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Brzozowska MM, Bliuc D, Mazur A, Baldock PA, Eisman JA, Greenfield JR, Center JR. Sex-differential testosterone response to long-term weight loss. Int J Obes (Lond) 2024; 48:1481-1488. [PMID: 39014246 DOI: 10.1038/s41366-024-01591-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 07/07/2024] [Accepted: 07/10/2024] [Indexed: 07/18/2024]
Abstract
OBJECTIVES Obesity-associated gonadal dysfunction is a common comorbidity in patients seeking weight loss interventions. We examined the incremental effect of weight loss on gonadal axes in men and women over 3 years. Changes in sex hormones were compared between dietary intervention (Diet) and bariatric procedures: Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG) and laparoscopic adjustable gastric banding (LAGB). Additional analysis assessed changes in corticotropic, somatotropic and thyroid axes after weight loss interventions. METHODS This prospective, observational study included 61 adults with Body Mass Index >30 kg/m2, mean age 51 (SD = 11) years. Endocrine parameters were measured at baseline and at 6 timepoints over 36-months. RESULTS For each 1 kg of weight lost, between baseline and 36 months, total testosterone increased by 0.6% (95% CI: 0.2%, 1.0%, p = 0.002) in males and decreased by 0.8% (95% CI: -1.4%, -0.3%, p = 0.003) in females. These changes remained statistically significant when controlled for age and for menopausal status in females. At 36 months, in comparison with Diet, RYGB women had lower total testosterone by 54% (95% CI: -90%, -17%, p = 0.004), reduced free androgen index (FAI) by 65% (95% CI; -114%, -17%, p = 0.009) while SG had reduced FAI by 39% (95% CI; -77%, 0%, p = 0.05). No such differences between groups were noted for male subjects. Adrenocorticotropic hormone declined by 0.3% (95% CI: 0.0, -0.5%, p = 0.05), insulin-like growth factor-1 increased by 0.4% (95% CI; 0.2%, 0.7%, p = 0.005), without such thyrotrophin change for each 1 kg of weight loss, for entire cohort, over 36 months. CONCLUSIONS The testosterone changes observed in this study were proportional to the amount of weight loss. In females, reduction in androgens was independent of age and menopausal status and more pronounced after bariatric procedures. This study finding warrants further clinical research to explore an impact of androgen reduction on functional and cognitive status in postmenopausal women. The observed changes in pituitary hormones may contribute to the metabolic benefits of bariatric surgery.
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Affiliation(s)
- Malgorzata M Brzozowska
- Garvan institute of Medical Research, Darlinghurst, NSW, Australia.
- Sutherland and St George Hospitals, Caringbah, NSW, Australia.
- University of New South Wales Sydney, Faculty of Medicine, Sydney, NSW, Australia.
| | - Dana Bliuc
- Garvan institute of Medical Research, Darlinghurst, NSW, Australia
- University of New South Wales Sydney, Faculty of Medicine, Sydney, NSW, Australia
| | - Artur Mazur
- University of Rzeszow, Faculty of Medicine, Rzeszow, Poland
| | - Paul A Baldock
- Garvan institute of Medical Research, Darlinghurst, NSW, Australia
- University of New South Wales Sydney, Faculty of Medicine, Sydney, NSW, Australia
- University of Notre Dame Australia, School of Medicine Sydney, Sydney, NSW, Australia
| | - John A Eisman
- Garvan institute of Medical Research, Darlinghurst, NSW, Australia
- University of New South Wales Sydney, Faculty of Medicine, Sydney, NSW, Australia
- University of Notre Dame Australia, School of Medicine Sydney, Sydney, NSW, Australia
- St Vincent's Hospital Clinical School, Department of Endocrinology, Darlinghurst, NSW, Australia
| | - Jerry R Greenfield
- Garvan institute of Medical Research, Darlinghurst, NSW, Australia
- University of New South Wales Sydney, Faculty of Medicine, Sydney, NSW, Australia
- St Vincent's Hospital Clinical School, Department of Endocrinology, Darlinghurst, NSW, Australia
| | - Jacqueline R Center
- Garvan institute of Medical Research, Darlinghurst, NSW, Australia
- University of New South Wales Sydney, Faculty of Medicine, Sydney, NSW, Australia
- University of Notre Dame Australia, School of Medicine Sydney, Sydney, NSW, Australia
- St Vincent's Hospital Clinical School, Department of Endocrinology, Darlinghurst, NSW, Australia
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Shenoy MT, Mondal S, Fernandez CJ, Pappachan JM. Management of male obesity-related secondary hypogonadism: A clinical update. World J Exp Med 2024; 14:93689. [PMID: 38948417 PMCID: PMC11212738 DOI: 10.5493/wjem.v14.i2.93689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 04/22/2024] [Accepted: 05/15/2024] [Indexed: 06/19/2024] Open
Abstract
The global obesity pandemic has resulted in a rise in the prevalence of male obesity-related secondary hypogonadism (MOSH) with emerging evidence on the role of testosterone therapy. We aim to provide an updated and practical approach towards its management. We did a comprehensive literature search across MEDLINE (via PubMed), Scopus, and Google Scholar databases using the keywords "MOSH" OR "Obesity-related hypogonadism" OR "Testosterone replacement therapy" OR "Selective estrogen receptor modulator" OR "SERM" OR "Guidelines on male hypogonadism" as well as a manual search of references within the articles. A narrative review based on available evidence, recommendations and their practical implications was done. Although weight loss is the ideal therapeutic strategy for patients with MOSH, achievement of significant weight reduction is usually difficult with lifestyle changes alone in real-world practice. Therefore, androgen administration is often necessary in the management of hypogonadism in patients with MOSH which also improves many other comorbidities related to obesity. However, there is conflicting evidence for the appropriate use of testosterone replacement therapy (TRT), and it can also be associated with complications. This evidence-based review updates the available evidence including the very recently published results of the TRAVERSE trial and provides comprehensive clinical practice pearls for the management of patients with MOSH. Before starting testosterone replacement in functional hypogonadism of obesity, it would be desirable to initiate lifestyle modification to ensure weight reduction. TRT should be coupled with the management of other comorbidities related to obesity in MOSH patients. Balancing the risks and benefits of TRT should be considered in every patient before and during long-term management.
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Affiliation(s)
- Mohan T Shenoy
- Department of Endocrinology, Sree Gokulam Medical College, and Research Foundation, Trivandrum 695607, Kerala, India
| | - Sunetra Mondal
- Department of Endocrinology, NRS Medical College and Hospital, Kolkata 700014, West Bengal, India
| | - Cornelius James Fernandez
- Department of Endocrinology & Metabolism, Pilgrim Hospital, United Lincolnshire Hospitals NHS Trust, Boston PE21 9QS, United Kingdom
| | - Joseph M Pappachan
- Department of Endocrinology and Metabolism, Lancashire Teaching Hospitals NHS Trust, Preston PR2 9HT, United Kingdom
- Faculty of Science, Manchester Metropolitan University, Manchester M15 6BH, United Kingdom
- Faculty of Biology, Medicine & Health, The University of Manchester, Manchester M13 9PL, United Kingdom
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Santi D, Lotti F, Sparano C, Rastrelli G, Isidori AM, Pivonello R, Barbonetti A, Salonia A, Minhas S, Krausz C, Vignozzi L, Maggi M, Corona G. Does an increase in adipose tissue 'weight' affect male fertility? A systematic review and meta-analysis based on semen analysis performed using the WHO 2010 criteria. Andrology 2024; 12:123-136. [PMID: 37226894 DOI: 10.1111/andr.13460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/10/2023] [Accepted: 05/16/2023] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Obesity negatively impact on the metabolism of sex hormones, leading to reduced testosterone serum levels. However, how the obesity could negatively impact on the overall gonadal function, particularly on male fertility, remained unclear so far. OBJECTIVE To systematically review evidences regarding the influence of body weight excess on the sperm production. METHODS A meta-analysis was conducted, searching all prospective and retrospective observational studies reporting male subjects older than 18 years old, with body weight excess from overweight to severe obesity were considered. Only studies using the V edition of the World Health Organization (WHO) manual for semen analysis interpretation were considered. No specific interventions were considered. Search was focused on studies comparing overweight/obese to normal weight subjects. RESULTS Twenty-eight studies were considered. Total sperm count and sperm progressive motility were significantly lower in overweight compared to normal weight subjects. Meta-regression analyses demonstrated that patients' age impacted on sperm parameters. Similarly, obese men showed lower sperm concentration, total sperm number, progressive and total motilities, and normal morphology lower than normal weight subjects. Reduced sperm concentration in obese men was influenced by age, smoking habit, varicocele, and total testosterone serum levels at meta-regression analyses. CONCLUSIONS The male potential fertility is reduced in subjects with increased body weight, compared to normal weight men. The higher was the increased body weight, the worst was the sperm quantity/quality. This result comprehensively included obesity among non-communicable risk factor for male infertility, shedding new lights on the negative impact of increased body weight on overall gonadal function.
