Male sex hormones, aging, and inflammation

High-Fat Diet and Metabolic Diseases: A Comparative Analysis of Sex-Dependent Responses and Mechanisms

Sex differences in metabolic disorders and susceptibility to chronic diseases induced by a high-fat diet (HFD) exhibit significant dimorphic characteristics. A long-standing male-centric bias in medical research and healthcare, predominantly focused on male physiological traits, has hindered the precise treatment of metabolic diseases in female patients. A comprehensive understanding of sex differences in metabolic health and their underlying mechanisms is crucial for advancing personalized health promotion and precision medicine. This review systematically elucidates sex-specific manifestations in high-fat diet-associated metabolic disorders: males predominantly develop visceral adiposity, insulin resistance, and dyslipidemia, accompanied by a significantly elevated risk of cardiovascular and metabolic syndromes. Premenopausal females maintain metabolic homeostasis through the estrogen-mediated optimization of glucose and lipid metabolism and oxidative stress buffering mechanisms, whereas postmenopausal-phase females experience dramatic metabolic vulnerability due to z loss of protective barriers. Furthermore, we emphasize multidimensional mechanistic interpretations of metabolic sexual dimorphism from perspectives including sex chromosome complement, sex hormone signaling pathways, epigenetic regulation, gut microbiota composition, and neuroendocrine dimorphism. This work provides critical theoretical foundations for rectifying unisex research paradigms and optimizing sex-specific early warning systems and precision therapeutic strategies for metabolic disorders.

Sex steroid hormones and asthma in males: a state-of-the-art review

INTRODUCTION

The incidence, prevalence, and disease prognosis of asthma differ between males and females throughout the life course. However, the underlying mechanisms are not known. Sex hormones might have a potential role in asthma pathogenesis. But most studies on the role of sex hormones in asthma have focused on females, with a paucity of evidence in males.

AREAS COVERED

This paper provides a comprehensive review of the state-of-the-art on sex steroids in asthma, focusing on males, covering mechanistic, clinical, and epidemiological studies. Literature search was conducted in PubMed in September 2024.

EXPERT OPINION

Androgen signaling has a protective role in asthma by reducing airway smooth muscle (ASM) contractility and decreasing airway inflammation. In contrast, estrogens appear to promote type 2 (T2) airway inflammation, while the effect on ASM remains controversial. To date, suggested mechanisms have not fully clarify the underlying pathways through which sex steroids modulate ASM and T2 inflammation in asthma. The balance between androgen and estrogen signaling might also play a role. While epidemiological studies support a protective role for androgens, the evidence on onset of puberty and asthma is inconclusive. Larger longitudinal population samples and stratification based on age and obesity are needed to resolve these questions.

Early identification of sarcopenia in patients with diabetes mellitus combined with osteoporosis: development and validation of a gender-specific nomogram

Objective

The aim of this study was to develop a predictive model to screen for sarcopenia in patients with type 2 diabetes mellitus (T2DM) combined with osteoporosis, with a view to identifying and intervening early in those at high risk of falls and fractures, thereby reducing the risk of disability and death in the elderly.

Methods

Clinical data collection, physical performance evaluations, and dual-energy X-ray absorptiometry were performed on 847 patients with T2DM combined with osteoporosis. Risk factors for sarcopenia were identified using the least absolute shrinkage and selection operator method. Furthermore, a sex-specific nomogram was constructed based on these indicators to predict the occurrence of sarcopenia, and the predictive efficacy and clinical value of the model were evaluated by receiver operating characteristic curve and decision curve analysis.

Results

The prevalence of sarcopenia in patients with T2DM combined with osteoporosis was 33.88%, with men having a significantly higher prevalence than women. Among male patients, body mass index, 25-hydroxyvitamin D, and calcium levels were associated with a decreased risk of sarcopenia, whereas age and weight-adjusted waist index were associated with an increased risk. In female patients, body mass index and creatine kinase were associated with a decreased risk of sarcopenia, while age, weight-adjusted waist index, and low-density lipoprotein cholesterol were associated with an increased risk. The area under the receiver operating characteristic curve of the nomogram was 91.2% in males and 84.5% in females, showing high predictive accuracy.

Conclusions

In this study, gender-specific nomograms were successfully established, which provided an effective tool for early screening of sarcopenia in patients with T2DM combined with osteoporosis. These models help healthcare professionals identify individuals at high risk of falls and fractures, facilitating timely preventive measures and reducing the burden on the social healthcare system.

Hallmarks of Cancer Cachexia: Sexual Dimorphism in Related Pathways

Cancer-associated cachexia (CAC), also known as wasting syndrome, is a systemic condition that affects multiple tissues and organs via a variety of metabolic pathways. Systemic inflammation, progressive weight loss, depletion of adipose tissue, and skeletal muscle impairment are some of the hallmark features of cachexia. Despite various studies on the clinical features of CAC, the complexity of the syndrome continues to pose significant challenges in clinical practice, leading to late diagnoses and the absence of a standardised treatment. Men and women respond differently to CAC, which may be prompted by the pre-existing physiologic sex differences. This review presents the sexual dimorphism associated with the hallmark pathways involved in CAC. A comprehensive understanding of sexual dimorphism in these pathways could drive research on cachexia to prioritise the inclusion of more females in related studies in order to achieve personalised sex-based therapeutic approaches and, consequently, enhance treatment efficacy and better patient outcomes.

