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Nierman, David M., and Jeffrey I. Mechanick. "Hypotestosteronemia in chronically critically ill men." Critical Care Medicine 27, no. 11 (1999): 2418–21. http://dx.doi.org/10.1097/00003246-199911000-00016.
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Akmal, Mohammad, David A. Goldstein, Oscar A. Kletzky, and Shaul G. Massry. "Hyperparathyroidism and Hypotestosteronemia of Acute Renal Failure." American Journal of Nephrology 8, no. 2 (1988): 166–69. http://dx.doi.org/10.1159/000167576.
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Hromadová, Melita, T. Háčik, E. Malatinský, and I. Riečanský. "Alterations of Lipid Metabolism in Men with Hypotestosteronemia." Hormone and Metabolic Research 23, no. 08 (1991): 392–94. http://dx.doi.org/10.1055/s-2007-1003708.
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Agarwal, S. K. "459 – Hypovitaminosis d and hypotestosteronemia in schizophrenia patients." European Psychiatry 28 (January 2013): 1. http://dx.doi.org/10.1016/s0924-9338(13)75786-9.
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Wortsman, Jacobo, Lanie E. Eagleton, William Rosner, and Maria L. Dufau. "Mechanism for the Hypotestosteronemia of the Sleep Apnea Syndrome." American Journal of the Medical Sciences 293, no. 4 (1987): 221–25. http://dx.doi.org/10.1097/00000441-198704000-00004.
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Gupta, Aditya, Somnath B. Ghosh, Nelson B. Watts, and Khalid Almoosa. "Incidence and Outcomes of Hypotestosteronemia in Mechanically Ventilated Patients." Chest 138, no. 4 (2010): 271A. http://dx.doi.org/10.1378/chest.10457.
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Kogan, M. I., S. S. Todorov, I. V. Popov, et al. "Morphogenesis of Penile Cavernous Fibrosis in Hypotestosteronemia: an Experimental Study." Urology Herald 8, no. 1 (2020): 14–24. http://dx.doi.org/10.21886/2308-6424-2020-8-1-14-24.
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Introduction. Erectile dysfunction is a multifactorial condition that is the inability to achieve or maintain an erection sufficient for sexual intercourse. The classic method for studying the fundamental aspects of erectile reactions in normal and pathological conditions, as well as creating new methods of treatment, is experimental animal models used in preclinical studies. However, for more than 30 years of studying this problem in experimental researches, the specific moment of occurrence of morphological alterations in the cavernous bodies of the penis has not been established. In addition, the choice of the time frame of the developed therapeutic effects on the penis is not substantiated and differs for various authors, which indicates the lack of validity of their results.Purpose of the study. To determine the features of morphological alterations and the severity of fibrogenic pathological process in the cavernous bodies of the penis in the time dynamics of experimental modeling of hypotestosteronemia.Materials and methods. Laboratory animals is 20 white male rabbits, «New Zealand» breed, Oryctolagus cuniculus genus. Penile cavernous fibrosis in rabbits was induced by hypotestosteinemia due to bilateral orchiectomy. The level of total testosterone in the systemic blood flow in laboratory animals was determined on 1, 2, 3, 14, 21, and 28 days. Biopsies of penile tissues were evaluated by pathomorphological examination (Hematoxylin-eosin, Masson’s trichrome, Weigert’s staining, and light microscopy). Statistical processing of the obtained data was performed using Microsoft Excel and «Statistica 10.0» programs using the Student`s T-criteria.Results. Castration of rabbits leads to a 10-fold decrease in blood testosterone levels after 1 day after castration. Testosterone deficiency occurs by day 28. Morphological signs of the restructuring of smooth muscle cells, sinuses and connective tissue structures in the cavernous bodies of the penis are clearly defined by the day 7 after castration. Severe fibrotic changes in the cavernous tissues of the penis were noted at day 28.Conclusion. Thus, the obtained data demonstrate the dynamics of morphological alterations in penile tissues as early as 7 days after inducing hypotestosteronemia, which indicates the need to revise the time frame of therapeutic effects in studies using the castration animal model of erectile dysfunction.
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Phillips, G. B., B. H. Pinkernell, and T. Y. Jing. "The association of hypotestosteronemia with coronary artery disease in men." Arteriosclerosis and Thrombosis: A Journal of Vascular Biology 14, no. 5 (1994): 701–6. http://dx.doi.org/10.1161/01.atv.14.5.701.
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Wu, Yixing, Chuntao Yang, Fuhui Meng, et al. "Nerve Growth Factor Improves the Outcome of Type 2 Diabetes–Induced Hypotestosteronemia and Erectile Dysfunction." Reproductive Sciences 26, no. 3 (2018): 386–93. http://dx.doi.org/10.1177/1933719118773421.
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Antonucci, Michele, Giuseppe Palermo, Salvatore Marco Recupero, et al. "Male sexual dysfunction in patients with chronic end-stage renal insufficiency and in renal transplant recipients." Archivio Italiano di Urologia e Andrologia 87, no. 4 (2016): 299. http://dx.doi.org/10.4081/aiua.2015.4.299.
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Materials and Methods: The study was conducted from December 2011 to December 2012 on 95 patients between the ages of 20 and 65 years: 44 of which had been undergoing dialysis for over a year and 51 of whom had undergone kidney transplants more than 6 months before. Comorbidities were carefully recorded, erectile function was evaluated the with IIEF5 questionnaire and serum levels of total testosterone / free and prolactin were tested at early morning (7 AM). To assess the relationship between erectile dysfunction (ED) and clinical laboratory tests, Student's t-test statistical (quantitative variables), chi-square (qualitative variables), the uni and multivariate analysis were used. Results: In patients undergoing dialysis and in recently transplanted patients a higher instance of ED was found (70% and 65% of cases respectively). Amongst dialyzed patients, patients aged over 50 suffer from ED more frequently. Patients aged over 50s represent 61% of the total number of patients suffering from ED, and just 31% of patients not suffering from ED, (p = 0.006); Hyperprolactinemia was found in 23% and 20% of both groups respectively. Fifty nine % of the dialyzed patients presented values of testosterone serum levels of less than 250 ng/dl with a significant difference between those who were suffering from ED and those who were not (65% of ED patients vs. 46%,of patients not affected from ED p = 0.019). This was found in only 37% of transplanted patients and there does not appear to be a statistically significant correlation with the onset of ED (p = 0.12). In patients over the age of 50, diabetes and a condition of hypotestosteronemia were significantly correlated with ED at univariate and multivariate analyses. Conclusions: The ED in patients with end stage chronic kidney failure (CKF) continues to have a strong prevalence, either in the patients who are undergoing dialysis or in those who have received transplants. In literature this issue is not sufficiently considered if not at all. Hypotestosteronemia is a risk factor for the onset of ED in end stage CKF patients. A significantly lower prevalence of hypogonadism among dialyzed patents and transplant recipients suggests that renal transplantation may be protective for the sexual capabilities of these patients.