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Affiliation(s)
- Daniele Santi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Unit of Endocrinology, Department of Medical Specialties, AziendaOspedaliero-Universitaria of Modena, Modena, Italy
| | - Francesco Lotti
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Center for Prevention, Diagnosis and Treatment of Infertility, Careggi Hospital, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Clotilde Sparano
- Endocrinology Unit, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Giulia Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Center for Prevention, Diagnosis and Treatment of Infertility, Careggi Hospital, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Andrea M Isidori
- Department of Experimental Medicine, "Sapienza" University of Rome, Centre for Rare Diseases (Endo-ERN accredited), Policlinico Umberto I Hospital, Rome, Italy
| | - Rosario Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Diabetologia, Andrologia e Nutrizione, Unità di Andrologia e Medicina della Riproduzione e della Sessualità Maschile e Femminile, Università Federico II di Napoli, Naples, Italy
- UNESCO, Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy
| | - Arcangelo Barbonetti
- Andrology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Suks Minhas
- Department of Urology, Imperial College NHS Healthcare, London, UK
| | - Csilla Krausz
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Center for Prevention, Diagnosis and Treatment of Infertility, Careggi Hospital, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Linda Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Center for Prevention, Diagnosis and Treatment of Infertility, Careggi Hospital, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Mario Maggi
- Endocrinology Unit, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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Kummer KK, Mangweth-Matzek B. Male eating disorders in midlife-possible links between excessive sports and hormones. Aging Male 2023; 26:2154571. [PMID: 36790384 DOI: 10.1080/13685538.2022.2154571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Although eating disorders were long considered a typical female disorder, it is now clear that men are also affected. However, the literature on eating disorders in men is still very limited, and the actual extent is not known. Even less is known about the epidemiology of eating disorders in older individuals. In this focused review, we will present an update of the available data on disordered eating and eating disorders in middle-aged and older males. In addition, we will highlight the relationship of eating disorders with excessive sports as a purging method of choice for this age group and discuss the impact of age-related hormonal imbalances in aging men.
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Affiliation(s)
- Kai K Kummer
- Institute of Physiology, Medical University of Innsbruck, Innsbruck, Austria
- Department of Psychiatry, Psychotherapy, Psychosomatics and Psychological Medicine, University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Barbara Mangweth-Matzek
- Department of Psychiatry, Psychotherapy, Psychosomatics and Psychological Medicine, University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
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Al Amri A, Alshahrani MAA, Asiri MA, Abdulrahman MA, Alshehri AYA, Alqahtani MMM, Oraydan AAA, Summan SI, Alqahtani TS, Al Hunaif AM. Prevalence of Sleep Disorders Among Patients With Type 2 Diabetes Mellitus at Primary Healthcare Centers in the South Region of Abha City. Cureus 2023; 15:e44749. [PMID: 37809270 PMCID: PMC10556360 DOI: 10.7759/cureus.44749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
Background Type 2 diabetes is a chronic condition that affects the way the body processes blood sugar (glucose). This issue is of considerable importance in the field of public health, as it has a global impact on a substantial number of individuals. The primary emphasis in the management of type 2 diabetes is centered around achieving glycemic control, implementing lifestyle adjustments, and employing pharmaceutical therapies as preventive measures or for the purpose of managing problems that may arise as a result of the disease. Aim This research aimed to investigate the prevalence of sleep-belated issues among individuals diagnosed with type 2 diabetes. Methodology A total of 230 participants with type 2 diabetes patients of primary healthcare in Abha city whose age is ≥18 years were included in the study. The data collection process involved the distribution of a self-administered questionnaire that assessed various aspects of sleep disturbances, including difficulties in falling asleep, waking up during the night, excessive daytime sleepiness, and restless legs or leg muscle cramps. The questionnaire also collected demographic information and data on potential risk factors such as alcohol consumption, caffeine consumption, and smoking/tobacco product use. Data analysis was conducted using chi-square tests and significance levels were set at p < 0.05. Results The findings revealed a prevalence of sleep disturbances among individuals with type 2 diabetes. Difficulties in falling asleep and waking up during the night were reported by a substantial proportion of participants, and a notable number experienced excessive daytime sleepiness. Restless legs or leg muscle cramps that interrupted sleep were experienced occasionally by 16.5% and frequently by 8.7% of the participants. The study also found a significant association between the presence of sleep problems and lower sleep quality ratings. However, no significant associations were found between sleep disturbances and the duration of type 2 diabetes or the examined risk factors. Conclusion The findings from this study emphasize the detrimental effects of sleep disturbances on sleep quality and suggest that improving sleep quality can positively influence the overall health and well-being of individuals with type 2 diabetes.
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Affiliation(s)
- Ali Al Amri
- Family Medicine, Asir Central Hospital, Abha, SAU
| | | | - Mousa A Asiri
- Technician Pharmacy, Primary Care Center Al Mansak, Abha, SAU
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Cai Y, Liu P, Xu Y, Xia Y, Peng X, Zhao H, Chen Q. Biomarkers of obesity-mediated insulin resistance: focus on microRNAs. Diabetol Metab Syndr 2023; 15:167. [PMID: 37537674 PMCID: PMC10401761 DOI: 10.1186/s13098-023-01137-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/09/2023] [Indexed: 08/05/2023] Open
Abstract
Obesity and metabolic syndromes are becoming increasingly prevalent worldwide. Insulin resistance (IR) is a common complication of obesity. However, IR occurrence varies across individuals with obesity and may involve epigenetic factors. To rationalize the allocation of healthcare resources, biomarkers for the early risk stratification of individuals with obesity should be identified. MicroRNAs (miRNAs) are closely associated with metabolic diseases and involved in epigenetic regulation. In this review, we have summarized the changes in miRNA expression in the peripheral circulation and tissues of patients and animals with obesity-associated IR over the last 5 years and identified several candidate biomarkers that predict obesity-related IR. There are areas for improvement in existing studies. First, more than the predictive validity of a single biomarker is required, and a biomarker panel needs to be formed. Second, miRNAs are often studied in isolation and do not form a network of signaling pathways. We believe that early biomarkers can help clinicians accurately predict individuals prone to obesity-related IR at an early stage. Epigenetic regulation may be one of the underlying causes of different clinical outcomes in individuals with obesity. Future studies should focus on objectively reflecting the differences in miRNA profile expression in individuals with obesity-related IR, which may help identify more reliable biomarkers. Understanding the metabolic pathways of these miRNAs can help design new metabolic risk prevention and management strategies, and support the development of drugs to treat obesity and metabolic disorders.
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Affiliation(s)
- Yichen Cai
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Pan Liu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yumei Xu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuguo Xia
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Xiaowan Peng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Haiyan Zhao
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qiu Chen
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China.