An Overview of Sarcopenia: Focusing on Nutritional Treatment Approaches

Sarcopenia is a syndrome characterized by the progressive and generalized loss of skeletal muscle mass and strength. This condition is associated with physical disability, decreased quality of life, and increased mortality. Therefore, reducing the prevalence of sarcopenia could significantly lower healthcare costs. Sarcopenia can be classified into primary and secondary sarcopenia. The former is related to aging and begins after the fourth decade of life; after that, there is a muscle loss of around 8% per decade until age 70 years, which subsequently increases to 15% per decade. On the other hand, secondary sarcopenia can affect all individuals and may result from various factors including physical inactivity, malnutrition, endocrine disorders, neurodegenerative diseases, inflammation, and cachexia. Understanding the multiple mechanisms involved in the onset and progression of sarcopenia allows for us to develop strategies that can prevent, treat, or at least mitigate muscle loss caused by increased protein breakdown. One potential treatment of sarcopenia is based on nutritional interventions, including adequate caloric and protein intake and specific nutrients that support muscle health. Such nutrients include natural food rich in whey protein and omega-3 fatty acids as well as nutritional supplements like branched-chain amino acids, β-hydroxy-β-methylbutyrate, and vitamin D along with food for special medical purposes. It is important to emphasize that physical exercises, especially resistance training, not only promote muscle protein synthesis on their own but also work synergistically with nutritional strategies to enhance their effectiveness.

Sex Hormones and Heart Failure Risk

Heart failure (HF) is a significant cause of morbidity and mortality. Although there are inconsistencies, epidemiological studies have implicated sex hormones (SHs) in pathways that are linked to HF. The age-related decline in SH levels causes physiological changes that differentially impact HF risk in both sexes. Conversely, SHs are tightly regulated by complex feedback loops that become disrupted in chronic HF to create a vicious cycle that further worsens the HF syndrome. By altering the androgenic balance, SHs exert variable effects that could impact HF risk in men and women. Further studies are needed to clarify whether measurement of SH levels can identify future HF patients for early intervention, as well as HF patients who may benefit from more intensive treatments.

Association between the oxidative balance score and testosterone deficiency: a cross-sectional study of the NHANES, 2011-2016

There is increasing recognition of the role of oxidative balance in testosterone deficiency (TD). This study investigates the association between the oxidative balance score (OBS) and TD prevalence among adult males in the United States. Data were obtained from a cross-sectional study of 3276 adult men in the 2011-2016 National Health and Nutrition Examination Survey. OBS was assessed based on 16 nutrient and 4 lifestyle components. Multivariate logistic regression and subgroup analyses were conducted to calculate the odds ratios (OR) and 95% confidence intervals (CI) for the association between OBS and TD prevalence. After adjusting for potential confounders, a negative linear association was observed between OBS and TD prevalence (OR = 0.98, 95% CI 0.97-1.00). Participants in the highest OBS tertile had lower odds of TD compared to those in the lowest tertile (OR = 0.92, 95% CI 0.69-1.21). Lifestyle components of OBS were significantly associated with lower TD prevalence (OR = 0.85, 95% CI 0.81-0.90). Furthermore, least absolute shrinkage and selection operator regression identified key OBS components most strongly associated with TD, with physical activity exerting the greatest influence. A predictive nomogram model incorporating these components demonstrated a discriminatory power with an area under the curve of 0.744 (95% CI 72.4-76.4%). In conclusion, this study demonstrates an inverse association between OBS and TD prevalence, suggesting a potential role of oxidative balance in testosterone regulation among US males.

Sex-specific associations of neurodegeneration and inflammatory biomarkers with intrinsic capacity in older adults: Findings from the 4-year longitudinal Multidomain Alzheimer's Prevention Trial (MAPT)

This four-year longitudinal study investigated whether the cross-sectional and longitudinal associations of inflammation-related and neurodegenerative-related blood biomarkers with intrinsic capacity differ according to sex. The sample comprised 1117 older adults (<70 years, 63.8 % females) from the Multidomain Alzheimer's Prevention Trial (MAPT). The domains of intrinsic capacity were operationalized as cognition (Mini-Mental State Examination), locomotion (Short Physical Performance Battery), vitality (Handgrip Strength), and psychological well-being (Geriatric Depression Scale), each scaled from 0 (worst intrinsic capacity possible) to 100 (best intrinsic capacity possible). Plasma biomarkers included interleukin 6 (picograms per milliliter), growth differentiation factor-15 (picograms per milliliter), tumor necrosis factor receptor 1 (picograms per milliliter), neurofilament light chain (picograms per milliliter), progranulin (nanograms per milliliter), and amyloid-beta ratio. Linear mixed models were analyzed to examine whether sex modified the cross-sectional and longitudinal association between biomarkers and intrinsic capacity. No significant interaction effect was observed at baseline. Longitudinal analyses revealed a significant interaction between sex and interleukin 6 (p = .005), such that higher levels of interleukin 6 tended to be associated with a faster decline in intrinsic capacity for males (B = -0.385; p = .055; 95 % CI = -0.778; 0.008) but not for females (B = 0.287; p = .041; 95 % CI = 0.011; 0.563). The other biomarkers had no sex-dependent associations with intrinsic capacity. A potential sex-dependent effect of the inflammatory status on intrinsic capacity must be further investigated. Clinical trial registration with ClinicalTrials.govNCT00672685.

Progesterone suppresses rhinovirus-induced airway inflammation by inhibiting neutrophil infiltration and extracellular traps formation

BACKGROUND

The process of NETosis is observed in a range of inflammatory conditions. Progesterone (P4) has been shown to alleviate inflammation caused by viral infections such as influenza and SARS-CoV-2. However, the precise molecular mechanisms responsible for this effect are not yet fully understood. Therefore, the present investigation aims to explore whether P4 can exert its anti-inflammatory properties by inhibiting NETosis and the related molecular pathways.

METHODS

Airway inflammation caused by rhinovirus serotype-1b (RV-1b) was induced in male BALB/c mice. The inflammation was assessed through histological examination and calculation of inflammatory cells present in the bronchoalveolar lavage fluid. Flow cytometry was used to analyze the inflammatory cells and NETotic neutrophils. Western blotting analysis was conducted to detect proteins associated with NETosis, inflammasome activation, and signaling. Furthermore, confocal microscopy was utilized to observe neutrophil extracellular trap (NET) structures in vivo tissues and in vitro neutrophils, neutrophil infiltration, and inflammasome formation.