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Niccoli, Giampaolo, Domenico Milardi, Domenico D’Amario, et al. "Hypotestosteronemia is frequent in ST-elevation myocardial infarction patients and is associated with coronary microvascular obstruction." European Journal of Preventive Cardiology 22, no. 7 (2014): 855–63. http://dx.doi.org/10.1177/2047487314533084.
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Loves, Sandra, Jos de Jong, Adriaan van Sorge, et al. "Somatic and psychological effects of low-dose aromatase inhibition in men with obesity-related hypogonadotropic hypotestosteronemia." European Journal of Endocrinology 169, no. 5 (2013): 705–14. http://dx.doi.org/10.1530/eje-13-0190.
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IntroductionReduced testosterone levels are frequently observed in obese men. Increased aromatase activity may be an etiological factor.ObjectiveIn this study, we evaluate the clinical effects of aromatase inhibition in obesity-related hypogonadotropic hypotestosteronemia (OrHH).MethodsDouble-blind, placebo-controlled, 6-month trial in 42 obese men with a BMI >35 kg/m2, and a serum total testosterone <10 nmol/l. All patients started on one tablet of 2.5 mg/week, with subsequent dose escalation every month until a serum total testosterone of 20 nmol/l was reached.EndpointsPsychological function, body composition, exercise capacity, and glucose, lipid, and bone metabolism.ResultsThirty-nine patients completed the study according to protocol. Letrozole decreased serum estradiol from 119.1±10.1 to 59.2±6.1 pmol/l (P<0.001), and increased serum LH from 3.3±0.3 to 8.8±0.9 U/l (P<0.0001) and serum total testosterone from 8.6±0.7 to 21.5±1.3 nmol/l (P<0.0001). Significant effects on the predefined endpoints were not observed.ConclusionDespite a marked rise in serum testosterone, low-dose aromatase inhibition had no somatic or psychological effects in men with OrHH.
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Chang, C., Y. T. Chen, S. D. Yeh, et al. "Infertility with defective spermatogenesis and hypotestosteronemia in male mice lacking the androgen receptor in Sertoli cells." Proceedings of the National Academy of Sciences 101, no. 18 (2004): 6876–81. http://dx.doi.org/10.1073/pnas.0307306101.
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Rice, Timothy R., and Leo Sher. "Low testosterone levels in aging men may mediate the observed increase in suicide in this age group." International Journal on Disability and Human Development 16, no. 1 (2017): 123. http://dx.doi.org/10.1515/ijdhd-2016-0007.
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Abstract This short communication suggests that there may be biological in addition to psychosocial reasons underlying the rise in suicide among older men. Testosterone, the major male sex hormone, has attracted interest as a putative biological mediator of suicide risk, but observational data have been mixed. Age stratification may reveal that high levels of testosterone in adolescents and young adults but low levels in the elderly may mediate suicide risk. A putative age-testosterone-suicide differential may be mediated by divergent central nervous system architecture between adolescents and the elderly. Whereas the prefrontal and prefontal-limbic connectivity underdevelopment observed in adolescents may render vulnerability to testosterone-mediated increases in impulsivity as a risk factor for suicide, declining function of dopaminergic striato-thalamic reward pathways in the aging cohort may render older men vulnerable to the loss of testosterone’s protective effects against anhedonia, thereby increasing suicide risk through a different biological pathway. Further research is needed regarding the role of hypotestosteronemia in elderly suicide.
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Seminara, Giuseppe, Paola Chiarello, Rodolfo Iuliano, et al. "Gynecomastia and Leydigioma: An Unexpected Case Report Outcome." Endocrines 4, no. 3 (2023): 656–63. http://dx.doi.org/10.3390/endocrines4030046.
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We report a case of a 19-year-old male referred to the Endocrine Unit because of gynecomastia. Initial investigation revealed elevated levels of estradiol (E2) along with secondary hypogonadism (hypotestosteronemia and severe oligoasthenoteratozoospermia (OAT)) despite normal testicular volume (12 mL) and secondary sexual characteristics. Surprisingly, an ultrasound examination revealed a small hypoechoic mass (1.1 cm) with intense intralesional vascularization within the right testicle, even though tumor markers were normal. Surgical removal of testicular mass led to the identification of Leydigioma, and the patient showed regression of gynecomastia during the nine-month follow-up. Unexpectedly, hypergonadotropinemia manifested along with normal testosterone (T) levels and significant improvement in OAT. Magnetic resonance imaging (MRI) showed pituitary hyperplasia (PH). Gynecomastia represents an atypical manifestation of Leydig cell tumors and typically resolves after surgical removal. However, unilateral orchiectomy may determine compensatory PH. Currently, it is uncertain whether the shift from hypogonadotropic to permanent hypergonadotropinemia was the only factor responsible for the high sperm count occurring in our patient. Further research is needed to elucidate the underlying mechanisms.
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Saad, Farid. "The role of testosterone in type 2 diabetes and metabolic syndrome in men." Arquivos Brasileiros de Endocrinologia & Metabologia 53, no. 8 (2009): 901–7. http://dx.doi.org/10.1590/s0004-27302009000800002.
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Over the last three decades, it has become apparent that testosterone plays a significant role in glucose homeostasis and lipid metabolism. The metabolic syndrome is a clustering of risk factors predisposing to diabetes mellitus type 2, atherosclerosis and cardiovascular morbidity and mortality. The main components of the syndrome are visceral obesity, insulin resistance, glucose intolerance, raised blood pressure and dyslipidemia (elevated triglycerides, low levels of high-density lipoprotein cholesterol), and a pro-inflammatory and thrombogenic state. Cross-sectional epidemiological studies have reported a direct correlation between plasma testosterone and insulin sensitivity, and low testosterone levels are associated with an increased risk of type 2 diabetes mellitus, dramatically illustrated by androgen deprivation in men with prostate carcinoma. Lower total testosterone and sex hormone-binding globulin (SHBG) predict a higher incidence of the metabolic syndrome. There is evidence that hypotestosteronemia should be an element in the definition of the metabolic syndrome since low levels of testosterone are associated with or predict the development of the metabolic syndrome and of diabetes mellitus. Administration of testosterone to hypogonadal men reverses part of the unfavorable risk profile for the development of diabetes and atherosclerosis. So far, studies on the effects of normalization of testosterone in hypogonadal men on glucose homeostasis are limited, but convincing, and if diabetes mellitus is viewed in the context of the metabolic syndrome, the present results of testosterone treatment are very encouraging.
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Van Loan, Marta D., Alison Strawford, Mary Jacob, and Marc Hellerstein. "Monitoring changes in fat-free mass in HIV-positive men with hypotestosteronemia and AIDS wasting syndrome treated with gonadal hormone replacement therapy." AIDS 13, no. 2 (1999): 241–48. http://dx.doi.org/10.1097/00002030-199902040-00012.