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Spaziani M, Carlomagno F, Tarantino C, Angelini F, Vincenzi L, Gianfrilli D. New perspectives in functional hypogonadotropic hypogonadism: beyond late onset hypogonadism. Front Endocrinol (Lausanne) 2023; 14:1184530. [PMID: 37455902 PMCID: PMC10344362 DOI: 10.3389/fendo.2023.1184530] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023] Open
Abstract
Functional hypogonadotropic hypogonadism (FHH) is an increasingly frequent condition, whose pathological mechanisms are not yet fully clarified. The concept of FHH has now completely replaced that of late onset hypogonadism, that only concerned the ageing man. FHH is the result of an impairment of the hypothalamic-pituitary gonadal axis (HPG-A) function, resulting in decreased testosterone concentrations associated with low or inappropriately normal gonadotropin levels and infertility; it can be diagnosed once organic causes of hypogonadism are excluded. The growing occurrence of FHH derives from its association with widespread conditions, such as obesity and diabetes mellitus, but also to the increasing ease and frequency of use of several drugs, such as opioids, glucocorticoids, and sex steroids. Moreover, given the tendency of many subjects to excessive physical activity and drastic reduction in caloric intake, FHH may also be secondary to low energy availability. Finally, the association with HIV infection should not be overlooked. Therefore, there is an important variability in the diseases that can lead to FHH. Despite the heterogeneity of the underlying pathologies, the mechanisms leading to FHH would seem quite similar, with the initial event represented by the impairment at the HPG-A level. Nevertheless, many different biological pathways are involved in the pathogenesis of FHH, therefore the aim of the current paper is to provide an overview of the main relevant mechanisms, through a detailed analysis of the literature, focusing specifically on pathogenesis and clinical, diagnostic and therapeutic aspects.
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Affiliation(s)
- Matteo Spaziani
- Section of Medical Pathophysiology and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- Centre for Rare Diseases (Endo-ERN Accredited), Policlinico Umberto I, Rome, Italy
| | - Francesco Carlomagno
- Section of Medical Pathophysiology and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- Centre for Rare Diseases (Endo-ERN Accredited), Policlinico Umberto I, Rome, Italy
| | - Chiara Tarantino
- Section of Medical Pathophysiology and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- Centre for Rare Diseases (Endo-ERN Accredited), Policlinico Umberto I, Rome, Italy
| | - Francesco Angelini
- Section of Medical Pathophysiology and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- Centre for Rare Diseases (Endo-ERN Accredited), Policlinico Umberto I, Rome, Italy
| | - Ludovica Vincenzi
- Section of Medical Pathophysiology and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- Centre for Rare Diseases (Endo-ERN Accredited), Policlinico Umberto I, Rome, Italy
| | - Daniele Gianfrilli
- Section of Medical Pathophysiology and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- Centre for Rare Diseases (Endo-ERN Accredited), Policlinico Umberto I, Rome, Italy
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Ubuka T, Bu G, Tobari Y. Editorial: Stress and reproduction in animal models. Front Endocrinol (Lausanne) 2023; 14:1202275. [PMID: 37214241 PMCID: PMC10198259 DOI: 10.3389/fendo.2023.1202275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 04/18/2023] [Indexed: 05/24/2023] Open
Affiliation(s)
- Takayoshi Ubuka
- Initiative for Research and Development, International Cancer Laboratory Co., Ltd., Tokyo, Japan
| | - Guixian Bu
- College of Life Science, Sichuan Agricultural University, Ya’an, China
| | - Yasuko Tobari
- School of Veterinary Medicine Department of Animal Science and Biotechnology, Azabu University, Sagamihara, Japan
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Makhija N, Tayade S, Toshniwal S, Tilva H. Clinico-Metabolic Profile in Lean Versus Obese Polycystic Ovarian Syndrome Women. Cureus 2023; 15:e37809. [PMID: 37214034 PMCID: PMC10196695 DOI: 10.7759/cureus.37809] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/18/2023] [Indexed: 05/23/2023] Open
Abstract
Background Polycystic ovarian syndrome (PCOS), which affects women of reproductive age, is the most prevalent endocrine disorder. Signs of excessive androgen, irregular menses, prolonged anovulation, and infertility are characteristics of the clinical phenotype. Women with PCOS are more likely to have diabetes, obesity, dyslipidemia, hypertension, anxiety, and depression. PCOS affects women's health starting before conception and continuing through their post-menopausal years. Methods Ninety-six study subjects were recruited from women visiting the gynaecology clinic according to the Rotterdam criteria for PCOS. Study subjects were then divided into lean and obese groups according to their body mass index (BMI). Demographic data, and obstetrical and gynaecological history were obtained including marital status, menstrual cycle regularity, recent abnormal weight gain (in the preceding six months), and subfertility. To identify any clinical signs of hyperandrogenism such as acne, acanthosis nigricans, or hirsutism, a general and systemic examination was conducted. Data were analyzed after the clinico-metabolic profile was assessed, compared, and contrasted between the two groups. Results The findings showed a significant correlation between obese women with PCOS and the clinical profile of PCOS i.e. menstrual irregularities, acne vulgaris, acanthosis nigricans and hirsutism; the waist-hip ratio was higher in both groups. Higher levels of fasting insulin, fasting glucose: insulin ratio, postprandial sugars, homeostasis model assessment of insulin resistance (HOMA-IR) index, total testosterone, free testosterone, and luteinizing hormone/follicle-stimulating hormone (LH: FSH) ratio were seen in obese women with PCOS, whereas the levels of fasting glucose, serum triglycerides, serum high-density lipoprotein cholesterol (HDL) were higher in all the study subjects irrespective of BMI. Conclusion The study showed that women with PCOS have a deranged metabolic profile like abnormal blood sugar, insulin resistance (IR), and hyperandrogenemia with clinical derangements like irregular menses, subfertility, and recent weight gain more frequently with higher BMI.
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Affiliation(s)
- Nidhi Makhija
- Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Surekha Tayade
- Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shikha Toshniwal
- Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Hard Tilva
- Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Nikitina IM, Sуnkina AA, Yakymchuk YB, Sukhostavets NP, Kopytsia TV, Нerasymenko SF, Babar TV. MENSTRUAL DISORDER IN ADOLESCENTS DURING WAR. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 76:984-991. [PMID: 37326080 DOI: 10.36740/wlek202305115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The aim: To investigate the peculiarities of menstrual cycle disorders in teenagers against the background of excessive stress in order to develop a scientifically based set of measures for their correction. PATIENTS AND METHODS Materials and methods: 120 girls aged 9-18 who were in the war zone or became forced migrants were examined. Examination methods included anamnesis collection, assessment of psycho-emotional state, anthropometry, laboratory and instrumental studies. RESULTS Results: It was found that the frequency of menstrual cycle disorders in the subjects was 65.8% (n = 79). Among menstrual cycle disorders: dysmenorrhea - 45.6% (n = 36), excessive menstruation - 27.8% (n = 22), secondary amenorrhea - 26.6% (n = 21). 71.7% (n = 86) of the examinees noted a change in eating behavior over the past few months. Almost half of these children had dyshormonal disorders or met the criteria of metabolic syndrome - 45.3% (n = 39). CONCLUSION Conclusion: Timely detection and adequate correction of psycho-emotional and metabolic disorders in adolescent girls in stressful conditions contributes to the prevention of disorders of menstrual and reproductive function.
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Affiliation(s)
| | | | - Yulia B Yakymchuk
- TERNOPIL STATE MEDICAL UNIVERSITY NAMED AFTER I. YA. HORBACHEVSKI, TERNOPIL, UKRAINE
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Yao T, Song C, Yu Y, Cheng Y, Lu H, Li J, Yang Y, Tang D, Yi X. Diet and exercise interventions reduce serum asprosin and the corresponding hypothalamic– pituitary–gonad-axis dysfunction in obese men. Front Physiol 2022; 13:896735. [PMID: 36225310 PMCID: PMC9549162 DOI: 10.3389/fphys.2022.896735] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 09/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Asprosin (ASP) is a recently discovered adipocyte factor that participates in glucose metabolism and inflammatory reactions. Recent findings suggest that it may be involved in the regulation of sex hormone secretion in the hypothalamic-pituitary-gonad (HPG) axis, but no studies have been reported in related populations. The purpose of this study was to evaluate the changes in serum ASP levels in healthy men and obese men, as well as before and after exercise weight loss, and to investigate male hypogonadism, insulin resistance, inflammatory response, and relationships induced by ASP and obesity. Methods: Thirty-eight young male volunteers were recruited and divided into a normal group (n = 20) and an obese group (n = 18) according to their body mass index. Fourteen of the obese men underwent a 14-week exercise and diet intervention (first 8 weeks of aerobic exercise at 60%–70% HRmax for 30–50 min/4 days a week). Beginning at week 9, the intensity was increased to 75% HRmax. Participants in the obese groups maintained a calorie-restricted diet throughout the study period. Results: Serum ASP levels in the obese group were significantly higher than those in the normal group, and serum gonadotropin-releasing hormone (GnRh), luteinizing hormone (LH), and testosterone (T) levels were decreased. After 14 weeks of exercise and diet intervention, serum ASP decreased significantly, the levels of body weight, lean body weight, body fat rate, fasting insulin (FINS), homeostatic model assessment for insulin resistance, TNF-α, IL-6, and IL-1β decreased significantly, and the serum GnRH, LH, and T levels increased significantly. ASP was positively correlated with body weight, body fat percentage, FINS, tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-1β and negatively correlated with relative lean body weight and serum LH and T levels. Conclusion: The serum ASP levels were increased in obese men compared with those of normal weight individuals, resulting in a chronic inflammatory reaction, high serum insulin, and HPG axis injury. Fourteen weeks of exercise and diet intervention effectively alleviated this phenomenon. It has been speculated that ASP might regulate male reproductive function by regulating the inflammatory response and insulin sensitivity.
