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Xie H, Jiang Y, Liu L, Peng H, Li J, Chen Z. Global prevalence and risk factors of depression in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis from 2000 to 2022. J Psychosom Res 2023; 175:111537. [PMID: 37907038 DOI: 10.1016/j.jpsychores.2023.111537] [Citation(s) in RCA: 1] [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: 11/25/2022] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVE This study aims to assess the global and regional prevalence and the potential risk factors for depression among COPD patients. METHODS Web of Science, EMBASE, PubMed, and PsycINFO databases were searched for the literature related to the prevalence and risk factors of depression in COPD. Random-effect models were performed to pool the global prevalence. Sub-group analysis and meta-regression were conducted to investigate the potential heterogeneity. Meta-analysis was performed only on the risk factors that have been reported in a minimum of three studies. RESULTS A total of 79 studies from 25 countries were included. The pooled global prevalence of variably defined depression among COPD patients was 34.5% (95% CI: 30.9-38.1). The odds of depression in COPD patients were 3.53 times higher than in non-COPD participants (95% CI: 2.35-5.29). Meta-regression results showed that region, income level, and research setting are the main sources of heterogeneity. Female sex (OR=1.92), living alone (OR=2.29), BODE index (OR=1.48), dyspnea (OR=3.02), impaired quality of life (OR=1.26), and GOLD stage III∼IV (OR=1.96) were found to be significant risk factors for depression in meta-analyses. CONCLUSIONS More than one-third of COPD patients experience depression, with marked variations in prevalence across countries and regions. This study further highlights the need for the consolidation of mental health considerations into COPD treatments. High-quality, longitudinal studies and further research are needed to gain a better understanding of risk and protective factors.
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Affiliation(s)
- Hongmei Xie
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yunlan Jiang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Lu Liu
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Hanmei Peng
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jie Li
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zengli Chen
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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2
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Ran B, Zhang Y, Wu Y, Wen F. Association between depression and COPD: results from the NHANES 2013-2018 and a bidirectional Mendelian randomization analysis. Expert Rev Respir Med 2023; 17:1061-1068. [PMID: 38085600 DOI: 10.1080/17476348.2023.2282022] [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: 10/14/2023] [Accepted: 11/07/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Observational studies showed a bidirectional association between depression and chronic obstructive pulmonary disease (COPD). However, it is unclear whether the observed association is causal. Thus we estimated the relationship using observational studies combined with bidirectional Mendelian randomization [MR]. MATERIALS AND METHODS The study included 9977 participants from the 2013-2018 National Health and Nutrition Examination Survey and used weighted logistic regression analysis to assess the association between depression and COPD, followed by a bidirectional Mendelian randomization analysis to verify their causality. RESULTS Adjusted-weighted logistic regression in observational studies showed a significant association between COPD and mild depression (OR (95% CI): 1.81 (1.30, 2.52), P = 0.002) and COPD and depression (OR (95% CI): 1.93 (1.49, 2.50), P < 0.001). MR suggested depression may play a causal role in COPD risk (OR (95% CI): 1.45 (1.32, 1.60), P < 0.001), but more evidence for reverse causation is lacking (reverse MR OR (95% CI): 1.03 (0.99, 1.07), P = 0.151). CONCLUSION In conclusion, our study found depression may play a potential causal role in the morbidity of COPD suggesting depression might be the etiology of COPD. This finding needs to be validated in further prospective cohort studies with large sample sizes and adequate follow-up time.
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Affiliation(s)
- Bi Ran
- Department of Respiratory and Critical Care Medicine, West China Hospital and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Sichuan University, Chengdu, Sichuan, China
| | - Yutian Zhang
- Department of Respiratory and Critical Care Medicine, West China Hospital and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Sichuan University, Chengdu, Sichuan, China
| | - Yanqiu Wu
- Department of Respiratory and Critical Care Medicine, West China Hospital and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Sichuan University, Chengdu, Sichuan, China
| | - Fuqiang Wen
- Department of Respiratory and Critical Care Medicine, West China Hospital and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Sichuan University, Chengdu, Sichuan, China
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Mielewczyk J, Świętochowska E, Ostrowska Z, Miczek I. Diagnosis and Management of Testosterone Deficiency
in men: A review of the European and American Urology
Associations. POSTEP HIG MED DOSW 2021. [DOI: 10.5604/01.3001.0014.8308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Ambiguous data on both terminology, diagnostics, and treatment of testosterone deficiency in
men prompted us to attempt a critical analysis of existing knowledge on this subject.