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Perusquía, Mercedes, Daniela Contreras, and Nieves Herrera. "Hypotestosteronemia is an important factor for the development of hypertension: elevated blood pressure in orchidectomized conscious rats is reversed by different androgens." Endocrine 65, no. 2 (2019): 416–25. http://dx.doi.org/10.1007/s12020-019-01978-x.
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Rosenblatt, Alberto, Joel Faintuch, and Ivan Cecconello. "Androgen and Estrogen Shifts in Men Before and After Bariatric Surgery and Links to Vitamins and Trace Elements." International Journal for Vitamin and Nutrition Research 86, no. 5-6 (2016): 198–241. http://dx.doi.org/10.1024/0300-9831/a000295.
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Abstract. Androgens and estrogens play a key role regarding sexual life and reproduction. Along with hypotestosteronemia, obese men exhibit a 2-fold increase in estradiol concentration, adversely infl uencing these parameters. Estrogens and adipokines also infl uence bone metabolism, exerting a direct effect on vitamin D, calcium homeostasis and bone health. Bariatric procedures normalize some sex hormones, and may reverse several obesity-related conditions. Estrogens levels may remain elevated postoperatively, and despite its protective effect on the skeleton, bariatric patients are more prone to fractures when compared to the general population. Multiple nutritional defi cits are common after bariatric interventions, and hypozincemia is the most likely to negatively infl uence reproductive parameters. Zinc is an essential element for normal spermatogenesis, and severe hypozincemia is associated with infertility in both sexes. Vitamin D also acts as a regulator of several enzymes involved in steroid hormone production, and its defi ciency could impair reproductive function. Few studies have addressed changes in sex hormones and in reproductive function in the male bariatric population, as they represent a minority of surgical candidates. Although obesity rates and burden are similar for both sexes, society is more lenient with the obese male. Moreover, 73 % of overweight/obese men are satisfi ed with their health, causing body weight and obesity-related health problems to increase when they opt for bariatric surgery. In the present article, we discuss shifts of sex hormones before and after bariatric surgery, surgery impact on semen quality, skeletal health and nutrients, and new research directions regarding links between vitamin D, zinc, androgens and reproduction.
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Pradnya, Phalak, and Pratap Abhijit. "Study of Testosterone Levels in Coronary Artery Disease with Poorly Controlled Diabetes Mellitus in Males." International Journal of Pharmaceutical and Clinical Research 15, no. 7 (2023): 552–54. https://doi.org/10.5281/zenodo.11643128.
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<strong>Introduction: </strong>Coronary artery disease including myocardial infarction is a growing pandemic worldwide and is an important cause of morbidity and mortality. Millions of lives are lost to coronary artery disease every year and is a significant medical problem. The disease is multifactorial, and an important risk factor is diabetes mellitus and patients having poor glycemic control. Testosterone is a steroid hormone which also has cardio metabolic benefits apart for reproductive functions. It is believed to cause vasodilatation of coronary vessels and thus protects or is beneficial against coronary artery diseases. Low testosterone is seen both in diabetes mellitus and as we age from adulthood to elderly. The study aims to compare the testosterone levels between diabetes mellitus patients and non-diabetes mellitus patients who have been diagnosed or suffered from acute coronary syndrome. <strong>Materials and Method: </strong>A total of 50 patients were included in the study, patients’ sample was tested for total testosterone, fasting blood sugar levels, glycated hemoglobin levels (HbA1c) and BMI was measured. <strong>Results:</strong> 42 out of 50 were diabetic and having a mean age of around 63 years. Testosterone levels were low in diabetic patients as compared to non-diabetic, which was statistically significant and the decrease in testosterone levels were proportional to the increase in fasting blood sugar and HbA1c levels, which was also significant however the relationship could not be statistically assessed due to insufficient data. <strong>Discussion:</strong> All cases of acute coronary syndrome are associated with low testosterone levels. This finding is supported by numerous studies which highlight the cardiometabolic role of testosterone. Poorer the glycemic control as shown by increasing HbA1c levels lower the serum testosterone levels, which was a novel finding requiring further studies in this area.
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Belli, S., D. Santi, E. Leoni, et al. "Human chorionic gonadotropin stimulation gives evidence of differences in testicular steroidogenesis in Klinefelter syndrome, as assessed by liquid chromatography–tandem mass spectrometry." European Journal of Endocrinology 174, no. 6 (2016): 801–11. http://dx.doi.org/10.1530/eje-15-1224.
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Background Men with Klinefelter syndrome (KS) show hypergonadotropic hypogonadism, but the pathogenesis of hypotestosteronemia remains unclear. Testicular steroidogenesis in KS men was evaluated over three decades ago after human chorionic gonadotropin (hCG) stimulation, but inconclusive results were obtained. Intriguingly, some recent studies show increased intratesticular testosterone concentrations in men with KS. Objective To analyze serum steroid profile, as a proxy of testicular steroidogenesis, after hCG stimulation in KS compared with control men. Design A prospective, longitudinal, case–control, clinical trial. Methods Thirteen KS patients (36±9 years) not receiving testosterone (TS) replacement therapy and 12 eugonadic controls (32±8 years) were enrolled. Serum steroids were measured by liquid chromatography–tandem mass spectrometry (LC–MS/MS) at baseline and for five consecutive days after intramuscular injection of 5000IU hCG. Results Progesterone (P), 17-hydroxyprogesterone (17OHP), TS, and estradiol (E2) showed a significant increase (P<0.001) after hCG stimulation in both groups. On the contrary, androstenedione (AS) and dehydroepiandrosterone did not increase after hCG stimulation. The 17OHP/P ratio increased in both groups (P<0.001), the TS/AS ratio (17β-hydroxysteroid dehydrogenase type 3 (17βHSD3) activity) did not increase after hCG in any group, and the E2/TS ratio (aromatase activity) increased significantly in both groups (P=0.009 in KS and P<0.001 in controls). Luteinizing hormone decreased after hCG in both groups (P=0.014 in KS and P<0.001 in controls), whereas follicle-stimulating hormone decreased only in control men (P<0.001). Conclusion This study demonstrates for the first time using LC–MS/MS that Leydig cells of KS men are able to respond to hCG stimulation and that the first steps of steroidogenesis are fully functional. However, the TS production in KS men is impaired, possibly related to reduced hydroxysteroid deydrogenase activity due to an unfavorable intratesticular metabolic state.
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Grigorova, Marina, Margus Punab, Olev Poolamets, Mart Adler, Vladimir Vihljajev, and Maris Laan. "Genetics of Sex Hormone-Binding Globulin and Testosterone Levels in Fertile and Infertile Men of Reproductive Age." Journal of the Endocrine Society 1, no. 6 (2017): 560–76. http://dx.doi.org/10.1210/js.2017-00050.