RESULTS

The administration of P4 proved to be an effective treatment for reducing airway inflammation and the production of NETs caused by RV-1b infection. The infection triggered the activation of NLRP3 inflammasomes in neutrophils, which led to the maturation of IL-1β and subsequent activation of both the NF-κB and p38 signaling pathways. The activation of NF-κB signaling resulted in the secretion of downstream chemokines CCL3 and IL-6, which led to an increase in neutrophil infiltration into the lung airways. Moreover, the activation of p38 signaling led to the generation of reactive oxygen species, resulting in NETosis. However, the administration of P4 inhibited the activation of the NLRP3 inflammasome, which subsequently led to the deactivation of both the IL-1β-NF-κB and IL-1β-p38 axes. As a result, there was a reduction in neutrophil infiltration and NETosis. Furthermore, TGF-β-activated kinase 1 (TAK1) was identified as an intermediary enzyme. P4 inhibits both the NF-κB and IL-1β-p38 pathways by suppressing the activity of TAK1.

CONCLUSION

The capacity of P4 to mitigate rhinovirus-induced airway inflammation is attributed to its ability to impede the infiltration of neutrophils and NETosis. As inflammation mediated by NETosis is widespread in diverse disorders, our findings propose that P4 could potentially function as a universal therapeutic agent in the management of such ailments.

The relationship between remnant cholesterol and low testosterone in adult males

BACKGROUND

Remnant cholesterol (RC) is the cholesterol of triglyceride-rich lipoproteins, which has a high degree of atherogenic effect.

AIM

This study investigates the association between RC and low testosterone in male adults in the United States.

METHODS

Data were drawn from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 and 2015-2016 cycles, focusing on males aged over 20. RC was measured as the difference between total cholesterol (TC) and the sum of high-density lipoprotein cholesterol (HDL-c) and low-density lipoprotein cholesterol (LDL-c). Analyses between RC and low testosterone included logistic regression, subgroup assessment, smooth curve fitting, and mediation analysis.

OUTCOMES

Low testosterone was defined by a serum testosterone level below 300 ng/dL in male adults.

RESULTS

Out of the 2248 participants, 442 exhibited low testosterone levels. Those deficient in testosterone demonstrated notably higher RC levels (P < 0.001). A direct relationship between RC and low testosterone was evident (OR = 1.02, 95% CI: 1.01-1.03, P < 0.001), and smooth curve fitting revealed a linear trend. Subgroup analysis did not identify any special populations. Moreover, body mass index (BMI) and HOMA-IR was found to partially mediate this relationship.

CLINICAL IMPLICATIONS

Evaluating low testosterone in individuals with high RC levels can be beneficial. Similarly, monitoring lipid profiles, particularly RC levels, in patients with low testosterone might be important for preventing cardiovascular diseases.

STRENGTHS & LIMITATIONS

This study uses data from NHANES, which is nationally representative and has a large sample size. However, the causal relationship needs further investigation due to the cross-sectional design of this study.

CONCLUSION

This nationwide study provides initial evidence of a close correlation between RC and the risk of low testosterone.

An update on the role of sex hormones in the function of the cardiorenal mitochondria

Multiple studies have highlighted the crucial role of mitochondrial bioenergetics in understanding the progression of cardiorenal diseases, revealing new potential treatment targets related to mitochondrial metabolism. There are well-established sexual dimorphisms in cardiac and renal physiology, with premenopausal females being generally protected from pathology compared with males. The mechanisms of this protection remain to be fully elucidated, however, they clearly depend, at least in part, on sex hormones. Sex hormones contribute to regulating mitochondrial function, and vice versa, highlighting the existence of a bidirectional relationship pivotal for cellular energy metabolism; however, there are still large gaps in knowledge when the sex differences in mitochondrial bioenergetics in health and disease are concerned. This manuscript provides an overview of the new evidence that has been accumulated regarding the role of sex hormones in renal and cardiac mitochondria-dependent cellular energetics, metabolism, and signaling, mainly focusing on the data obtained within the last 3-5 years. We briefly discuss mitochondrial function and different types of sex hormones for the reader and then focus on novel research underscoring the emerging mitochondrial pathways regulated by sex hormones, which might be of interest for the development of novel therapeutic strategies for cardiorenal conditions.

Unraveling the complexity of the impact of physical exercise on male reproductive functions: a review of both sides of a coin

Regular exercise is widely recognized for its numerous physical and mental benefits, but its effects on male reproductive health are less understood. This review aims to summarize the current evidence on the impact of exercise on male reproduction, including reproductive hormone regulation, spermatogenesis sperm quality, and fertility. Moderate exercise improves sperm quality, increasing count, motility, and morphology, while excessive and severe exercise may have detrimental effects. Exercise positively influences fertility by reducing oxidative stress and enhancing sperm DNA integrity. Regular physical activity regulates reproductive hormones, including testosterone, follicle-stimulating hormone, and luteinizing hormone. Exercise-induced weight management and improved insulin sensitivity also contribute to better reproductive health. In conclusion, exercise has a profound impact on male reproductive health, with moderate physical activity promoting improved hormonal balance, sperm quality, and fertility. However, severe/excessive exercise exerts negative effects. These findings imply that a balanced exercise routine, usually mild to moderate, combined with a healthy lifestyle is essential for optimal male reproductive health. However, once exercise is severe and prolonged, it could impair male reproductive health. Further research is needed to understand the mechanisms underlying the exercise-reproduction relationship fully.