Current guidelines of both American and European Association of Urology (AUA, EUA) define
testosterone therapy as effective and safe. However, media reports and some scientific reports
indicating negative effects of the abovementioned therapy arouse aversion to its use by doctors
and potential patients for fear of developing prostate cancer or cardiovascular incidents. The
peak of scepticism about testosterone therapy was observed after the publication in 2013 and
2014, respectively, two retrospective data analysis on this topic, which resulted in the discontinuation
of therapy in many patients with long histories of benefits from testosterone therapy.
In addition, in many men with indications for testosterone therapy, this treatment was not
used for fear of patient safety. However, the latest data on these concerns do not confirm any
negative effects. More than 100 recently published scientific studies have shown the beneficial effects of testosterone
therapy on many aspects of health. The American Society of Clinical Endocrinologists
(AACE) and the American College of Endocrinology (ACE) have jointly developed their own
literature assessment, stating that there is no convincing evidence that testosterone therapy
increases the risk of cardiovascular incidents. The same conclusions can be drawn from the
current EAU and AUA guidelines.
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Affiliation(s)
- Jarosław Mielewczyk
- Katedra i Zakład Biologii Medycznej i Molekularnej, Wydział Nauk Medycznych w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach
| | - Elżbieta Świętochowska
- Katedra i Zakład Biologii Medycznej i Molekularnej, Wydział Nauk Medycznych w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach
| | - Zofia Ostrowska
- Katedra i Zakład Biologii Medycznej i Molekularnej, Wydział Nauk Medycznych w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach
| | - Igor Miczek
- Katedra i Zakład Biologii Medycznej i Molekularnej, Wydział Nauk Medycznych w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach
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Glucocorticoid receptor dysfunction orchestrates inflammasome effects on chronic obstructive pulmonary disease-induced depression: A potential mechanism underlying the cross talk between lung and brain. Brain Behav Immun 2019; 79:195-206. [PMID: 30738183 DOI: 10.1016/j.bbi.2019.02.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 12/21/2018] [Accepted: 02/05/2019] [Indexed: 01/01/2023] Open
Abstract
Depression is highly prevalent among patients with chronic obstructive pulmonary disease (COPD). However, depression with COPD comorbidity is often underdiagnosed and undertreated, and pathogenic research is also insufficient. In the present study, we characterised pulmonary and hippocampal dysfunction by researching the interaction between inflammasome-regulated cytokines and glucocorticoid receptor (GR) signalling by investigating the role of fluoxetine (FLU), one of the most widely used antidepressants in clinical practice. Mice were exposed to cigarette smoke (CS) to induce the model of COPD with comorbid depression, and pathological alterations in serum, hippocampus, lung, and bronchoalveolar lavage fluid were determined. Our results showed that the CS procedure induced the accumulation of inflammatory cells (macrophages, neutrophils, and lymphocytes), the production of cytokines, the activation of inflammasome components (NLRP3, ASC, caspase-1), depression-related behaviours, and the stimulation of GR signalling. Intriguingly, glucocorticoid resistance occurred in CS-exposed mice, with elevated serum corticosterone and suppressed hippocampal GR levels, which suggested a novel potential regulatory mechanism underlying COPD-induced depression comorbidity. Furthermore, chronic CS exposure decreased the pGR-S211/pGR-S226 ratio, increased the active nuclear GR, and impaired cytosolic GR binding capacity and GR transcriptional activity, which might be responsible for the activation of the inflammasome-induced inflammatory cascade. These alterations were reversed by chronic FLU treatment, indicating that FLU-mediated GR signalling was involved in the COPD induced inflammasome activation. Our research explored the underlying molecular mechanism of comorbid COPD/depression and provided in vivo evidence that glucocorticoid resistance occurred during CS-induced central nervous system inflammation, a potential mechanism underlying the cross talk between the lung and brain.