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Context: Testosterone (T) is a central androgenic hormone, and sex hormone-binding globulin (SHBG) is the major determinant of its bioactivity. There are no acknowledged genetic variants with clear-cut clinical implications, modulating T levels in men. Objective: To confirm genetic associations of top loci (SHBG, GCKR, SLCO1B1, and JMJD1C) from genome-wide association (GWA) studies for serum SHBG and T. Design, Patients: Groups differing in general and reproductive parameters: young men (n = 540; 19.3 ± 1.8 years), severe idiopathic male infertility patients (n = 641; 31.6 ± 6.0 years), and male partners of pregnant women (n = 324; 31.9 ± 6.6 years). All patients were recruited at the Andrology Centre, Tartu University Hospital, Estonia. Main Outcome Measure(s): Genetic associations with reproductive hormones, testicular and sperm parameters (linear regression, additive model); intergroup allele/genotype distribution comparisons. Results: Associations with serum SHBG levels were robust for SHBG −68 G&gt;A [rs1799941; meta-analysis: P = 3.7 × 10−14; allelic effect (standard error) = 4.67 (0.62) nmol/L], SHBG +1091 C&gt;T [rs727428; P = 7.3 × 10−11; −3.74 (0.57)], SHBG Pro185Leu [rs6258; P = 1.2 × 10−4, −12.2 (3.17)], and GCKR Pro446Leu [rs1260326; P = 1.5 × 10−4; −2.2 (0.59)]. Measured T concentrations correlated with genetically modulated levels of SHBG (r = 0.48 to 0.74, P &lt; 0.0001), guaranteeing stable availability of free T. Among infertile men, SHBG Pro185Leu substitution showed additional downstream effect on luteinizing hormone [P = 5.1 × 10−5; −1.66 (0.57) IU/L] and follicle-stimulating hormone [P = 3.4 × 10−3; −2.48 (1.23) IU/L]. No associations with male reproductive parameters were detected for SHBG Asp327Asn (rs6259), SLCO1B1 Val174Ala (rs4149056), and JMJD1C intronic variant rs7910927. Conclusions: Claims were replicated and additional associations were detected for four of seven tested GWAS top loci. Perspective clinical investigations of these variants are hypotestosteronemia among aging men and pharmacogenetics of hormone replacement therapy.
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Salukhov, V. V., and S. V. Aisaeva. "Functional hypogonadism in men: key causes and neuroendocrine mechanisms of its development." Meditsinskiy sovet = Medical Council, no. 6 (May 19, 2024): 112–23. http://dx.doi.org/10.21518/ms2024-210.
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Modern concepts of hypogonadism in men are undergoing significant transformation. The concept of functional hypogonadism, which is gaining increasing support among expert communities today, is based on the reversibility of symptomatic hypotestosteronemia after eliminating the causal factor or disease in men with an intact hypothalamic-pituitary-gonadal system. This makes the diagnosis of functional hypogonadism an exclusion diagnosis of organic hypogonadism, which can be congenital (genetic) or acquired (destructive or structural) irreversible disorder occurring at any level of the hypothalamic-pituitary-gonadal axis. Functional hypogonadism in men is becoming more common, attributed to its association with non-infectious pandemics such as obesity, type 2 diabetes, and other comorbid pathologies. Additionally, age-related hypogonadism meets the criteria of functional hypogonadism, as accumulating age-associated comorbidities have been shown to play a significant role in testosterone decline in aging men. Moreover, excessive physical activity, drastic calorie restriction, high psycho-emotional stress, injuries, surgeries, and the use of certain medications can also be causes of functional hypogonadism. Despite the wide range and heterogeneity of diseases and conditions underlying functional hypogonadism, the mechanisms driving its development are quite similar since in most cases, this androgen deficiency is secondary hypogonadotropic (central). However, in some cases, functional hypogonadism can be primary or mixed. Therefore, understanding the pathogenesis of functional hypogonadism is crucial as it involves a variety of biological pathways depending on the etiological factor or disease, which is detailed through a literature review. The article pays special attention to the evolutionary significance of the phenomenon of functional hypogonadism, an adapted classification of its causes, and describes the achievements of Russian researchers who have studied the impact of acute conditions and extreme influences on the hypothalamic-pituitary-gonadal system in men.
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Каплиева, И. В., Е. М. Франциянц, Л. К. Трепитаки, and Н. Д. Черярина. "Experimental assessment of major regulatory systems (adrenal, thyroid and gonadal) in liver metastases from s45 sarcoma." ZHurnal «Patologicheskaia fiziologiia i eksperimental`naia terapiia», no. 2() (August 29, 2018): 90–97. http://dx.doi.org/10.25557/0031-2991.2018.02.90-97.
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Метастазирование в печень - частый признак прогрессирования злокачественного процесса, механизм которого до конца не изучен. Цель - изучение особенностей функционирования основных систем нейрогуморальной регуляции: надпочечниковой (ГГНС), тиреоидной (ГГТС) и гонадной (ГГГС), на этапах метастазирования саркомы 45 (С45) в печень. Методика. Работа выполнена на 43 белых крысах-самцах. Через 1, 2, 5, 7 нед. от момента введения клеток саркомы 45 в дислоцированную под кожу селезенку. Органы взвешивались, в сыворотке крови (СК) методом РИА исследовали уровни фолликулостимулирующего гормона, лютеинизирующего гормона (ЛГ), тиреотропного гормона, адренокортикотропного гормона, кортизола, альдостерона, общей формы тестостерона, свободной и общей форм тироксина и трийодтиронина (Тсв и Т); методом ИФА - эстрона, эстрадиола, свободного тестостерона. Результаты. Метастазирование в печень сопровождалось активацией с последующим истощением ГГНС со снижением в 1,8 раза уровней кортизола и альдостерона в крови; значительной активацией ГГГС (пятикратное увеличение ЛГ в крови и уменьшение в 1,7 раза массы семенников) вследствие гипотестостеронемии (в 9,7 раза) на фоне гиперэстрадиолемии (в 2,3 раза); активацией ГГТС с формированием «low T» синдрома (в 4,6 раза). Заключение. Процесс метастазирования в печень - системная патология, в основе которой лежат глубокие нарушения работы основных систем регуляции организма. Aim: To evaluate functioning of three major systems of neurohumoral regulation, adrenal (HPA), thyroid (HPT), and gonadal (HPG) axes, in liver metastasis based on weights of organs and blood levels of hormones. Methods: The study included 34 white male rats. Organs were weighted at 1, 2, 5, and 7 weeks after S45 sarcoma cell injections into the subcutaneously transferred spleen; blood serum levels of FSH, LH, TSH, ACTH, cortisol, aldosterone, total testosterone, free and total thyroxine, and triiodothyronine were measured by RIA; estrone, estradiol, and free testosterone concentrations were measured by ELISA. Results. The process of liver metastasis was accompanied by activation and following exhaustion of the HPA axis with 1.8 time decreases in blood levels of cortisol and aldosterone , significant activation of the HPG axis (5-fold increased LH level and 59% decreased testicular weight) due to hypotestosteronemia (9.7 times) and hyperestradiolemia (2.3 times), and activation of the HPT axis with the low T3 syndrome (4.6 times). Conclusion. Liver metastasis is a systemic pathology based on profound dysfunction of the major regulatory systems.
