinical evidence of the relationship between ADT under luteinizing hormone-releasing hormone (LHRH) analogues and cognitive deterioration in 1-year follow-up, but there are impairments in the sleep quality in men with PCa undergoing ADT and an increase in depressive symptoms which has important implications for clinicians as they would impair quality of life and adherence to treatment.
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26
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Liu PY, Irwin MR, Krueger JM, Gaddameedhi S, Van Dongen HPA. Night shift schedule alters endogenous regulation of circulating cytokines. Neurobiol Sleep Circadian Rhythms 2021; 10:100063. [PMID: 33748539 PMCID: PMC7970107 DOI: 10.1016/j.nbscr.2021.100063] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 01/20/2023] Open
Abstract
Night shift work is a risk factor for viral infection, suggesting that night shift schedules compromise host defense mechanisms. Prior studies have investigated changes in the temporal profiles of circulating cytokines important for priming and restraining the immune response to infectious challenges from night shift work, but not by way of a 24-h constant routine of continuous wakefulness devoid of behavioral or environmental influences. Hence the true endogenous pattern of cytokines, and the combined effect of sleep loss and circadian misalignment on these cytokines remains unknown. Here, 14 healthy young men and women underwent three days of either a simulated night shift or a simulated day shift schedule under dim light in a controlled in-laboratory environment. This was followed by a 24-h constant routine protocol during which venous blood was collected at 3-h intervals. Those who had been in the night shift schedule showed lower mean circulating TNF-α (t13 = -6.03, p < 0.001), without any significant differences in IL-1β, IL-8 and IL-10, compared with those who had been in the day shift (i.e., control) schedule. Furthermore, circulating IL-6 increased with time awake in both shift work conditions (t13 = 6.03, p < 0.001), such that temporal changes in IL-6 were markedly shifted relative to circadian clock time in the night shift condition. These results indicate that night shift work compromises host defense by creating cytokine conditions that initially impede anti-viral immunity (lower TNF-α) and may eventually promote autoimmunity (mistimed rise in IL-6). Night shift schedules compromise host defense mechanisms to infection. This could be from dysregulated cytokine responses. We show by a novel constant routine paradigm, that cytokine dysregulation occurs. Cytokine dysregulation exposes night shift workers to increased risk for SARS-CoV-2.
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Affiliation(s)
- Peter Y Liu
- Division of Endocrinology, The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA.,David Geffen School of Medicine, University of California - Los Angeles, Los Angeles, CA, 90095, USA
| | - Michael R Irwin
- David Geffen School of Medicine, University of California - Los Angeles, Los Angeles, CA, 90095, USA.,Cousins Center for Psychoneuroimmunology, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California - Los Angeles, Los Angeles, CA, 90095, USA
| | - James M Krueger
- Department of Integrative Physiology and Neuroscience, Washington State University, Spokane, WA, 99202, USA
| | - Shobhan Gaddameedhi
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27606, USA.,Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, 27606, USA
| | - Hans P A Van Dongen
- Sleep and Performance Research Center, Washington State University, Spokane, WA, 99202, USA.,Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, 9202, USA
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27
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Roelfsema F, Liu PY, Yang R, Takahashi P, Veldhuis JD. Interleukin-2 drives cortisol secretion in an age-, dose-, and body composition-dependent way. Endocr Connect 2020; 9:637-648. [PMID: 32520721 PMCID: PMC7424344 DOI: 10.1530/ec-20-0211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 06/08/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Interleukin-2 (IL-2), one of the proinflammatory cytokines, is used in the treatment of certain malignancies. In some studies, transient increases in cortisol and ACTH secretion occurred. Thus, this agent may be used as an experimental probe of adrenal cortisol secretion. OBJECTIVE This study quantifies the effects of low and moderate doses of IL-2 on cortisol secretion and assesses the modulation by age, dose and body