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Kulej-Lyko K, Majda J, von Haehling S, Doehner W, Lopuszanska M, Szklarska A, Banasiak W, Anker SD, Ponikowski P, Jankowska EA. Could gonadal and adrenal androgen deficiencies contribute to the depressive symptoms in men with systolic heart failure? Aging Male 2016; 19:221-230. [PMID: 27650467 DOI: 10.1080/13685538.2016.1208166] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Testosterone (TT) and dehydroepiandrosterone sulphate (DHEAS) are neurosteroids and their deficiencies constitute the hormone risk factors promoting the development of depression in elderly otherwise healthy men. We investigated the link between hypogonadism and depression in accordance with age and concomitant diseases in men with systolic HF using the novel scale previously dedicated for elderly population. METHODS We analysed the prevalence of depression and severity of depressive symptoms in population of 226 men with systolic HF (40-80 years) compared to 379 healthy peers. The severity of depression was assessed using the Polish long version of Geriatric Depression Scale (GDS). RESULTS In men aged 40-59 years the severity of depressive symptoms was greater in NYHA classes III-IV compared to NYHA classes I-II and reference group. In men aged 60-80 years depressive symptoms were more severe in NYHA class III-IV compared to controls (all p ≤ 0.001). In multivariate logistic regression model in men aged 40-59 years advanced NYHA class was associated with higher prevalence of mild depression (OR = 2.14, 95%CI: 1.07-4.29) and chronic obstructive pulmonary disease (COPD) with higher prevalence of severe depression (OR = 69.1, 95%CI: 2.11-2264.3). In men aged 60-80 years advanced NYHA class and TT deficiency were related to higher prevalence of mild depression (respectively: OR = 2.9, 95%CI: 1.3-6.4; OR = 3.6, 95%CI: 1.2-10.63). CONCLUSION TT deficiency, COPD and advanced NYHA class were associated with higher prevalence of depression in men with systolic HF.
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Affiliation(s)
| | - Jacek Majda
- b Laboratory Department , Military Hospital , Wroclaw , Poland
| | - Stephan von Haehling
- c Applied Cachexia Research, Department of Cardiology, Charité Medical School , Berlin , Germany
| | - Wolfram Doehner
- c Applied Cachexia Research, Department of Cardiology, Charité Medical School , Berlin , Germany
- d Center for Stroke Research Berlin, Charité Medical School , Berlin , Germany
| | - Monika Lopuszanska
- e Polish Academy of Sciences, Institute of Anthropology , Wroclaw , Poland
| | - Alicja Szklarska
- e Polish Academy of Sciences, Institute of Anthropology , Wroclaw , Poland
| | | | - Stefan D Anker
- c Applied Cachexia Research, Department of Cardiology, Charité Medical School , Berlin , Germany
- f Centre for Clinical and Basic Research, IRCCS San Raffaele , Rome , Italy , and
| | - Piotr Ponikowski
- a Centre for Heart Diseases, Military Hospital , Wroclaw , Poland
- g Laboratory for Applied Research on Cardiovascular System , Department of Heart Diseases, Wroclaw Medical University , Wroclaw , Poland
| | - Ewa A Jankowska
- a Centre for Heart Diseases, Military Hospital , Wroclaw , Poland
- e Polish Academy of Sciences, Institute of Anthropology , Wroclaw , Poland
- g Laboratory for Applied Research on Cardiovascular System , Department of Heart Diseases, Wroclaw Medical University , Wroclaw , Poland
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Zheng R, Cao L, Cao W, Chu X, Hu Y, Zhang H, Xu J, Sun H, Bao W, Liu K, Liu C. Risk Factors for Hypogonadism in Male Patients with Type 2 Diabetes. J Diabetes Res 2016; 2016:5162167. [PMID: 27006953 PMCID: PMC4781970 DOI: 10.1155/2016/5162167] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 01/27/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Male hypogonadism is an endocrine disease characterized by low levels of serum testosterone and is closely related to the development of diabetes. The purpose of the present study was to observe the risk factors for hypogonadism in male patients with type 2 diabetes. METHODS A total of 213 patients with type 2 diabetes were enrolled and divided into a low total testosterone (TT) group (=75) and a normal TT group (=138). The patients' blood glucose, blood lipids, serum insulin, and sex hormones were measured. The correlations between the patients' metabolic index and sex hormone levels were analyzed. RESULTS Compared with the normal TT group, body mass index (BMI), fasting insulin (FINS), and HOMA insulin resistance index (HOMA-IR) levels were significantly higher, but the luteinizing hormone (LH) levels were significantly lower in the low TT group (p < 0.05). Correlation analyses found that TT was negatively correlated with BMI, waist circumference (WC), FINS, and HOMA-IR. TT was positively correlated with LH and follicle-stimulating hormone (FSH). CONCLUSIONS Several risk factors of diabetes associated closely with hypogonadism. BMI, metabolic syndrome (MS), HOMA-IR, and LH are independent risk factors for hypogonadism in male patients with type 2 diabetes.