Testosterone therapy for functional hypogonadism in middle-aged and elderly males: current evidence and future perspectives

Population aging is a global phenomenon driving research focus toward preventing and managing age-related disorders. Functional hypogonadism (FH) has been defined as the combination of low testosterone levels, typically serum total testosterone below 300-350 ng/dL, together with manifestations of hypogonadism, in the absence of an intrinsic pathology of the hypothalamic-pituitary-testicular (HPT) axis. It is usually seen in middle-aged or elderly males as a product of aging and multimorbidity. This age-related decline in testosterone levels has been associated with numerous adverse outcomes. Testosterone therapy (TTh) is the mainstay of treatment for organic hypogonadism with an identifiable intrinsic pathology of the HPT axis. Current guidelines generally make weak recommendations for TTh in patients with FH, mostly in the presence of sexual dysfunction. Concerns about long-term safety have historically limited TTh use in middle-aged and elderly males with FH. However, recent randomized controlled trials and meta-analyses have demonstrated safe long-term outcomes regarding prostatic and cardiovascular health, together with decreases in all-cause mortality and improvements in various domains, including sexual function, body composition, physical strength, bone density, and hematopoiesis. Furthermore, there are numerous insightful studies suggesting additional benefits of TTh, for instance in cardio-renal-metabolic conditions. Specifically, future trials should investigate the role of TTh in improving symptoms and prognosis in various clinical contexts, including sarcopenia, frailty, dyslipidemia, arterial hypertension, diabetes mellitus, fracture risk, heart failure, stable angina, chronic kidney disease, mood disorders, and cognitive dysfunction.

Testosterone and estradiol reduce inflammation of human macrophages induced by anti-SARS-CoV-2 IgG

COVID-19, the disease caused by SARS-CoV-2, particularly causes severe inflammatory disease in elderly, obese, and male patients. Since both aging and obesity are associated with decreased testosterone and estradiol expression, we hypothesized that decreased hormone levels contribute to excessive inflammation in the context of COVID-19. Previously, we and others have shown that hyperinflammation in severe COVID-19 patients is induced by the production of pathogenic anti-spike IgG antibodies that activate alveolar macrophages. Therefore, we developed an in vitro assay in which we stimulated human macrophages with viral stimuli, anti-spike IgG immune complexes, and different sex hormones. Treatment with levels of testosterone reflecting young adults led to a significant reduction in TNF and IFN-γ production by human macrophages. In addition, estradiol significantly attenuated the production of a very broad panel of cytokines, including TNF, IL-1β, IL-6, IL-10, and IFN-γ. Both testosterone and estradiol reduced the expression of Fc gamma receptors IIa and III, the two main receptors responsible for anti-spike IgG-induced inflammation. Combined, these findings indicate that sex hormones reduce the inflammatory response of human alveolar macrophages to specific COVID-19-associated stimuli, thereby providing a potential immunological mechanism for the development of severe COVID-19 in both older male and female patients.

The long noncoding RNA (LINC-RBE) expression in testicular cells is associated with aging of the rat

Long noncoding RNAs (lncRNAs) are important regulatory biomolecules responsible for many cellular processes. The aging of mammals is manifested by a slow and gradual decline of physiological functions after adulthood, progressively resulting in age-related diseases. Testis comprises different cell-types with defined functions for producing haploid gametes and androgens in males, contributing gene-pool to the next generation with genetic variations to species for evolutionary advantage. The LINC-RBE (long intergenic noncoding-rat brain expressed) RNA showed highest expression in the Leydig cells, responsible for steroidogenesis and production of testosterone; higher expression in primary spermatocytes (pachytene cells), responsible for generation of haploid gametes and high expression in Sertoli cells, the nursing cells of the testes. Testes of immature (4-weeks), adult (16- and 44-weeks), and nearly-old (70-weeks) rats showed low, high, and again low levels of expression, respectively. This along with the nuclear-cytoplasmic localization of LINC-RBE RNA showed age-related expression and function. Thus, expression of LINC-RBE is involved in the molecular physiology of testes, especially Leydig cells, primary spermatocytes, and Sertoli cells. The decline in its expression correlates with diminishing reproductive function of the testes during aging of the rat.

Sirt1 m6A modification-evoked Leydig cell senescence promotes Cd-induced testosterone decline

Diminished testosterone levels have been documented as a key factor in numerous male health disorders. Both human and animal studies have consistently demonstrated that cadmium (Cd), a pervasive environmental heavy metal, results in decreased testosterone levels. However, the exact mechanism through which Cd interferes with testosterone synthesis remains incompletely elucidated. This research sought to examine the impact of cellular senescence on Cd-suppressed testosterone synthesis. We also investigated the related m6A modification mechanism. The results demonstrated that Cd (100 mg/L) led to a decrease in testosterone levels, along with downregulated expression of testosterone synthase in C57BL/6 N male mice. Furthermore, Cd significantly increased β-galactosidase staining intensity, senescence-related proteins, and senescence-related secretory phenotypes in mouse testicular Leydig cells. Subsequent investigations revealed that Cd decreased the mRNA and protein levels of NAD-dependent deacetylase Sirtuin-1 (SIRT1) in Leydig cells. Mechanistically, mice treated with resveratrol (50 mg/kg), a specific SIRT1 activator, mitigated Leydig cell senescence and reversed Cd-reduced testosterone levels in mouse testes. These effects were also restored by SIRT1 overexpression in Leydig cells. Additionally, we found that Cd increased the level of methyltransferase enzyme METTL3 and Sirt1 m6A modification in Leydig cells. Mettl3 siRNA effectively restored Cd-enhanced Sirt1 m6A level and reversed Cd-downregulated Sirt1 mRNA expression in Leydig cells. Overall, our findings suggest that Cd exposure inhibits testosterone synthesis via Sirt1 m6A modification-mediated senescence in mouse testes. These results offer an experimental basis for investigating the causes and potential treatments of hypotestosteronemia induced by environmental factors.

A gender-based analysis of retinal microvascular alterations in patients with diabetes mellitus using OCT angiography

PURPOSE

To assess the difference in microvascular changes between males and females with diabetes mellitus (DM) without diabetic retinopathy (NoDR) and with mild-to-moderate non-proliferative diabetic retinopathy (NPDR) using Optical Coherence Tomography Angiography (OCT-A).