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Мamotenko, A. V. "The Influence of Long-Term Change in the Light Regime on the Level of Sex Hormones in Rats’ Blood." Ukraïnsʹkij žurnal medicini, bìologìï ta sportu 6, no. 1 (2021): 311–18. http://dx.doi.org/10.26693/jmbs06.01.311.
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The modern lifestyle of many people takes place in conditions of "light pollution". Prolongation of the photoperiod not only inhibits the synthesis and secretion of melatonin (universal endogenous adaptogen), but also causes induction of anovulation and promotes premature puberty and premature aging, which may occur against the background of impaired secretion of sex hormones. The purpose of the study was to examine the long-term change in the light regime to the level of sex hormones, testosterone and estradiol in the blood plasma of rats. The experiment was performed on 120 Wistar rats. According to the nature of the action and intensity of lighting, we formed 3 groups (20 rats in each): K – control (intact), the animals of which were in natural light; group 12/12 – under the influence of artificial lighting for 12 hours a day: from 6 am to 6 pm and group 24/00 – under the influence of noctidial artificial lighting. Artificial lighting was carried out with an incandescent lamp with a power of 100 watts. The light intensity in the cages, which was measured using a Yu-117 luxmeter, was 40-50 lux. The content of free testosterone and estradiol was determined in the blood plasma of rats by enzyme-linked immunosorbent assay. Statistical processing of the obtained data was performed by methods of mathematical statistics. A statistically significant difference in averages was established using Student's test (t). The changes were considered significant at p≤0.05. While processing the obtained data, the ratio of testosterone/estradiol was calculated, the median estimate was given, and the oscillation ranges were 25-75% of the intervals. The study proved that in males, the change in light regime caused a statistically significant decrease in free testosterone levels and an increase in estradiol in plasma, while in females the opposite changes were observed. Hypertestosteronemia in females and hypotestosteronemia in males with changes in estradiol levels were also shown to be adaptive responses to the changes in the photoperiod. We found out that a statistically significant decrease in the ratio of testosterone/ estradiol in males (in the 12/12 group by 42.6%; in the 24/00 group – by 65%) and its increase in females (in the 12/12 group by 60.6%, in the 24/00 group – by 79%), were probably compensatory reactions to the stress factor, which was a long-term change in lighting. In general, a higher range of testosterone/estradiol index deviations in 24-hour rats (24/00) indicated that they had a more acute stress response to changes in lighting and reduced adaptability. This "adaptation fee" is generally aimed at survival, but leads to sexual dysfunction in rats
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Li, Yun-Ren, Shu-Han Tsao, Chien-Lun Chen, et al. "Endoscopic Enucleation of Prostate Could Increase Testosterone Levels in Hypotestosteronemic Patients with Bladder Outlet Obstruction." Journal of Clinical Medicine 11, no. 22 (2022): 6808. http://dx.doi.org/10.3390/jcm11226808.
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Background: We evaluated the impact of endoscopic enucleation of the prostate on testosterone levels in hypotestosteronemic patients with bladder outlet obstruction. Methods: We enrolled 294 men with lower urinary tract symptoms (LUTS) who received surgery between January 2019 and December 2020 in simple tertiary centre. The inclusion criteria were as follows: being a male patient aged 45–95 years and having recurrent urinary tract infection, having previously failed medical treatment for LUTS or urine retention, and undergoing bipolar or thulium laser enucleation of the prostate. The preoperative and postoperative data were retrospectively reviewed. Results: This study included 112 men with a mean age of 69.4 years. The mean preoperative and postoperative testosterone levels were 4.8 and 4.98, respectively. Of the patients, 88 (78.6%) received ThuLEP and 24 received BipolEP. We divided the patients into two groups according to preoperative serum testosterone levels: normal-testosterone (≥3 ng/mL) and low-testosterone (<3 ng/mL) groups. A significant change in testosterone levels (p = 0.025) was observed in the low-testosterone group. In contrast, no significant difference in testosterone levels was noted in the normal-testosterone group (p = 0.698). Conclusions: Endoscopic enucleation surgery of the prostate could improve postoperative testosterone levels in hypotestosteronemic patients with bladder outlet obstruction.
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Ionov, A. Yu, E. A. Kuznetsova, O. G. Kindalyova, I. V. Kryuchkova, E. E. Poplavskaya, and A. A. Avagimyan. "Clinical significance of endocrine disorders in the development of early vascular aging in males with abdominal obesity and concomitant arterial hypertension: An observational cohort study." Kuban Scientific Medical Bulletin 31, no. 1 (2024): 74–87. http://dx.doi.org/10.25207/1608-6228-2024-31-1-74-87.