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Affiliation(s)
- Tingting Yao
- School of Physical Education, Liaoning Normal University, Dalian, Liaoning, China
| | - Chenglin Song
- Exercise and Health Research Center/Department of Kinesiology, Shenyang Sport University, Shenyang, Liaoning, China
| | - Yajie Yu
- Exercise and Health Research Center/Department of Kinesiology, Shenyang Sport University, Shenyang, Liaoning, China
| | - Yang Cheng
- Exercise and Health Research Center/Department of Kinesiology, Shenyang Sport University, Shenyang, Liaoning, China
| | - Hongyan Lu
- School of Physical Education, Liaoning Normal University, Dalian, Liaoning, China
| | - Jing Li
- School of Physical Education, Liaoning Normal University, Dalian, Liaoning, China
| | - Yang Yang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Donghui Tang
- Department of College of P.E and Sport, Beijing Normal University, Beijing, China
- *Correspondence: Donghui Tang, ; Xuejie Yi,
| | - Xuejie Yi
- Exercise and Health Research Center/Department of Kinesiology, Shenyang Sport University, Shenyang, Liaoning, China
- *Correspondence: Donghui Tang, ; Xuejie Yi,
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12
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de Siqueira Guedes J, Pla I, Sahlin KB, Monnerat G, Appelqvist R, Marko-Varga G, Giwercman A, Domont GB, Sanchez A, Nogueira FCS, Malm J. Plasma metabolome study reveals metabolic changes induced by pharmacological castration and testosterone supplementation in healthy young men. Sci Rep 2022; 12:15931. [PMID: 36151245 PMCID: PMC9508133 DOI: 10.1038/s41598-022-19494-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
Testosterone is a hormone that plays a key role in carbohydrate, fat, and protein metabolism. Testosterone deficiency is associated with multiple comorbidities, e.g., metabolic syndrome and type 2 diabetes. Despite its importance in many metabolic pathways, the mechanisms by which it controls metabolism are not fully understood. The present study investigated the short-term metabolic changes of pharmacologically induced castration and, subsequently, testosterone supplementation in healthy young males. Thirty subjects were submitted to testosterone depletion (TD) followed by testosterone supplementation (TS). Plasma samples were collected three times corresponding to basal, low, and restored testosterone levels. An untargeted metabolomics study was performed by liquid chromatography–high resolution mass spectrometry (UHPLC–HRMS) to monitor the metabolic changes induced by the altered hormone levels. Our results demonstrated that TD was associated with major metabolic changes partially restored by TS. Carnitine and amino acid metabolism were the metabolic pathways most impacted by variations in testosterone. Furthermore, our results also indicated that LH and FSH might strongly alter the plasma levels of indoles and lipids, especially glycerophospholipids and sphingolipids. Our results demonstrated major metabolic changes induced by low testosterone that may be important for understanding the mechanisms behind the association of testosterone deficiency and its comorbidities.
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Affiliation(s)
- Jéssica de Siqueira Guedes
- Laboratory of Proteomics, LADETEC, Institute of Chemistry, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-598, Brazil.,Proteomics Unit, Institute of Chemistry, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-909, Brazil
| | - Indira Pla
- Clinical Protein Science and Imaging, Department of Biomedical Engineering, Biomedical Centre, Lund University, BMC D13, 221 84, Lund, Sweden.,Section for Clinical Chemistry, Department of Translational Medicine, Lund University, Skåne University Hospital Malmö, 205 02, Malmö, Sweden
| | - K Barbara Sahlin
- Clinical Protein Science and Imaging, Department of Biomedical Engineering, Biomedical Centre, Lund University, BMC D13, 221 84, Lund, Sweden.,Section for Clinical Chemistry, Department of Translational Medicine, Lund University, Skåne University Hospital Malmö, 205 02, Malmö, Sweden
| | - Gustavo Monnerat
- Laboratory of Proteomics, LADETEC, Institute of Chemistry, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-598, Brazil.,National Institute of Cardiology, Rio de Janeiro, 22240-006, Brazil
| | - Roger Appelqvist
- Clinical Protein Science and Imaging, Department of Biomedical Engineering, Biomedical Centre, Lund University, BMC D13, 221 84, Lund, Sweden
| | - György Marko-Varga
- Clinical Protein Science and Imaging, Department of Biomedical Engineering, Biomedical Centre, Lund University, BMC D13, 221 84, Lund, Sweden.,First Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjiku Shinjiku-ku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Aleksander Giwercman
- Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, 214 28, Malmö, Sweden
| | - Gilberto Barbosa Domont
- Proteomics Unit, Institute of Chemistry, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-909, Brazil
| | - Aniel Sanchez
- Clinical Protein Science and Imaging, Department of Biomedical Engineering, Biomedical Centre, Lund University, BMC D13, 221 84, Lund, Sweden. .,Section for Clinical Chemistry, Department of Translational Medicine, Lund University, Skåne University Hospital Malmö, 205 02, Malmö, Sweden.
| | - Fábio César Sousa Nogueira
- Laboratory of Proteomics, LADETEC, Institute of Chemistry, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-598, Brazil. .,Proteomics Unit, Institute of Chemistry, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-909, Brazil.
| | - Johan Malm
- Clinical Protein Science and Imaging, Department of Biomedical Engineering, Biomedical Centre, Lund University, BMC D13, 221 84, Lund, Sweden.,Section for Clinical Chemistry, Department of Translational Medicine, Lund University, Skåne University Hospital Malmö, 205 02, Malmö, Sweden
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13
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Roa J, Ruiz-Cruz M, Ruiz-Pino F, Onieva R, Vazquez MJ, Sanchez-Tapia MJ, Ruiz-Rodriguez JM, Sobrino V, Barroso A, Heras V, Velasco I, Perdices-Lopez C, Ohlsson C, Avendaño MS, Prevot V, Poutanen M, Pinilla L, Gaytan F, Tena-Sempere M. Dicer ablation in Kiss1 neurons impairs puberty and fertility preferentially in female mice. Nat Commun 2022; 13:4663. [PMID: 35945211 PMCID: PMC9363423 DOI: 10.1038/s41467-022-32347-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/26/2022] [Indexed: 12/16/2022] Open
Abstract
Kiss1 neurons, producing kisspeptins, are essential for puberty and fertility, but their molecular regulatory mechanisms remain unfolded. Here, we report that congenital ablation of the microRNA-synthesizing enzyme, Dicer, in Kiss1 cells, causes late-onset hypogonadotropic hypogonadism in both sexes, but is compatible with pubertal initiation and preserved Kiss1 neuronal populations at the infantile/juvenile period. Yet, failure to complete puberty and attain fertility is observed only in females. Kiss1-specific ablation of Dicer evokes disparate changes of Kiss1-cell numbers and Kiss1/kisspeptin expression between hypothalamic subpopulations during the pubertal-transition, with a predominant decline in arcuate-nucleus Kiss1 levels, linked to enhanced expression of its repressors, Mkrn3, Cbx7 and Eap1. Our data unveil that miRNA-biosynthesis in Kiss1 neurons is essential for pubertal completion and fertility, especially in females, but dispensable for initial reproductive maturation and neuronal survival in both sexes. Our results disclose a predominant miRNA-mediated inhibitory program of repressive signals that is key for precise regulation of Kiss1 expression and, thereby, reproductive function.