DESIGN

Retrospective cross-sectional study.

METHODS

267 DM patients, 133 females (49.81 %), 111 with NoDR (41.57 %) and 156 NPDR (58.43 %) were included. Foveal-centered 3 × 3 mm OCT-A images corresponding to the superficial (SCP), intermediate (ICP) and deep capillary plexus (DCP), and full retinal (RET) slab were used for analysis. For each slab, FAZ area, perimeter, and circularity index (CI) were determined, following manual delineation of the FAZ; perfusion (PD) and vessel density (VD), fractal dimension (FD), vessel length density (VLD), geometric perfusion deficits (GPD) were also computed. Flow voids (FV) were determined in the choriocapillaris plexus; and perfused capillary density (PCD) in the RET slab.

RESULTS

Females showed larger FAZ CI in SCP and greater FAZ area and perimeter than males in NPDR group. Males had higher central macular thickness than females in NPDR group. All density metrics at the level of ICP and DCP were affected in the NPDR group with no gender differences. Of note, the same significant findings were found in type 1 DM patients, and not in type 2 DM patients.

CONCLUSIONS

Our OCT-A findings suggest significant microvascular changes in females with NPDR compared to males, but no such differences in patients without DR. Therefore, gender-related vascular alterations might be present in early stages of DR with potential role.

Effects of Heat Stress-Induced Sex Hormone Dysregulation on Reproduction and Growth in Male Adolescents and Beneficial Foods

Heat stress due to climate warming can significantly affect the synthesis of sex hormones in male adolescents, which can impair the ability of the hypothalamus to secrete gonadotropin-releasing hormone on the hypothalamic-pituitary-gonadal axis, which leads to a decrease in luteinizing hormone and follicle-stimulating hormone, which ultimately negatively affects spermatogenesis and testosterone synthesis. For optimal spermatogenesis, the testicular temperature should be 2-6 °C lower than body temperature. Heat stress directly affects the testes, damaging them and reducing testosterone synthesis. Additionally, chronic heat stress abnormally increases the level of aromatase in Leydig cells, which increases estradiol synthesis while decreasing testosterone, leading to an imbalance of sex hormones and spermatogenesis failure. Low levels of testosterone in male adolescents lead to delayed puberty and incomplete sexual maturation, negatively affect height growth and bone mineral density, and can lead to a decrease in lean body mass and an increase in fat mass. In order for male adolescents to acquire healthy reproductive capacity, it is recommended to provide sufficient nutrition and energy, avoid exposure to heat stress, and provide foods and supplements to prevent or repair testosterone reduction, germ cell damage, and sperm count reduction caused by heat stress so that they can enter a healthy adulthood.

Novel predictive factor for erectile dysfunction: systemic immune inflammation index

Systemic immune inflammation index (SII) is a global parameter that comprehensively reflects body inflammation, this study aims to assess the correlation between this index and erectile dysfunction (ED). This cross-sectional study incorporated 164 ED patients and 95 healthy adult males. The collection of general demographic information and pertinent hematological data from the participants enabled the computation of corresponding SII values. Statistical analysis, encompassing descriptive statistics as well as normality and logistic regression analyses, was carried out employing SPSS version 26. The findings of the univariate analysis revealed a noteworthy distinction in triglyceride levels (TG) (P = 0.017) and SII (P < 0.001) between ED patients and the healthy population. Subsequent multivariate logistic regression analysis unveiled a significant association between SII (odd ratio (OR):1.012, 95% confidence interval (CI):1.008-1.015; P < 0.001) and the occurrence of ED. Since the impact value is not clearly visible, SII/100 is utilized to magnify the effect value one hundredfold. The regression analysis results indicate that the OR value of SII/100 is 3.171, and the 95% CI is 2.339-4.298 (P < 0.001). The Receiver Operating Characteristic (ROC) curve analysis ascertained an AUC of 0.863 (P < 0.001) for SII, with a determined cut-off value of 391.53(109/L), exhibiting a sensitivity of 81.7% and specificity of 83.2%. Moreover, when comparing patients with varying degrees of ED severity, both univariate (P < 0.001) and subsequent multivariate logistic regression analyses (OR: 1.007, 95% CI: 1.004-1.010; P < 0.001) underscored the significance of the SII value. At this point, SII/100 OR: 1.971, 95% CI: 1.508-2.576 (P < 0.001). The ROC curve analysis in this context demonstrated an AUC of 0.799 (P < 0.001), with a determined cut-off value of 746.63(109/L), featuring a sensitivity of 60.6% and specificity of 91.6%. These discerned outcomes affirm a correlation between SII and ED, establishing its potential not only in predicting the onset of ED but also in differentiating among various levels of ED severity.

Testosterone Inhibits Lipid Accumulation in Porcine Preadipocytes by Regulating ELOVL3

Castration is commonly used to reduce stink during boar production. In porcine adipose tissue, castration reduces androgen levels resulting in metabolic disorders and excessive fat deposition. However, the underlying detailed mechanism remains unclear. In this study, we constructed porcine preadipocyte models with and without androgen by adding testosterone exogenously. The fluorescence intensity of lipid droplet (LD) staining and the fatty acid synthetase (FASN) mRNA levels were lower in the testosterone-treated cells than in the untreated control cells. In contrast, the mRNA levels of adipose triglycerides lipase (ATGL) and androgen receptor (AR) were higher than in the testosterone-treated cells than in the control cells. Subsequently, transcriptomic sequencing of porcine preadipocytes incubated with and without testosterone showed that the mRNA expression levels of very long-chain fatty acid elongase 3 (ELOVL3), a key enzyme involved in fatty acids synthesis and metabolism, were high in control cells. The siRNA-mediated knockdown of ELOVL3 reduced LD accumulation and the mRNA levels of FASN and increased the mRNA levels of ATGL. Next, we conducted dual-luciferase reporter assays using wild-type and mutant ELOVL3 promoter reporters, which showed that the ELOVL3 promoter contained an androgen response element (ARE); furthermore, its transcription was negatively regulated by AR overexpression. In conclusion, our study reveals that testosterone inhibits fat deposition in porcine preadipocytes by suppressing ELOVL3 expression. Moreover, our study provides a theoretical basis for further studies on the mechanisms of fat deposition caused by castration.