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Background. Visceral obesity is a risk factor in the development of metabolic and endocrine disorders leading to arterial hypertension and cardiovascular complications. Their early predictors include increased vascular stiffness and early vascular aging. The current literature lacks studies into the effects of changes in testosterone, cortisol, and aldosterone levels in serum on vascular stiffness and the development of early vascular aging in patients with visceral obesity. Objective. To determine the relationship between hypercortisolemia, hyperaldosteronemia, and hypotestosteronemia and vascular stiffness and the presence of early vascular aging in male patients with visceral obesity. Methods. An observational cohort study of 78 males aged 35–45 years (mean age 38.1 ± 6.5 years) diagnosed with abdominal obesity and grade 1 arterial hypertension was conducted. The mean waist circumference ranged 105.5 ± 6.9 cm; systolic and diastolic blood pressure ranged 152.5 ± 5.0 and 92.5 ± 5.0 mm Hg, respectively. The vascular age of the studied patients (n = 78) comprised 44.1 ± 6.2 years, which was statistically higher than their passport age (р < 0.001). The studied patients were divided into subgroups according to both total testosterone (< 12.1 nmol/l in subgroup 1A (n = 49) and ≥ 12.1 nmol/L in subgroup 1B (n = 29)) and cortisol in the evening saliva portion (> 4.5 nmol/L in subgroup 2A (n = 24) and ≤ 4.5 nmol/L in subgroup 2B (n = 24)). All the patients completed the study. To assess the hormonal status, the total testosterone sex steroid-binding globulin (SSBP) and insulin in morning serum samples were investigated. Insulin resistance was assessed based on the NOMA-IR index. The concentration of total testosterone was determined by enhanced chemiluminescence (Ortho-Clinical Diagnostics, J&J); the SSBP and insulin levels were determined by delayed fluorescence. Aldosterone content was determined by radioimmunoassay; free cortisol and testosterone were measured by luminescent LIA. Free and bioavailable testosterone concentrations in serum were calculated using an online calculator (issam.ch/freetesto.htm). The cardio-ankle vascular index (CAVI) was determined using a VaSera VS-15000N device, which automatically calculated the vascular age. Statistical analysis was performed using the Statistica 10.0 Windows package (StatSoft, Inc., USA). Results. The vascular age of patients with hypogonadism was statistically significantly ( р < 0.001) higher than their passport age and the vascular age in males without hypogonadism. The CAVI and vascular age were also statistically significantly higher in males with functional hypercorticism (р < 0.001) compared with a subgroup of patients without hypercorticism. The vascular age and CAVI increased with an increase in the salivary cortisol concentration 2200 (r = 0.5; р < 0.05) and decreased with an increase in the salivary cortisol level 900 (r = –0.5; р < 0.05). These parameters decreased with an increase in serum aldosterone obtained in the morning (r = –0.4; p < 0.05) and increased with an increase in serum aldosterone in the evening (r = 0.4; p < 0.05). In 23% (n = 18), an inversion of the daily rhythm of cortisol production was observed; in these patients, salivary cortisol levels of 2200 exceeded salivary cortisol levels of 900. The vascular age of patients with the inversion of cortisol production (49.4 ± 4.4 years) was statistically significantly ( р < 0.001) different from that of patients with normal changes in salivary cortisol concentrations (41.9 ± 4.9 years). CAVI was also higher (р < 0.001) in males with inverted fluctuations in salivary cortisol levels (7.51 ± 0.62) compared to those with normal diurnal rhythm (6.45 ± 0.69). The results of aldosterone evaluation revealed that 17% of the patients (n = 13) had higher aldosterone levels in the evening serum portion compared to the morning serum portion. In these patients, the vascular age (45.8 ± 5.1 years) was higher ( р < 0.001) than that in males with normal physiologic changes in aldosterone levels (41.6 ± 5.7 years). A similar pattern was observed when comparing vascular stiffness indices. Thus, the CAVI in men with inverted changes in aldosterone concentration (6.9 ± 0.8) was significantly higher ( р < 0.001), compared to that in men with physiological changes in blood aldosterone levels (6.4 ± 0.8). Conclusion. Endocrinologic disorders in male patients with visceral obesity and concomitant arterial hypertension (functional hypogonadism, functional hypercorticism, inverted daily rhythms of cortisol and aldosterone production) contribute to the development of early vascular aging by increasing vascular stiffness.
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Sauve, Florent, Sreekala Nampoothiri, Sophie Clarke, et al. "GnRH neuronal disruption and hypotestosteronemia in COVID-19." Endocrine Abstracts, October 31, 2023. http://dx.doi.org/10.1530/endoabs.94.p371.
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Munari, Elisabetta Veronica, Myriam Amer, Alessandro Amodeo, et al. "The complications of male hypogonadism: is it just a matter of low testosterone?" Frontiers in Endocrinology 14 (June 28, 2023). http://dx.doi.org/10.3389/fendo.2023.1201313.
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The history of diagnosing hypogonadism and hypotestosteronemia shows us the many steps that were necessary to achieve our current knowledge and the ability to improve these patients’ well-being. Moreover, so far, criteria for diagnosing hypotestosteronemia varies according to the underlying condition, and according to the consensus or guideline adopted. Furthermore, besides the many signs and symptoms, there are several complications associated with low testosterone levels such as osteoporosis, metabolic alterations, as well as cardiovascular disorders. However, data are often conflicting regarding the severity, timing or even the real clinical relevance of these complications, although these studies often lack essential information such as gonadotropin levels or the underlying cause of hypogonadism. The present review focus on the complications of male hypogonadism according to the cause of testosterone deficiency, highlighting the lack of information found in many studies investigating its effects. We thereby stress the necessity to always perform a complete evaluation of the type of hypogonadism (including at least gonadotropins and secondary causes) when investigating the effects of low testosterone levels.
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Ashoka, H. G., M. V. Prakashini, M. Manthappa, and P. Ashok. "study of serum testosterone as a prognostic indicator in patients with respiratory failure on mechanical ventilation." International journal of health sciences, April 8, 2022, 2753–61. http://dx.doi.org/10.53730/ijhs.v6ns2.5670.
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Patients on mechanical ventilation tend to have a multitude of biochemical changes, many due to adrenal suppression or functional adrenal insufficiency Abnormal levels of gonadal steroids poses significant physiologic effects in critically ill patients. Hypotestosteronemia, defined as a serum total testosterone level <250 ng/dL (<8.7 nmol/L) or free testosterone level <0.75 ng/dL (<0.03 nmol/L), is a common finding among male patients with critical illness. In this this study we determine if serum testosterone can be used as a prognostic indicator in patients with respiratory failure, on mechanical ventilation. This is a prospective observational study done over a period of 18 months at a tertiary care canter in Mysore. Study participants included male patients admitted to ICU of JSS Hospital with documented acute respiratory failure on arterial blood gas analysis (ABG), who were mechanically ventilated for more than 24 hours. Blood sample was collected at 24 hours and 72 hours post intubation and serum testosterone levels were estimated using Electro Chemiluminescence assay. Our results indicate 90.5% of the patients had low testosterone levels at 24 hours, whereas 97.1% of the patients had hypotestosteronemia at 72 hours post intubation.
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Krysiak, Robert, Karolina Kowalcze, and Bogusław Okopień. "The impact of hypotestosteronemia on cardiometabolic effects of atorvastatin in men with hypercholesterolemia." Coronary Artery Disease Publish Ahead of Print (March 16, 2021). http://dx.doi.org/10.1097/mca.0000000000001031.
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Hanson, Andrea E., Joshua M. McKenna, Mercedes Perusquia, and John N. Stallone. "Hypotestosteronemia‐induced hypertension in male Sprague‐Dawley rats is renin‐ angiotensin system‐dependent." FASEB Journal 31, S1 (2017). http://dx.doi.org/10.1096/fasebj.31.1_supplement.1028.5.