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Affiliation(s)
- Juan Roa
- Instituto Maimónides de Investigación Biomédica de Córdoba, 14004, Córdoba, Spain. .,Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004, Córdoba, Spain. .,Hospital Universitario Reina Sofia, 14004, Córdoba, Spain. .,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 14004, Córdoba, Spain.
| | - Miguel Ruiz-Cruz
- Instituto Maimónides de Investigación Biomédica de Córdoba, 14004, Córdoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004, Córdoba, Spain.,Hospital Universitario Reina Sofia, 14004, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 14004, Córdoba, Spain
| | - Francisco Ruiz-Pino
- Instituto Maimónides de Investigación Biomédica de Córdoba, 14004, Córdoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004, Córdoba, Spain.,Hospital Universitario Reina Sofia, 14004, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 14004, Córdoba, Spain
| | - Rocio Onieva
- Instituto Maimónides de Investigación Biomédica de Córdoba, 14004, Córdoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004, Córdoba, Spain.,Hospital Universitario Reina Sofia, 14004, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 14004, Córdoba, Spain
| | - Maria J Vazquez
- Instituto Maimónides de Investigación Biomédica de Córdoba, 14004, Córdoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004, Córdoba, Spain.,Hospital Universitario Reina Sofia, 14004, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 14004, Córdoba, Spain
| | - Maria J Sanchez-Tapia
- Instituto Maimónides de Investigación Biomédica de Córdoba, 14004, Córdoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004, Córdoba, Spain.,Hospital Universitario Reina Sofia, 14004, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 14004, Córdoba, Spain
| | - Jose M Ruiz-Rodriguez
- Instituto Maimónides de Investigación Biomédica de Córdoba, 14004, Córdoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004, Córdoba, Spain.,Hospital Universitario Reina Sofia, 14004, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 14004, Córdoba, Spain
| | - Veronica Sobrino
- Instituto Maimónides de Investigación Biomédica de Córdoba, 14004, Córdoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004, Córdoba, Spain.,Hospital Universitario Reina Sofia, 14004, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 14004, Córdoba, Spain
| | - Alexia Barroso
- Instituto Maimónides de Investigación Biomédica de Córdoba, 14004, Córdoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004, Córdoba, Spain.,Hospital Universitario Reina Sofia, 14004, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 14004, Córdoba, Spain
| | - Violeta Heras
- Instituto Maimónides de Investigación Biomédica de Córdoba, 14004, Córdoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004, Córdoba, Spain.,Hospital Universitario Reina Sofia, 14004, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 14004, Córdoba, Spain
| | - Inmaculada Velasco
- Instituto Maimónides de Investigación Biomédica de Córdoba, 14004, Córdoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004, Córdoba, Spain.,Hospital Universitario Reina Sofia, 14004, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 14004, Córdoba, Spain
| | - Cecilia Perdices-Lopez
- Instituto Maimónides de Investigación Biomédica de Córdoba, 14004, Córdoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004, Córdoba, Spain.,Hospital Universitario Reina Sofia, 14004, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 14004, Córdoba, Spain
| | - Claes Ohlsson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530, Gothenburg, Sweden
| | - Maria Soledad Avendaño
- Instituto Maimónides de Investigación Biomédica de Córdoba, 14004, Córdoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004, Córdoba, Spain.,Hospital Universitario Reina Sofia, 14004, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 14004, Córdoba, Spain
| | - Vincent Prevot
- Univ. Lille, Inserm, CHU Lille, Laboratory of Development and Plasticity of the Neuroendocrine Brain, Lille Neuroscience & Cognition, UMR-S1172, 59000, Lille, France
| | - Matti Poutanen
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530, Gothenburg, Sweden.,Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, and Turku Center for Disease Modeling, University of Turku, 20520, Turku, Finland
| | - Leonor Pinilla
- Instituto Maimónides de Investigación Biomédica de Córdoba, 14004, Córdoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004, Córdoba, Spain.,Hospital Universitario Reina Sofia, 14004, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 14004, Córdoba, Spain
| | - Francisco Gaytan
- Instituto Maimónides de Investigación Biomédica de Córdoba, 14004, Córdoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004, Córdoba, Spain.,Hospital Universitario Reina Sofia, 14004, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 14004, Córdoba, Spain
| | - Manuel Tena-Sempere
- Instituto Maimónides de Investigación Biomédica de Córdoba, 14004, Córdoba, Spain. .,Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004, Córdoba, Spain. .,Hospital Universitario Reina Sofia, 14004, Córdoba, Spain. .,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 14004, Córdoba, Spain. .,Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, and Turku Center for Disease Modeling, University of Turku, 20520, Turku, Finland.
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14
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Jian Z, Yuan C, Ma L, Jin X. Genetic Associations of Birthweight, Childhood, and Adult BMI on Testosterone Levels: A Mendelian Randomization. J Clin Endocrinol Metab 2022; 107:1871-1877. [PMID: 35435991 DOI: 10.1210/clinem/dgac236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Indexed: 02/08/2023]
Abstract
CONTEXT Birthweight, childhood, and adult BMI have been indicated associated with the testosterone levels, but the current studies are plagued by significant heterogeneity, and a consensus about the role of these weight traits in testosterone levels is still debated. OBJECTIVE This work aims to evaluate the genetic associations of birthweight and childhood and adult body mass index (BMI) on the adult testosterone levels (bioavailable testosterone [BT], sex hormone-binding globulin [SHBG], and total testosterone [TT]) in women and men. METHODS Random-effect inverse-variance weighted (IVW) and 7 sensitivity analyses were performed. Data for weight traits were collected from large-scale genome-wide association studies (GWAS) ranging from 39 620 to 434 794 individuals. Summarized data for testosterone levels were obtained from a GWAS up to 230 454 individuals. RESULTS Higher adult BMI are significantly associated with lower BT (β = -0.13; 95% CI, -0.16 to -0.09) and TT in men (β = -0.25; 95% CI, -0.30 to -0.20). On the contrary, higher adult BMI increased the levels of BT (β = 0.23; 95% CI, 0.23 to 0.20) and TT (β = 0.04; 95% CI, 0.01 to 0.07) in women. Similar genetic associations on testosterone levels with sexual differences were observed for childhood BMI. However, higher birthweight led to lower BT levels in adult men (β = -0.08; 95% CI, -0.12 to -0.03) and women (β = -0.07; 95% CI, -0.13 to -0.02). CONCLUSION Our study supports that birthweight, childhood BMI, and adult BMI affect testosterone levels in men and women in adult life. The genetic associations of childhood BMI on testosterone levels are consistent with adult BMI, but not with birthweight.
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Affiliation(s)
- Zhongyu Jian
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China
- West China Biomedical Big Data Center, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Chi Yuan
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Li Ma
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Xi Jin
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China
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15
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Zhou Y, Tian R, Wang X, Sun J, Zhu L, An X. The occurrence of hypogonadotropic hypogonadism in Chinese men with type 2 diabetes. Clin Endocrinol (Oxf) 2022; 96:837-846. [PMID: 35075664 DOI: 10.1111/cen.14680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/11/2022] [Accepted: 01/17/2022] [Indexed: 11/28/2022]
Abstract
CONTEXT The previous studies showed that hypogonadotropic hypogonadism (HH) occurred commonly in men with type 2 diabetes. However, since all the cohorts tested were from American and European studies, the occurrence of HH/nongonadal illness (NGI) in Chinese populations is unclear. OBJECTIVE The study aimed to explore the occurrence of HH/NGI in Chinese men with type 2 diabetes. Furthermore, the correlative factors and predictors of hypogonadism were investigated. DESIGN We conducted a cross-sectional study of 637 Chinese men with type 2 diabetes aged 20-75 years in our clinic. The prevalence of HH/NGI was investigated by measuring serum total testosterone (TT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in the enrolled subjects. Free testosterone (FT) was calculated by using SHBG and TT levels and hypogonadism was defined as TT lower than 10.4 nmol/L and calculated FT (cFT) lower than 0.225 nmol/L. The LH cut-off value for defining HH/NGI was 9.4 mIU/ml. RESULTS The results suggested that 31.9% of male Chinese type 2 diabetes patients had hypogonadism and 26.5% of subjects in our cohort were determined as HH/NGI. The occurrence of hypogonadism was markedly correlated with body mass index (BMI). There was a significant association between TT, cFT and SHBG levels with BMI. TT levels are inversely correlated with BMI and homeostasis model assessment-estimated insulin resistance (HOMA-IR) while positively related with SHBG. The cFT levels were inversely correlated with age, LH, FSH, BMI and HOMA-IR. Multiple regression analysis suggested that SHBG, BMI and HOMA-IR were significant predictors of TT and cFT. CONCLUSION Our present study offered the first evidence that the occurrence of HH/NGI in Chinese male type 2 diabetes was 26.5%. TT and cFT were significantly correlated with BMI, SHBG and HOMA-IR in Chinese men with type 2 diabetes.