Leptin Is Associated with Testosterone, Nutritional Markers, and Vascular Muscular Dysfunction in Chronic Kidney Disease

Chronic kidney disease (CKD) causes specific hormonal disturbances, such as variations in leptin and testosterone levels and function. These disturbances can promote errors in signaling interaction and cellular information processing and can be implicated in the pathogenesis of atherosclerosis. This study investigates the factors that affect leptin in CKD patients and examines how leptin is related to markers of vascular disease. We conducted a cross-sectional study of 162 patients with CKD in pre-dialysis and dialysis stages. We recorded clinical and laboratory data, including leptin, testosterone, and subclinical atherosclerosis markers like brachial-ankle pulse wave velocity (ba PWV) in pre-dialysis CKD patients and flow-mediated vasodilation (FMD) and nitroglycerin-mediated vasodilation (NMD) in hemodialysis (HD) patients. Leptin was significantly correlated with testosterone in CKD pre-dialysis stages (p < 0.001) and also in HD (p = 0.026), with adipose tissue mass in pre-dialysis stages (p < 0.001), and also in HD (p < 0.001). In women HD patients, leptin correlated with NMD (p = 0.039; r = -0.379); in all HD patients, leptin correlated with C reactive protein (p = 0.007; r = 0.28) and parathormone (p = 0.039; r = -0.220). Our research emphasizes the connection between leptin, adipose tissue, and testosterone in all stages of CKD. Leptin was associated with NMD in HD women and correlated with inflammatory syndrome and parathyroid hormone in all HD patients.

Aging in Ocular Blood Vessels: Molecular Insights and the Role of Oxidative Stress

Acknowledged as a significant pathogenetic driver for numerous diseases, aging has become a focal point in addressing the profound changes associated with increasing human life expectancy, posing a critical concern for global public health. Emerging evidence suggests that factors influencing vascular aging extend their impact to choroidal and retinal blood vessels. The objective of this work is to provide a comprehensive overview of the impact of vascular aging on ocular blood vessels and related diseases. Additionally, this study aims to illuminate molecular insights contributing to vascular cell aging, with a particular emphasis on the choroid and retina. Moreover, innovative molecular targets operating within the domain of ocular vascular aging are presented and discussed.

Understanding One Half of the Sex Difference Equation: The Modulatory Effects of Testosterone on Diabetic Cardiomyopathy

Diabetes is a prevalent disease, primarily characterized by high blood sugar (hyperglycemia). Significantly higher rates of myocardial dysfunction have been noted in individuals with diabetes, even in those without coronary artery disease or high blood pressure (hypertension). Numerous molecular mechanisms have been identified through which diabetes contributes to the pathology of diabetic cardiomyopathy, which presents as cardiac hypertrophy and fibrosis. At the cellular level, oxidative stress and inflammation in cardiomyocytes are triggered by hyperglycemia. Although males are generally more likely to develop cardiovascular disease than females, diabetic males are less likely to develop diabetic cardiomyopathy than are diabetic females. One reason for these differences may be the higher levels of serum testosterone in males compared with females. Although testosterone appears to protect against cardiomyocyte oxidative stress and exacerbate hypertrophy, its role in inflammation and fibrosis is much less clear. Additional preclinical and clinical studies will be required to delineate testosterone's effect on the diabetic heart.

The roles of sex hormones in the pathophysiology of age-related sarcopenia and frailty

Background

Sarcopenia is an age-related condition characterized by a progressive and systemic decline in skeletal muscle mass, quality, and strength. The incidence of sarcopenia contains sex-specific aspects, indicating the contribution of sex hormones to its pathophysiology. This review focuses on changing trends in sarcopenia, discusses alterations in definitions and diagnostic criteria, and emphasizes the association between sarcopenia and sex hormones.

Methods

A literature search was performed on PubMed for related articles published between 1997 and December 2023 using appropriate keywords.

Main Findings Results

Advances in research have emphasized the significance of muscle quality and strength over muscle mass, resulting in new diagnostic criteria for sarcopenia. Androgens demonstrated anabolic effects on skeletal muscles and played a significant role in the pathophysiology of sarcopenia. In clinical settings, androgen replacement therapy has exhibited certain positive outcomes for treating sarcopenia, despite concerns about potential side effects. Conversely, estrogen is involved in skeletal muscle maintenance, but the detailed mechanisms remain unclear. Moreover, results regarding the clinical application of estrogen replacement therapy for treating sarcopenia remained inconsistent.

Conclusion

The elucidation of molecular mechanisms that involve sex hormones is eagerly awaited for novel therapeutic interventions for sarcopenia.

Chronic stress-induced anxiety-like behavior, hippocampal oxidative, and endoplasmic reticulum stress are reversed by young plasma transfusion in aged adult rats

Objectives

Aging and stress synergistically induce behavioral dysfunctions associated with oxidative and endoplasmic reticulum (ER) stress in brain regions. Considering the rejuvenating effects of young plasma on aging brain function, in the current study, we examined the effects of young plasma administration on anxiety-like behavior, NADH oxidase, NADPH oxidase, and ER stress markers in the hippocampus of old male rats.

Materials and Methods

Young (3 months old) and aged (22 months old) rats were randomly assigned into five groups: young control (Y), aged control (A), aged rats subjected to chronic stress for four weeks (A+S), aged rats subjected to chronic stress and treated with old plasma (A+S+OP), and aged rats subjected to chronic stress and treated with young plasma (A+S+YP). Systemic injection of (1 ml) young and old plasma was performed for four weeks (3 times/week).