composition. SITE Mayo Clinical Translational Research Unit. SUBJECTS Study comprised 35 healthy men, 17 young and 18 older. METHODS Randomized prospective double-blind saline-controlled study of IL-2 administration in two doses with concurrent 10-min blood sampling for 24 h. OUTCOME MEASURES Deconvolution analysis and approximate entropy of cortisol secretion. RESULTS Low-dose IL-2 administration increased nocturnal pulsatile cortisol secretion from 1460 ± 160 to 2120 ± 220 nmol/L/8 h in young subjects and from 1680 ± 105 to 1960 ± 125 nmol/L/8 h (treatment P < 0.0001, but more in young than older, P = 0.02). Comparable results were obtained for total cortisol secretion (P treatment <0.0001, age effect P = 0.005). The higher IL-2 dose caused a large increase in young (P < 0.0001), but not in older (P = 0.90) subjects. This dose also increased approximate entropy from 0.877 ± 0.041 to 1.024 ± 0.049 (P = 0.008), pointing to reduced secretory orderliness. Incremental cortisol (nocturnal) secretion correlated negatively with visceral fat mass (R = -0.41, P = 0.019). CONCLUSION In healthy men, IL-2 injection drives pulsatile cortisol secretion in a dose-dependent way in young, but not older, individuals and erodes cortisol secretory orderliness at a higher dose in young subjects. Cortisol responses are diminished with increasing abdominal visceral fat mass.
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Affiliation(s)
- Ferdinand Roelfsema
- Department of Internal Medicine, Section Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter Y Liu
- Department of Medicine, David Geffen School of Medicine at UCLA, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Los Angeles, California, USA
| | - Rebecca Yang
- Endocrine Research Unit, Mayo Clinic College of Medicine, Center for Translational Science Activities, Mayo Clinic, Rochester, Minnesota, USA
| | - Paul Takahashi
- Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Johannes D Veldhuis
- Endocrine Research Unit, Mayo Clinic College of Medicine, Center for Translational Science Activities, Mayo Clinic, Rochester, Minnesota, USA
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28
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Liu PY, O'Byrne NA. Adipose tissue transcriptomes in obstructive sleep apnea: location matters. Sleep 2020; 43:5817066. [PMID: 32255472 DOI: 10.1093/sleep/zsaa059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Peter Y Liu
- Department of Medicine, Division of Endocrinology, David Geffen School of Medicine at UCLA, Harbor-UCLA Medical Center and The Lundquist Institute, Torrance, CA
| | - Nora A O'Byrne
- Department of Medicine, Division of Endocrinology, David Geffen School of Medicine at UCLA, Harbor-UCLA Medical Center and The Lundquist Institute, Torrance, CA
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29
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Andersen ML, Tufik S. A Review of Sleep Disturbance and Sexual Function: the Effect of Sleep Apnea on Erectile Function. CURRENT SLEEP MEDICINE REPORTS 2020. [DOI: 10.1007/s40675-020-00171-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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30
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Abstract
PURPOSE OF REVIEW To integrate evidence on the role of circadian rhythm in male reproduction. Several studies report on various aspects of the association between the circadian system and male reproductive function in animals and humans both in physiological condition as well as in the case of subfertility. RECENT FINDINGS Epidemiological data demonstrate diurnal and seasonal changes as well as the effect of sleep/wake cycles on the quality of semen. Rare and common genetic variation in circadian clock genes in humans and animal models support the role of circadian rhythms in male fertility in humans. SUMMARY Current data support the modest effect of the circadian clock on male reproductive potential; however, the evidence available is still fragmented and inconclusive. Additional well designed and sufficiently powered studies are needed to delineate the role of the circadian clock both in cause and potential interventional and preventive approaches in male subfertility.
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Affiliation(s)
- Ana Peterlin
- Faculty of Medicine, Institute of Histology and Embryology
| | - Tanja Kunej
- Department of Animal Science, Biotechnical Faculty, University of Ljubljana
| | - Borut Peterlin
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
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