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Affiliation(s)
- Yuexin Zhou
- Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Ruina Tian
- Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Xuening Wang
- Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Jiaxing Sun
- Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Lin Zhu
- Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Xiaofei An
- Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
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16
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Ruiz S, Vázquez F, Pellitero S, Puig-Domingo M. ENDOCRINE OBESITY: Pituitary dysfunction in obesity. Eur J Endocrinol 2022; 186:R79-R92. [PMID: 35333754 DOI: 10.1530/eje-21-0899] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 03/24/2022] [Indexed: 11/08/2022]
Abstract
Obesity, the growing pandemic of the 21st century, is associated with multiple organ dysfunction, either by a direct increase in fatty organ content or by indirect modifications related to general metabolic changes driven by a specific increase in biologic products. The pituitary gland is not protected against such a situation. Different hypothalamic-pituitary axes experience functional modifications initially oriented to an adaptive situation that, with years of obesity, turn to maladaptive dynamics that contribute to perpetuating obesity and specific symptoms of their hormonal nature. This paper reviews the recent knowledge on obesity-related pituitary dysfunction and its pathogenic mechanisms and discusses potential therapeutic actions aimed at contributing to ameliorating the complex treatment of severe cases of obesity.
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Affiliation(s)
- Sabina Ruiz
- Department of Endocrinology and Nutrition, Germans Trias i Pujol University Hospital and Research Institute, Badalona, Catalonia, Spain
| | - Federico Vázquez
- Department of Endocrinology and Nutrition, Germans Trias i Pujol University Hospital and Research Institute, Badalona, Catalonia, Spain
| | - Silvia Pellitero
- Department of Endocrinology and Nutrition, Germans Trias i Pujol University Hospital and Research Institute, Badalona, Catalonia, Spain
| | - Manel Puig-Domingo
- Department of Endocrinology and Nutrition, Germans Trias i Pujol University Hospital and Research Institute, Badalona, Catalonia, Spain
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17
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Старостина СВ, Стаценко ЯА, Свистушкин ВМ. [Optimization of an integrated approach to voice correction for endocrinopathies (analytical review)]. PROBLEMY ENDOKRINOLOGII 2022; 68:48-55. [PMID: 35488756 PMCID: PMC9761875 DOI: 10.14341/probl12822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/10/2022] [Accepted: 01/25/2022] [Indexed: 01/09/2023]
Abstract
Dysphonia is a symptom of many endocrine pathologies. Hoarseness, voice fatigue, decrease of the voice pitch, reduce of the range are typical complaints for hypothyroidism, caused by an increased amount of polysaccharides and accumulation of fluid in the lamina propria of the vocal folds. An excess of growth hormone causes an overproduction of insulin-like growth factor-1, which leads to abnormalities in the craniofacial region and proliferation of the upper respiratory tract tissues, including thickening of the laryngeal cartilages, vocal folds and decreasing of the voice pitch. Hyperglycemia, changes in the balance of fluid and electrolytes in diabetes mellitus can indirectly affect the voice: xerostomia complicates phonation due to impaired hydration of the laryngeal mucosa, diabetic neuropathy often disrupts the work of the laryngeal muscles involved in voice formation. Voice changes are observed not only in endocrine disorders, but also during puberty, the phases of the menstrual cycle and during menopause. Laryngeal structures are modified under the influence of hormones and external factors, which generally changes pitch and intensity of the voice, timbre and resonance, articulation and prosodic characteristics. The purpose of this review is to summarize and systematize data on physiological and pathological voice changes in patients of different age groups and sex. The possibilities of a multidisciplinary approach to rational voice correction are demonstrated.
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Affiliation(s)
- С. В. Старостина
- Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский университет)
| | - Я. А. Стаценко
- Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский университет)
| | - В. М. Свистушкин
- Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский университет)
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18
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Wang S, Wei Y, Hu C, Liu F. Proteomic analysis reveals proteins and pathways associated with declined testosterone production in male obese mice after chronic high-altitude exposure. Front Endocrinol (Lausanne) 2022; 13:1046901. [PMID: 36531490 PMCID: PMC9748565 DOI: 10.3389/fendo.2022.1046901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 11/10/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE Obesity is common in highland areas owing to lifestyle alterations. There are pieces of evidence to suggest that both obesity and hypoxia may promote oxidative stress, leading to hypogonadism in males. These findings indicate an increased risk of hypogonadism in obese males following hypoxia exposure. However, the mechanisms underlying the disease process remain unclear. The current study aims to explore the mechanism of testosterone production dysfunction in obese male mice exposed to a chronic high-altitude hypoxia environment. METHODS An obese male mouse model was generated by inducing obesity in mice via a high-fat diet for 14 weeks, and the obese mice were then exposed to a high-altitude hypoxia environment for 24 days. Sera and testicular tissues were collected to detect serum lipids, sex hormone level, and testicular oxidative stress indicators. Morphological examination was performed to assess pathological alterations in testicular tissues and suborganelles in leydig cells. Proteomic alterations in testicular tissues were investigated using quantitative proteomics in Obese/Control and Obese-Hypoxia/Obese groups. RESULTS The results showed that chronic high-altitude hypoxia exposure aggravated low testosterone production in obese male mice accompanied by increased testicular oxidative stress and histological damages. In total, 363 and 242 differentially expressed proteins (DEPs) were identified in the two comparison groups, Obese/Control and Obese-Hypoxia/Obese, respectively. Functional enrichment analysis demonstrated that several significant functional terms and pathways related to testosterone production were altered in the two comparison groups. These included cholesterol metabolism, steroid hormone biosynthesis, peroxisome proliferator-activated receptor (PPAR) signaling pathway, oxidative stress responses, as well as retinol metabolism. Finally, 10 representative DEPs were selected for parallel reaction monitoring verification. Among them, StAR, DHCR7, NSDHL, CYP51A1, FDPS, FDX1, CYP11A1, ALDH1A1, and GPX3 were confirmed to be downregulated in the two groups. CONCLUSIONS Chronic hypoxia exposure could exacerbate low testosterone production in obese male mice by influencing the expression of key proteins involved in steroid hormone biosynthesis, cholesterol biosynthesis, oxidative stress responses and retinol metabolism.
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Affiliation(s)
- Shuqiong Wang
- Research Center for High Altitude Medicine, Qinghai University, Xining, China
- Key Laboratory of High Altitude Medicine, Ministry of Education, Xining, China
- Key Laboratory of Application and Foundation for High Altitude Medicine Research in Qinghai Province, Qinghai-Utah Joint Research Key Lab for High Altitude Medicine, Xining, China
- Department of Endocrinology, Qinghai Provincial People’s Hospital, Xining, China
| | - Youwen Wei
- Department of Plague Prevention and Control, Qinghai Institute for Endemic Disease Prevention and Control, Xining, China
| | - Caiyan Hu
- Department of Laboratory Medicine, Baoding First Central Hospital, Baoding, China
| | - Fang Liu
- Department of Biochemistry, Medical College, Qinghai University, Xining, China
- *Correspondence: Fang Liu,
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19
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Ghaderpour S, Ghiasi R, Heydari H, Keyhanmanesh R. The relation between obesity, kisspeptin, leptin, and male fertility. Horm Mol Biol Clin Investig 2021; 43:235-247. [PMID: 34931507 DOI: 10.1515/hmbci-2021-0058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/22/2021] [Indexed: 11/15/2022]
Abstract
Over the past decades, obesity and infertility in men increased in parallel, and the association between both phenomena have been examined by several researchers. despite the fact that there is no agreement, obesity appears to affect the reproductive potential of men through various mechanisms, such as changes in the hypothalamic-pituitary-testicular (HPT) axis, spermatogenesis, sperm quality and/or alteration of sexual health. Leptin is a hormone produced by the adipose tissue, and its production elevates with increasing body fat. Many studies have supported the relationship between raised leptin production and reproductive function regulation. In fact, Leptin acts on the HPT axis in men at all levels. However, most obese men are insensitive to increased production of endogenous leptin and functional leptin resistance development. Recently, it has been recommended that Kisspeptin neurons mediate the leptin's effects on the reproductive system. Kisspeptin binding to its receptor on gonadotropin-releasing hormone (GnRH) neurons, activates the mammal's reproductive axis and stimulates GnRH release. Increasing infertility associated with obesity is probably mediated by the Kisspeptin-GnRH pathway. In this review, the link between obesity, kisspeptin, leptin, and male fertility will be discussed.