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Acutely, testosterone (TES) and other androgens are efficacious vasodilators, both in vitro and in vivo; however, long‐term effects of the androgens on arterial blood pressure (BP) are unclear. Thus, long‐term effects of endogenous and exogenous TES on BP were studied in male Sprague‐ Dawley rats. 12–13 wk old rats remained intact (InT) or were castrated (CsX). Weekly measurements of systolic BP (tail cuff plethysmography) revealed a progressive rise in BP over 10 wks in CsX (108 ± 0.9 vs. 139 ± 2 mmHg), while BP remained stable in InT (109 ± 3 vs. 113 ± 0.3). During the next 5 weeks, half of the CsX received TES replacement therapy (CsX+TES‐ enanthate‐replaced; 1.75 mg/kg, given 2X/wk). BP gradually declined to normal in CsX+TES replaced rats (118 ± 1), while BP remained elevated in CsX (141 ± 1) and normal in InT (112 ± 3). Seminal vesicle and body weights of InT (1.212 ± 0.038 g and 441 ± 9 g, respectively), CsX (0.065 ± 0.006 g and 420 ± 4 g) and CsX+TES (1.203 ± 0.080 g and 433 ± 3 g) revealed that TES replacement produced physiological levels of TES. In a separate group of CsX rats, treatment with Losartan (LST; 250 mg/L drinking water) prevented development of hypertension at 10 wks (94 ± 2 CsX+LST vs. 131 ± 3 CsX). During the next 5 weeks with TES replacement therapy, BP declined in CsX+TES (114 ± 2) and remained lower in CsX+LST (101 ± 1). These data suggest that: 1) endogenous androgens (TES) exert antihypertensive effects in male SD rats; and 2) these antihypertensive effects may involve TES‐induced reductions in renin‐ angiotensin system function. (State of Texas)
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Vergani, Edoardo, Carmine Bruno, Andrea Silvestrini, et al. "Oxidative stress and anabolic hormones in back pain: Current concept and preliminary analysis in male cohort." Orthopedic Reviews, June 26, 2020. http://dx.doi.org/10.4081/or.2020.8686.
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Back Pain (BP) is a common medical problem; anabolic hormones, through the modulation of oxidative stress (OS), could influence fracture risk. We evaluated the prevalence of anabolic hormonal deficiencies and their relationship with OS in males with BP, associated or not to nontraumatic fractures. 49 males with BP, from 36 to 80 years, were divided in two groups according to radiological evidence of nontraumatic fractures; group A (n=25): non-fractured; group B (n=24): fractured. A different prevalence of hormonal deficits was observed: 24% of hypotestosteronemia in A, 0% in B; 16% of GHD in A, 29% in B; Total Antioxidant Capacity (TAC) showed a trend toward higher levels in B. In A, despite lower TAC, a significant inverse correlation was present between TAC and IGF-1. A greater prevalence of GHD in patients with vertebral fractures was seen and, in a subgroup, OS could mediate the deleterious effects of hyposecretory GH state.
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PERUSQUÍA, M. "Correlation Between Nongenomic Action of C19-Steroids and COVID-19 Severity." Physiological Research, December 14, 2021, S135—S144. http://dx.doi.org/10.33549/physiolres.934789.
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The recent COVID-19 pandemic is the defining global health crisis of our time and little is known about this disease. It has been reported that advanced age is considered a major risk factor for COVID-19 complications, and data suggest that this disease is deadlier for men than women but these observations are currently unclear. Regarding androgen action, it has been shown that certain smooth muscles are a target for androgens by inducing an acute relaxing effect in airway and vascular tissues that is nongenomically mediated; likewise, androgens are capable of inducing genomic anti-inflammatory and nongenomic hypotensive responses. The aim of this report is to associate the relationship between COVID-19 and aging men as well as the comorbidities presented in this group of patients linked with androgen deficiency. Remarkably, the nongenomic mechanisms of androgens as potential protectors are reviewed. On this basis, it is suggested that hypotestosteronemia may be a risk factor for COVID-19 severity.
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Hanson, Andrea E., Nikolas W. Garcia, Joshua M. McKenna, Mercedes Perusquia, and John N. Stallone. "Hypotestosteronemia‐Induced Hypertension in Male Sprague‐Dawley Rats is Reversed by Testosterone Replacement Therapy, Which is a Non‐Genomic, Estrogen‐Independent Effect." FASEB Journal 32, S1 (2018). http://dx.doi.org/10.1096/fasebj.2018.32.1_supplement.584.9.
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Lazzerini, Pietro Enea, Silvia Cantara, Iacopo Bertolozzi, et al. "Transient Hypogonadism Is Associated With Heart Rate–Corrected QT Prolongation and Torsades de Pointes Risk During Active Systemic Inflammation in Men." Journal of the American Heart Association 11, no. 1 (2022). http://dx.doi.org/10.1161/jaha.121.023371.
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Background Systemic inflammation and male hypogonadism are 2 increasingly recognized “nonconventional” risk factors for long‐QT syndrome and torsades de pointes (TdP). Specifically, inflammatory cytokines prolong, while testosterone shortens the heart rate–corrected QT interval (QTc) via direct electrophysiological effects on cardiomyocytes. Moreover, several studies demonstrated important interplays between inflammation and reduced gonad function in men. We hypothesized that, during inflammatory activation in men, testosterone levels decrease and that this enhances TdP risk by contributing to the overall prolonging effect of inflammation on QTc. Methods and Results We investigated (1) the levels of sex hormones and their relationship with inflammatory markers and QTc in male patients with different types of inflammatory diseases, during active phase and recovery; and (2) the association between inflammatory markers and sex hormones in a cohort of male patients who developed extreme QTc prolongation and TdP, consecutively collected over 10 years. In men with active inflammatory diseases, testosterone levels were significantly reduced, but promptly normalized in association with the decrease in C‐reactive protein and interleukin‐6 levels. Reduction of testosterone levels, which also inversely correlated with 17‐β estradiol over time, significantly contributed to inflammation‐induced QTc prolongation. In men with TdP, both active systemic inflammation and hypogonadism were frequently present, with significant correlations between C‐reactive protein, testosterone, and 17‐β estradiol levels; in these patients, increased C‐reactive protein and reduced testosterone were associated with a worse short‐term outcome of the arrhythmia. Conclusions During systemic inflammatory activation, interleukin‐6 elevation is associated with reduced testosterone levels in males, possibly deriving from an enhanced androgen‐to‐estrogen conversion. While transient, inflammatory hypotestosteronemia is significantly associated with an increased long‐QT syndrome/TdP risk in men.
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Belli, S., D. Santi, E. Leoni, et al. "Human chorionic gonadotropin stimulation gives evidence of differences in testicular steroidogenesis in Klinefelter syndrome, as assessed by liquid chromatography–tandem mass spectrometry." May 18, 2016. https://doi.org/10.1530/eje-15-1224.