Results

Young plasma transfusion significantly improved anxiety-like behavior in aged rats and modulated oxidative stress in the hippocampus, evidenced by the increased NADH oxidase (NOX) activity and the reduced NADPH oxidase. In addition, the levels of C/EBP homologous protein (CHOP) and Glucose-Regulated Protein 78 (GRP-78), as ER stress markers, markedly reduced in the hippocampus following the administration of young plasma.

Conclusion

These findings suggest that young plasma transfusion could reverse anxiety-like behavior in stress-exposed aged rats by modulating the hippocampal oxidative and ER stress markers.

Development and Validation of a Risk Prediction Model for Frailty in Patients with Chronic Diseases

The occurrence rate of frailty is high among patients with chronic diseases. However, the assessment of frailty among these patients is still far from being a routine part of clinical practice. The aim of this study is to develop a validated predictive model for assessing frailty risk in patients with chronic illnesses. This study recruited 543 patients with chronic diseases, and 237 were included in the development and validation of the predictive model. A total of 57 frailty related indicators were analyzed, encompassing sociodemographic variables, health status, physical measurements, nutritional assessment, physical activity levels, and blood biomarkers. There were 100 cases (42.2%) presenting frailty symptoms. Multivariate logistic regression analysis revealed that gender, age, chronic diseases, Mini Nutritional Assessment score, and Clinical Frailty Scale score were predictive factors for frailty in chronic disease patients. Utilizing these factors, a nomogram model demonstrated good consistency and accuracy. The AUC values for the predictive model and validation set were 0.946 and 0.945, respectively. Calibration curves, ROC, and DCA indicated the nomogram had favorable predictive performance. Altogether, the comprehensive nomogram developed here is a promising and convenient tool for assessing frailty risk in patients with chronic diseases, aiding clinical practitioners in screening high-risk populations.

Hormonal assessment and body composition in young males with metabolic syndrome

OBJECTIVE

Aim: To determine the relationship between body composition and hormonal levels in young men with metabolic syndrome.

PATIENTS AND METHODS

Materials and Methods: 123 males with a mean age of 24.1 ± 4.3 years (33 with metabolic syndrome (MS group) and 90 healthy physically active men (control group) were recruited at the study of body composition and hormone status. The total testosterone, cortisol, and insulin in blood serum by ELISA, the body weight (kg), lean body mass (kg) and fat mass (kg, %) by bioimpedance analysis method were investigated.

RESULTS

Results: It was establish the significand difference the mean value of body composition (body weight, lean body weight, fat body mass (kg, %), testosterone, cortisol insulin, and glucose concentration between MS group and control group.

CONCLUSION

Conclusions: A present study established the significant correlation of testosterone, insulin, and glucose concentration with fat body mass in all participants (MS and control groups). The negativee effect of overweight (BMI > 25; FBM > 18 %) and obesity (BMI > 30; FBM > 25 %) for testosterone concentration was determined due to an increase of FBM > 20 % and insulin increasing > 9,0 μlU/l.

Autophagy-related 7 proteindependent autophagy mediates resveratrol-caused upregulation of mitochondrial biogenesis and steroidogenesis in aged Leydig cell

BACKGROUND

Mitochondrial dysfunction may contribute to decreased testosterone synthesis in aged Leydig cells. Resveratrol (RSV) as an antioxidant has been shown to exhibit multiple positive effects on mitochondrion, where steroidogenesis takes place. Whether RSV can improve steroidogenesis in aged testis is still unknown. This study investigates the effect of RSV on testosterone production during aging and corresponding changes in mitochondrial biogenesis and autophagy activity, which are closely associated with steroidogenesis. Whether ATG7, an important autophagy-related protein, functions in RSV-treated aged Leydig cells will also be explored.

METHODS AND RESULTS

Two-month-old male C57BL/6 mice were fed for 16 months by customized regular diet with or without RSV as diet supplement. Leydig cell line TM3 cells were treated with D-galactose to induce senescence, followed with or without RSV treatment. Results found that RSV supplement increased testosterone production in both aged mice and D-galactose-induced senescent Leydig cells. Western blot results revealed that RSV treatment elevated levels of steroidogenic rate-limiting enzymes StAR and 3β-HSD, as well as autophagy-related proteins LC3II, Beclin1, ATG5 and ATG7 and mitochondrial function-related proteins mtTFA and COXIV. However, after Atg7 was knocked down in senescent Leydig cells, even though RSV was added, levels of these proteins declined significantly, accompanied by decreased levels of mitochondrial transcript factors PGC-1α, mtTFA and NRF-1 and more fragmented mitochondria, demonstrating that Atg7 knockdown wrecked the protective effects of RSV on steroidogenesis in senescent Leydig cells.

CONCLUSION

ATG7-dependent autophagy plays a key role in RSV-brought testosterone production increase through regulating mitochondrial biogenesis in senescent Leydig cells.

Old muscle, new tricks: a clinician perspective on sarcopenia and where to next

PURPOSE OF REVIEW

This review offers a contemporary clinical approach to the recognition, prevention and management of sarcopenia, and discusses recent clinically relevant advances in the aetiopathogenesis of muscle ageing that may lead to future therapeutic targets.

RECENT FINDINGS

The key recent directions for sarcopenia are in the diagnosis, understanding molecular mechanisms and management. Regarding the recognition of the condition, it has become increasingly clear that different definitions hamper progress in understanding. Therefore, the Global Leadership in Sarcopenia has been established in 2022 to develop a universally accepted definition. Moreover, substantial work is occurring to understand the various roles and contribution of inflammation, oxidative stress, mitochondrial dysfunction and metabolic dysregulation on skeletal muscle function and ageing. Finally, the role of resistance-based exercise regimes has been continually emphasised. However, the role of protein supplementation and hormone replacement therapy (HRT) are still under debate, and current clinical trials are underway.