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Affiliation(s)
- Saber Ghaderpour
- Department of Physiology, Tabriz Faculty of Medical Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rafighe Ghiasi
- Department of Physiology, Tabriz Faculty of Medical Science, Tabriz University of Medical Sciences, Tabriz, Iran.,Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamed Heydari
- Department of Physiology, Tabriz Faculty of Medical Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rana Keyhanmanesh
- Department of Physiology, Tabriz Faculty of Medical Science, Tabriz University of Medical Sciences, Tabriz, Iran.,Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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20
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Barber TM, Franks S. Obesity and polycystic ovary syndrome. Clin Endocrinol (Oxf) 2021; 95:531-541. [PMID: 33460482 DOI: 10.1111/cen.14421] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/02/2020] [Accepted: 01/14/2021] [Indexed: 02/06/2023]
Abstract
The increased global prevalence of obesity over the last 40-years has driven a rise in prevalence of obesity-related co-morbidities, including polycystic ovary syndrome (PCOS). On a background of genetic susceptibility, PCOS often becomes clinically manifest following weight gain, commonly during adolescence. A common endocrinopathy affecting between 6%-10% of reproductive-age women, PCOS presents with the cardinal features of hyperandrogenism, reproductive and metabolic dysfunction. PCOS associates with insulin resistance, independently of (but amplified by) obesity. Insulin resistance in PCOS is characterized by abnormal post-receptor signalling within the phosphatidylinositol-kinase (PI3-K) pathway. Multiple factors (including most notably, weight gain) contribute towards the severity of insulin resistance in PCOS. Compensatory hyperinsulinaemia ensues, resulting in over-stimulation of the (intact) post-receptor mitogen-activated protein kinase (MAP-K) insulin pathway, with consequent implications for steroidogenesis and ovarian function. In this concise review, we explore the effects of weight gain and obesity on the pathogenesis of PCOS from the perspective of its three cardinal features of hyperandrogenism, reproductive and metabolic dysfunction, with a focus on the central mediating role of the insulin pathway. We also consider key lifestyle strategies for the effective management of obese and overweight women with PCOS.
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Affiliation(s)
- Thomas M Barber
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Stephen Franks
- Institute of Reproductive & Developmental Biology, Department of Metabolism, Digestion & Reproduction, Imperial College London, London, UK
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21
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Oladele CA, Akintayo CO, Badejogbin OC, Oniyide AA, Omoaghe AO, Agunbiade TB, Olaniyi KS. Melatonin ameliorates endocrine dysfunction and defective sperm integrity associated with high-fat diet-induced obesity in male Wistar rats. Andrologia 2021; 54:e14242. [PMID: 34490912 DOI: 10.1111/and.14242] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/12/2021] [Accepted: 08/31/2021] [Indexed: 12/18/2022] Open
Abstract
Obesity (OBS) has been established as a link to male hypogonadism with consequent infertility. Previous studies have shown that melatonin (MEL) modulates hypothalamic-pituitary-gonadal function. The present study therefore investigated the hypothesis that MEL supplementation would attenuate spermatogenic and steroidogenic dysfunctions associated with obesity induced by high-fat diet (HFD). Twenty-four adult male Wistar rats (n = 6/group) were used: control group received vehicle (normal saline), obese group received 40% high-fat diet and distilled water, MEL-treated group received MEL (4 mg/kg), and OBS + MEL group received MEL and 40% HFD and the treatment lasted for 12 weeks. HFD caused increased body weight, glucose intolerance, plasma triglyceride and low-density lipoprotein cholesterol/ very low-density lipoprotein cholesterol and malondialdehyde, as well as decreased antioxidant capacity, high-density lipoprotein cholesterol, gonadotrophin-releasing hormone, follicle-stimulating hormone and testosterone and altered sperm parameters. However, all these alterations were attenuated when supplemented with MEL. Taken together, these results indicate that HFD exposure causes endocrine dysfunction and disrupted sperm parameters in obese animals, which are accompanied by lipid peroxidation/defective antioxidant capacity. In addition, the present results suggest that melatonin supplementation restores endocrine function and sperm integrity in obese rat model by suppression of oxidative stress-dependent mechanism.
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Affiliation(s)
- Comfort Abisola Oladele
- Department of Physiology, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | | | | | - Adesola Adedotun Oniyide
- Department of Physiology, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Adams Olalekan Omoaghe
- Department of Physiology, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Toluwani Bosede Agunbiade
- Department of Medical Microbiology and Parasitology, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Kehinde Samuel Olaniyi
- Department of Physiology, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
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22
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Zhang CL, Wang JJ, Li JN, Yang Y. Nonalcoholic fatty pancreas disease: An emerging clinical challenge. World J Clin Cases 2021; 9:6624-6638. [PMID: 34447810 PMCID: PMC8362510 DOI: 10.12998/wjcc.v9.i23.6624] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/20/2021] [Accepted: 06/01/2021] [Indexed: 02/06/2023] Open
Abstract
Nonalcoholic fatty pancreas disease (NAFPD) is an emerging disease that has gained an increasing amount of attention in recent years. It describes fat accumulation in the pancreas with insignificant alcohol consumption, but the pathogenesis is largely unknown. A wide range of terms have been used to describe the phenomenon of pancreatic fat accumulation, but NAFPD remains an under-recognized and non-independent disorder. Obesity, age, sex, race, and unhealthy lifestyle are established independent risk factors for NAFPD, which is strongly associated with metabolic syndrome, type 2 diabetes, pancreatitis, pancreatic fistula, pancreatic cancer, and nonalcoholic fatty liver disease. At present, imaging techniques are common diagnostic aids, but uniform criteria and consensus are lacking. Therapeutically, healthy diet, weight loss, and exercise are the mainstays to reduce pancreatic fat accumulation. It can be seen that there is a limited understanding of NAFPD at this stage and further exploration is needed. Previous studies have revealed that NAFPD may directly affect diagnosis and clinical decision-making. Therefore, exploring the pathophysiological mechanism and clinical associations of NAFPD is a major challenge for researchers and clinicians.