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Background Men with Klinefelter syndrome (KS) show hypergonadotropic hypogonadism, but the pathogenesis of hypotestosteronemia remains unclear. Testicular steroidogenesis in KS men was evaluated over three decades ago after human chorionic gonadotropin (hCG) stimulation, but inconclusive results were obtained. Intriguingly, some recent studies show increased intratesticular testosterone concentrations in men with KS. Objective To analyze serum steroid profile, as a proxy of testicular steroidogenesis, after hCG stimulation in KS compared with control men. Design A prospective, longitudinal, case–control, clinical trial. Methods Thirteen KS patients (36±9 years) not receiving testosterone (TS) replacement therapy and 12 eugonadic controls (32±8 years) were enrolled. Serum steroids were measured by liquid chromatography–tandem mass spectrometry (LC–MS/MS) at baseline and for five consecutive days after intramuscular injection of 5000IU hCG. Results Progesterone (P), 17-hydroxyprogesterone (17OHP), TS, and estradiol (E2) showed a significant increase (P<0.001) after hCG stimulation in both groups. On the contrary, androstenedione (AS) and dehydroepiandrosterone did not increase after hCG stimulation. The 17OHP/P ratio increased in both groups (P<0.001), the TS/AS ratio (17β-hydroxysteroid dehydrogenase type 3 (17βHSD3) activity) did not increase after hCG in any group, and the E2/TS ratio (aromatase activity) increased significantly in both groups (P=0.009 in KS and P<0.001 in controls). Luteinizing hormone decreased after hCG in both groups (P=0.014 in KS and P<0.001 in controls), whereas follicle-stimulating hormone decreased only in control men (P<0.001). Conclusion This study demonstrates for the first time using LC–MS/MS that Leydig cells of KS men are able to respond to hCG stimulation and that the first steps of steroidogenesis are fully functional. However, the TS production in KS men is impaired, possibly related to reduced hydroxysteroid deydrogenase activity due to an unfavorable intratesticular metabolic state.
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Degregori, Emanuelle Bortolotto, Matheus Da Rosa Pippi, Ana Lúcia Ottolia Niederauer De Moura, Rogério Soila, Priscila Viau Furtado, and Álan Gomes Pöppl. "Evidence of Pituitary Hypoplasia Associated with Partial Central Diabetes Insipidus in a Young Persian Cat." Acta Scientiae Veterinariae 48 (October 27, 2020). http://dx.doi.org/10.22456/1679-9216.104148.
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Background: Congenital anomalies are an uncommon pituitary hypofunction cause associated to multiple hormone deficiencies. Congenital hyposomatotropism is often related to an inherited anomaly, characterized mainly by delayed growth. It is not uncommon to find associated thyroid-stimulating hormone and gonadotropin deficiencies. Pituitary malformation may be associated to progressive cystic lesion expansion. Central diabetes insipidus (CDI) is another rare disease associated to polyuria (PU) and polydipsia (PD) secondary to antidiuretic hormone (ADH) deficient secretion. The aim of this report is to describe a likely case of pituitary hypoplasia, associated with partial CDI in a cat.Case: A 9-month-old unneutered male Persian cat weighing 2 kg was presented due to severe polyuria and polydipsia associated with growth deficit when compared with its sibling. After clinical and laboratory evaluations during the months in which the patient was monitored, a reduced serum concentration of insulin-like growth factor-1 (IGF-1), thyroid-stimulating hormone (TSH), thyroid hormones, and testosterone was documented, confirming the diagnosis of hyposomatotropism, hypogonadism, and secondary hypothyroidism. Furthermore, therapeutic diagnosis with desmopressin revealed partial central diabetes insipidus (CDI). As the sibling showed normal development aging 13-months, a radiographic examination of the forelimb (carpus) was performed on both cats. There was lack of growth plate fusion in the patient, without any other evidence of dysgenesis, whereas complete epiphyseal closure was observed in the sibling. Despite desmopressin and levothyroxine therapeutic prescription the owners refuse further follow-up to the case.Discussion: Notwhistanding neuroimaging was not available for investigation of pituitary aspect in this particular case, the clinical symptoms added to the results of the complementary tests were consistent with pituitary hypoplasia, associated with hyposomatotropism, secondary hypothyroidism, hypogonadism, and partial CDI. Hyposomatotropism was presumably diagnosed based on the patient’s clinical characteristics, which included proportional growth delay, delayed tooth eruption, delayed growth plate fusion, associated with serum reduced IGF-1 results in comparison with its sibling. The report of low free T4 by equilibrium dialysis and of low total T4 levels, associated with low TSH levels, was considered compatible with secondary hypothyroidism. TRH stimulation test is considered the gold standard for secondary hypothyroidism diagnosis since low TSH could be secondary to assay´s low sensibility. However, normal TSH and thyroid hormone results in the sibling results ruled out this possible dismissed diagnose. The patient’s lack of sexual interest, associated with hypotestosteronemia and underdeveloped genitals (absence of penile spines and testicular hypoplasia), indicates hypogonadism. Finally, partial CDI diagnosis was demonstrated by cat´s partial ability to increase urinary specific gravity under water deprivation often made by the owners, as well as the response pattern to desmopressin therapy. Owing the lack of neurological signs expected to be associated with neoplastic or traumatic hypopituitarism etiology, hypoplasia hypothesis was raised. Quite often, patients with pituitary hypoplasia develop Rathke cleft cysts that might expand over time. In the present case, partial CDI is likely to be caused by the compression of the neurohypophysis by cyst formation secondary to adenohypophyseal hypoplasia since this kind of pituitary congenital anomaly does not justify per se neurohypophysis implications.
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Cannarella, Rossella, Carmelo Gusmano, Claudia Leanza, et al. "Testosterone replacement therapy and vascular thromboembolic events: a systematic review and meta-analysis." Asian Journal of Andrology, October 27, 2023. http://dx.doi.org/10.4103/aja202352.
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Abstract To evaluate the relationship between testosterone replacement therapy (TRT) and arterial and/or venous thrombosis in patients with pre-treatment total testosterone (TT) <12 nmol l−1, we performed a meta-analysis following the Population Intervention Comparison Outcome model. Population: men with TT <12 nmol l−1 or clear mention of hypogonadism in the inclusion criteria of patients; intervention: TRT; comparison: placebo or no therapy; outcomes: arterial thrombotic events (stroke, myocardial infarction [MI], upper limbs, and lower limbs), VTE (deep vein thrombosis [DVT], portal vein thrombosis, splenic thrombosis, and pulmonary embolism), and mortality. A total of 2423 abstracts were assessed for eligibility. Twenty-four studies, including 14 randomized controlled trials (RCTs), were finally included, with a total of 4027 and 310 288 hypotestosteronemic male patients, from RCTs and from observational studies, respectively. Based on RCT-derived data, TRT did not influence the risk of arterial thrombosis (odds ratio [OR] = 1.27, 95% confidence interval [CI]: 0.47–3.43, P = 0.64), stroke (OR = 1.34, 95% CI: 0.09–18.97, P = 0.83), MI (OR = 0.51, 95% CI: 0.11–2.31, P = 0.39), VTE (OR = 1.42, 95% CI: 0.22–9.03, P = 0.71), pulmonary embolism (OR = 1.38, 95% CI: 0.27–7.04, P = 0.70), and mortality (OR = 0.70, 95% CI: 0.20–2.38, P = 0.56). Meanwhile, when only observational studies are considered, a significant reduction in the risk of developing arterial thrombotic events, MI, venous thromboembolism, and mortality was observed. The risk for DVT remains uncertain, due to the paucity of RCT-based data. TRT in men with TT <12 nmol l−1 is safe from the risk of adverse cardiovascular events. Further studies specifically assessing the risk of DVT in men on TRT are needed.