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Affiliation(s)
- Rendong Zheng
- Department of Endocrinology and Metabolism, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
- Department of Endocrinology and Metabolism, Jiangsu Province Academy of Traditional Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
| | - Lin Cao
- Department of Endocrinology and Metabolism, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
- Department of Endocrinology and Metabolism, Jiangsu Province Academy of Traditional Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
| | - Wen Cao
- Department of Endocrinology and Metabolism, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
- Department of Endocrinology and Metabolism, Jiangsu Province Academy of Traditional Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
| | - Xiaoqiu Chu
- Department of Endocrinology and Metabolism, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
- Department of Endocrinology and Metabolism, Jiangsu Province Academy of Traditional Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
| | - Yongxin Hu
- Department of Endocrinology and Metabolism, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
- Department of Endocrinology and Metabolism, Jiangsu Province Academy of Traditional Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
| | - Huifeng Zhang
- Department of Endocrinology and Metabolism, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
- Department of Endocrinology and Metabolism, Jiangsu Province Academy of Traditional Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
| | - Juan Xu
- Department of Endocrinology and Metabolism, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
- Department of Endocrinology and Metabolism, Jiangsu Province Academy of Traditional Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
| | - Hongping Sun
- Department of Endocrinology and Metabolism, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
- Department of Endocrinology and Metabolism, Jiangsu Province Academy of Traditional Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
| | - Weiping Bao
- Department of Endocrinology and Metabolism, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
- Department of Endocrinology and Metabolism, Jiangsu Province Academy of Traditional Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
| | - Kemian Liu
- Department of Endocrinology and Metabolism, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
- Department of Endocrinology and Metabolism, Jiangsu Province Academy of Traditional Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
| | - Chao Liu
- Department of Endocrinology and Metabolism, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
- Department of Endocrinology and Metabolism, Jiangsu Province Academy of Traditional Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, Jiangsu 210028, China
- *Chao Liu:
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Systematic Literature Review of the Epidemiology of Nongenetic Forms of Hypogonadism in Adult Males. ACTA ACUST UNITED AC 2014. [DOI: 10.1155/2014/190347] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This study summarizes the literature on the prevalence, incidence, and proportion of patients receiving treatment for male hypogonadism and a systematic literature search was performed for articles published in the last 20 years. Of the 97 studies identified, 96 examined the prevalence, 2 examined the incidence, and 4 examined the proportion of males with hypogonadism patients receiving treatment. Based on studies conducted in Europe and USA, the prevalence of hypogonadism in the general population ranged from 2.1% to 12.8% of middle-aged to older men, with an estimated incidence of 12 new cases per 1,000 person-years. Prevalence was higher among patients with comorbid conditions, such as type 2 diabetes mellitus and obesity. Approximately 10–12% of men with hypogonadism were receiving testosterone treatment. This literature review suggests that there is potentially a significant burden of hypogonadism in the general population. Burden seems to increase with age and in the presence of certain disease conditions. Data suggests that many hypogonadal men who may benefit from testosterone replacement are not receiving treatment. This may be the result of underdiagnosis of the disease, lack of awareness by patients or physicians, irregularities surrounding the diagnostic criteria, and deficiency of long-term safety studies.