SUMMARY

With the global ageing of our population, there is increasing emphasis on maintaining good health. Maintenance of skeletal muscle strength and function are key to preventing frailty, morbidity and death.

Night shift work and serum markers of bone turnover in male shift workers

Night shift work is related to sleep disorders, disruption of circadian rhythm and low serum levels of vitamin D. It is known that all these conditions can adversely affect bone mass. The rate of bone turnover can be assessed through the measurement of molecules called bone turnover markers, including C-terminal telopeptide fragment of type I collagen (CTX) and procollagen type I N-terminal propeptide (P1NP). In this study, we evaluated the serum levels of CTX, P1NP and 25-Hydroxy Vitamin D in 82 male subjects (42 daytime workers and 40 night shift workers) to assess the possible risk of osteoporosis in male shift workers. Serum levels of CTX and P1NP were found to be higher in night shift workers than in daytime workers. No significant difference was found in vitamin D levels between night shift and daytime workers. The increased CTX and P1NP levels reveal a higher rate of bone turnover in night shift workers and thus a possible increased risk of osteoporosis in this category of workers compared with daytime workers. In view of this, our results highlight the importance of further studies investigating the bone health in male night shift workers.

Understanding the development of sarcopenic obesity

INTRODUCTION

Sarcopenic obesity (SarcO) is defined as the confluence of reduced muscle mass and function and excess body fat. The scientific community is increasingly recognizing this syndrome, which affects a subgroup of persons across their lifespans and places them at synergistically higher risk of significant medical comorbidity and disability than either sarcopenia or obesity alone. Joint efforts in clinical and research settings are imperative to better understand this syndrome and drive the development of urgently needed future interventions.

AREAS COVERED

Herein, we describe the ongoing challenges in defining sarcopenic obesity and the current state of the science regarding its epidemiology and relationship with adverse events. The field has demonstrated an emergence of data over the past decade which we will summarize in this article. While the etiology of sarcopenic obesity is complex, we present data on the underlying pathophysiological mechanisms that are hypothesized to promote its development, including age-related changes in body composition, hormonal changes, chronic inflammation, and genetic predisposition.

EXPERT OPINION

We describe emerging areas of future research that will likely be needed to advance this nascent field, including changes in clinical infrastructure, an enhanced understanding of the lifecourse, and potential treatments.

The frequency of sarcopenia has increased in patients with glomerulonephritis

AIM

Sarcopenia is defined as the loss of muscle mass and muscle strength, and its frequency increases in kidney patients. However, sarcopenia frequency in patients with glomerulonephritis is unknown. The present study aimed to investigate the frequency of sarcopenia in patients with glomerulonephritis and compare the results with the healthy population for the first time in the literature.

PATIENTS AND METHODS

A total of 110 participants, including 70 patients previously diagnosed with glomerulonephritis and 40 healthy individuals, were included in the study. The diagnosis of sarcopenia was made based on the EWSGOP 2 Criteria.

RESULTS

The mean age of the glomerulonephritis patients group was 39.3 ± 1.5. In the anthropometric measurements of the patients, walking speed was low in 50 patients (71.4%), muscle strength was decreased in 44 patients (62.9%), and sarcopenia was detected in 10 patients (14.3%) according to the EWGSOP 2 Criteria. Considering the anthropometric measurements of the control group, sarcopenia was not detected in any of the subjects according to the EWGSOP 2 Criteria.

CONCLUSION

The result of the present study revealed that the rate of sarcopenia was significantly higher in glomerulonephritis patients compared to the healthy population and that sarcopenia can also be observed even in middle age in this population. We think it would be beneficial for clinicians treating glomerulonephritis to be more careful regarding sarcopenia and keep these parameters in mind during treatment.

Effects on Bone and Muscle upon Treadmill Interval Training in Hypogonadal Male Rats

Testosterone deficiency in males is linked to various pathological conditions, including muscle and bone loss. This study evaluated the potential of different training modalities to counteract these losses in hypogonadal male rats. A total of 54 male Wistar rats underwent either castration (ORX, n = 18) or sham castration (n = 18), with 18 castrated rats engaging in uphill, level, or downhill interval treadmill training. Analyses were conducted at 4, 8, and 12 weeks postsurgery. Muscle force of the soleus muscle, muscle tissue samples, and bone characteristics were analyzed. No significant differences were observed in cortical bone characteristics. Castrated rats experienced decreased trabecular bone mineral density compared to sham-operated rats. However, 12 weeks of training increased trabecular bone mineral density, with no significant differences among groups. Muscle force measurements revealed decreased tetanic force in castrated rats at week 12, while uphill and downhill interval training restored force to sham group levels and led to muscle hypertrophy compared to ORX animals. Linear regression analyses showed a positive correlation between bone biomechanical characteristics and muscle force. The findings suggest that running exercise can prevent bone loss in osteoporosis, with similar bone restoration effects observed across different training modalities.

Role of sex hormones in diabetic nephropathy

Diabetic nephropathy (DN) is the most common microvascular complication in diabetes and one of the leading causes of end-stage renal disease. The standard treatments for patients with classic DN focus on blood glucose and blood pressure control, but these treatments can only slow the progression of DN instead of stopping or reversing the disease. In recent years, new drugs targeting the pathological mechanisms of DN (e.g., blocking oxidative stress or inflammation) have emerged, and new therapeutic strategies targeting pathological mechanisms are gaining increasing attention. A growing number of epidemiological and clinical studies suggest that sex hormones play an important role in the onset and progression of DN. Testosterone is the main sex hormone in males and is thought to accelerate the occurrence and progression of DN. Estrogen is the main sex hormone in females and is thought to have renoprotective effects. However, the underlying molecular mechanism by which sex hormones regulate DN has not been fully elucidated and summarized. This review aims to summarize the correlation between sex hormones and DN and evaluate the value of hormonotherapy in DN.