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Sexual dysfunction in men with COPD: impact on quality of life and survival. Lung 2012; 190:545-56. [PMID: 22752718 DOI: 10.1007/s00408-012-9398-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 05/28/2012] [Indexed: 12/31/2022]
Abstract
BACKGROUND Most patients with chronic obstructive pulmonary disease (COPD) are middle-aged or older, and by definition all have a chronic illness. Aging and chronic illness decrease sexual interest, sexual function, and testosterone levels. To date, researchers have not simultaneously explored prevalence, risk factors, and impact of sexual dysfunctions on quality of life and survival in men with COPD. We tested three hypotheses: First, sexual dysfunctions, including erectile dysfunction, are highly prevalent and impact negatively the quality of life of those with COPD. Second, gonadal state is a predictor of erectile dysfunction. Third, erectile dysfunction, a potential maker of systemic atherosclerosis, is a risk factor for mortality in men with COPD. METHODS In this prospective study, sexuality was assessed in 90 men with moderate-to-severe COPD (40 hypogonadal) by questionnaire. Testosterone levels, comorbidities, dyspnea, depressive symptoms, and survival (4.8 years median follow-up) were recorded. RESULTS Seventy-four percent of patients had at least one sexual dysfunction, with erectile dysfunction being the most common (72 %). Most were dissatisfied with their current and expected sexual function. Severity of COPD was equivalent in patients with and without erectile dysfunction. Low testosterone, depressive symptoms, and presence of partner were independently associated with erectile dysfunction. Severity of lung disease and comorbidities, but not erectile dysfunction, were independently associated with mortality (p = 0.006). CONCLUSIONS Sexual dysfunctions, including erectile dysfunction, were highly prevalent and had a negative impact on quality of life in men with COPD. In addition, gonadal state was an independent predictor of erectile dysfunction. Finally, erectile dysfunction was not associated with all-cause mortality.
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Abstract
PURPOSE OF REVIEW This review summarizes the literature on hypogonadism in men with chronic obstructive pulmonary disease (COPD). RECENT FINDINGS COPD is a systemic disease with effects beyond the lungs. Many prior studies have shown that middle-aged and elderly COPD patients may develop hypogonadism. Prevalence of hypogonadism in men with COPD can range from 22 to 69% and has been associated with several other systemic manifestations including osteoporosis, depression, and muscle weakness. Recent studies have revealed conflicting results with regards to these previous perceptions. The discrepancies in the findings can be mainly attributed to small sample size, differences in patient selection, and inconsistent findings. Testosterone replacement therapy may result in modest improvements in fat-free mass and limb muscle strength but its therapeutic efficacy in COPD patients still remains controversial. SUMMARY The relationship between hypogonadism and COPD still remains poorly understood. The current literature is at best circumstantial.
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Amore M, Innamorati M, Costi S, Sher L, Girardi P, Pompili M. Partial androgen deficiency, depression, and testosterone supplementation in aging men. Int J Endocrinol 2012; 2012:280724. [PMID: 22719760 PMCID: PMC3376477 DOI: 10.1155/2012/280724] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Revised: 04/08/2012] [Accepted: 04/10/2012] [Indexed: 12/12/2022] Open
Abstract
The aim of this review was to summarize current knowledge on the correlation between depressive symptoms with a syndrome called partial androgen deficiency of the aging male (PADAM) and on the potential benefits of testosterone (T) treatment on mood. Despite, the causative nature of the relationship between low T levels and depression is uncertain, many hypogonadal men suffer from depression and vice versa several depressed patients are affected by hypogonadism. Supplementation with testosterone failed to show sound evidence of effectiveness in the treatment of depression. Nevertheless, testosterone supplementation has proved to be effective on some domains significant for the quality of life of aged patients with PADAM (sexual function and cognitive functions, muscular strengths).
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Affiliation(s)
- Mario Amore
- Department of Neurosciences, Institute of Psychiatry, University of Parma, Piazza Matteotti 9, 43100 Parma, Italy
- *Mario Amore:
| | - Marco Innamorati
- Department of Neurosciences, Institute of Psychiatry, University of Parma, Piazza Matteotti 9, 43100 Parma, Italy
| | - Sara Costi
- Department of Neurosciences, Institute of Psychiatry, University of Parma, Piazza Matteotti 9, 43100 Parma, Italy
| | - Leo Sher
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA
| | - Paolo Girardi
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy
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