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Affiliation(s)
- Cheng-Lei Zhang
- Department of Clinical Laboratory, General Hospital of Ningxia Medical University, Yinchuan 750004, Ningxia Hui Autonomous Region, China
- The Institute of Endocrinology, Ningxia Medical University, Yinchuan 750004, Ningxia Hui Autonomous Region, China
| | - Jing-Jiao Wang
- Department of Stomatology, General Hospital of Ningxia Medical University, Yinchuan 750004, Ningxia Hui Autonomous Region, China
| | - Jian-Ning Li
- The Institute of Endocrinology, Ningxia Medical University, Yinchuan 750004, Ningxia Hui Autonomous Region, China
- School of Basic Medical Sciences, Ningxia Medical University, Yinchuan 750004, Ningxia Hui Autonomous Region, China
| | - Yi Yang
- The Institute of Endocrinology, Ningxia Medical University, Yinchuan 750004, Ningxia Hui Autonomous Region, China
- School of Basic Medical Sciences, Ningxia Medical University, Yinchuan 750004, Ningxia Hui Autonomous Region, China
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23
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Mechanisms of Central Hypogonadism. Int J Mol Sci 2021; 22:ijms22158217. [PMID: 34360982 PMCID: PMC8348115 DOI: 10.3390/ijms22158217] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/23/2021] [Accepted: 07/24/2021] [Indexed: 02/01/2023] Open
Abstract
Reproductive function depends upon an operational hypothalamo–pituitary–gonadal (HPG) axis. Due to its role in determining survival versus reproductive strategies, the HPG axis is vulnerable to a diverse plethora of signals that ultimately manifest with Central Hypogonadism (CH) in all its many guises. Acquired CH can result from any pituitary or hypothalamic lesion, including its treatment (such as surgical resection and/or radiotherapy). The HPG axis is particularly sensitive to the suppressive effects of hyperprolactinaemia that can occur for many reasons, including prolactinomas, and as a side effect of certain drug therapies. Physiologically, prolactin (combined with the suppressive effects of autonomic neural signals from suckling) plays a key role in suppressing the gonadal axis and establishing temporary CH during lactation. Leptin is a further key endocrine regulator of the HPG axis. During starvation, hypoleptinaemia (from diminished fat stores) results in activation of hypothalamic agouti-related peptide neurons that have a dual purpose to enhance appetite (important for survival) and concomitantly suppresses GnRH neurons via effects on neural kisspeptin release. Obesity is associated with hyperleptinaemia and leptin resistance that may also suppress the HPG axis. The suppressibility of the HPG axis also leaves it vulnerable to the effects of external signals that include morphine, anabolic-androgenic steroids, physical trauma and stress, all of which are relatively common causes of CH. Finally, the HPG axis is susceptible to congenital malformations, with reports of mutations within >50 genes that manifest with congenital CH, including Kallmann Syndrome associated with hyposmia or anosmia (reduction or loss of the sense of smell due to the closely associated migration of GnRH with olfactory neurons during embryogenesis). Analogous to the HPG axis itself, patients with CH are often vulnerable, and their clinical management requires both sensitivity and empathy.
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24
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Olooto WE, Oyelekan AA, Adewole OO, Fajobi AO, Adedo AA, Olasimbo O. Serum gonadotropins, cortisol, PSA, and micronutrient levels among men with prostate carcinoma. AFRICAN JOURNAL OF UROLOGY 2021. [DOI: 10.1186/s12301-021-00206-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Prostate cancer (PrCa) is a malignant tumour of the prostate that has many associated risk factors. There is continuous rise in the incidence among adult blacks which is a reflection of racial differences in testosterone concentrations.
Methods
The study involves 50 PrCa patients attending or referred to two tertiary health Institutions and 25 healthy men as controls. Weight and height of participants were measured, and body mass index (BMI) was calculated. Ten millilitres of venous blood sample was collected from each participant, allowed to clot, and then centrifuged at 5000 rpm for 5 min at room temperature (22–28 °C) to obtain the serum. Serum cortisol, testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), total prostate-specific antigen (TPSA), free prostate-specific antigen (FPSA), selenium, copper, magnesium, and zinc were determined. Prostate ultrasonography and biopsy were also done for histopathological studies.
Result
From this study, a significant increase (p < 0.05) in weight, BMI, serum FPSA, TPSA, and copper; a non-significant increase (p > 0.05) in serum cortisol, testosterone; a significant decrease (p < 0.05) in serum LH, selenium, zinc, and magnesium; and a non-significant decrease (p > 0.05) in serum FSH were observed among people living with PrCa when compared to the controls. However, no significant difference (p > 0.05) was observed in the height between the two groups. Ultrasonography and histology revealed evidence of prostatitis, hypertrophy, and carcinoma among the test group.
Conclusion
It can be concluded that PrCa is associated with increase serum cortisol, testosterone, and copper; and decreased serum LH, FSH, selenium, zinc, and magnesium concentrations and combination of biochemical, ultrasonographic, and histologic features are of diagnostic importance.
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Chen Y, Zhang L, Zhao S, Yuan L, Shi J, Zhang Y, Wang J, Gu W, Wang W, Hong J. Association of night-time sleep and day napping with the prevalence of MOSH in young obese men. Andrology 2021; 9:1872-1878. [PMID: 34197044 DOI: 10.1111/andr.13074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 05/26/2021] [Accepted: 06/28/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Obesity in men is also shown to be associated with reduced reproductive potential, and this particular subtype was described as male obesity-associated secondary hypogonadism (MOSH). Recent studies showing the influence of sleep disorders on testosterone levels suggested a potential role of sleep disorders in determining the development of MOSH. OBJECTIVES To assess the association between night-time sleep duration and day napping and the prevalence of MOSH. MATERIALS AND METHODS In this cross-sectional study, 226 obese male participants aged 18-30 years were enrolled. Daytime napping and night-time sleep duration data were collected using a standardized self-reported Chinese-language questionnaire. MOSH was defined as obese men (BMI ≥ 30 kg/m2 ) with hypogonadal symptoms and decreased total testosterone level and/or free testosterone level, excluding other causes of hypogonadism. RESULTS The overall prevalence of MOSH was 48.2% in this study. An inverse association was observed between night sleep duration and the risk of prevalent MOSH. Men who reported fewer than 6 h of night-time sleep had reduced total testosterone and free testosterone levels and an increased risk of MOSH. Further regression analysis revealed that after adjustment for potential confounders, the odds ratio of MOSH for the short night-time sleep group (<6 h vs. 6-8 h) was 6.17 (p = 0.040). No significant association was observed between day napping status and prevalence of MOSH. DISCUSSION AND CONCLUSION Short night sleep duration was associated with an increased risk of MOSH in the young obese Chinese population. Chronic sleep curtailment has a negative effect on obese men's health in terms of hypogonadism.
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Affiliation(s)
- Yufei Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China.,Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Ling Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China.,Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Shaoqian Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China.,Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Lihui Yuan
- Department of Endocrine and Metabolic Diseases, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China.,Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Juan Shi
- Department of Endocrine and Metabolic Diseases, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China.,Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Yifei Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China.,Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Jiqiu Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China.,Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Weiqiong Gu
- Department of Endocrine and Metabolic Diseases, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China.,Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China.,Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Jie Hong
- Department of Endocrine and Metabolic Diseases, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China.,Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
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Emami MR, Safabakhsh M, Khorshidi M, Moradi Moghaddam O, Mohammed SH, Zarezadeh M, Alizadeh S. Effect of bariatric surgery on endogenous sex hormones and sex hormone-binding globulin levels: a systematic review and meta-analysis. Surg Obes Relat Dis 2021; 17:1621-1636. [PMID: 34187743 DOI: 10.1016/j.soard.2021.05.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 04/14/2021] [Accepted: 05/06/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Most studies have shown beneficial effect of bariatric surgery (BS) on serum levels of sex hormones. OBJECTIVE A systematic review and meta-analysis was conducted to examine the magnitude of possible changes in levels of sex hormones following BS. SETTINGS Electronic databases were searched, including PubMed, Scopus, Web of Science, and Embase, for relevant studies. METHODS The heterogeneity of the studies was examined by χ2 tests and the degree of heterogeneity was estimated using I2 statistic. RESULTS The results of pooled analyses revealed that BS caused a significant increase in luteinizing hormone (LH), follicular stimulating hormone (FSH), total testosterone (TT), and sex hormone binding globulin (SHBG) levels and conversely, decreased dehydroepiandrosterone (DHEA) and estradiol (E2) levels in males. For females, BS significantly increased LH, FSH, and SHBG levels and conversely, decreased androstenedione (AE), E2 and TT levels. Additionally, the level of progesterone (P), prolactin (PRL), free testosterone (FT) and dehydroepiandrosterone sulfate (DHEA-S) showed no significant changes in patients who had undergone BS. CONCLUSION BS changed most sex hormones levels including LH, FSH, TT, SHBG, AE, DHEA, and E2. It seems that BS is able to exert substantial impacts on sex hormones levels and as well as sexual function, however, larger, and more precise trials are required to specifically focus on these claims.
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Affiliation(s)
- Mohammad Reza Emami
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Safabakhsh
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Khorshidi
- Pediatric Gastroenterology, Hepatology and Nutrition Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Pediatric Gastroenterology, Hepatology and Nutrition Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Omid Moradi Moghaddam
- Trauma and Injury Research Center, Critical Care Medicine Department, Iran University of Medical Sciences, Tehran, Iran
| | - Shimels Hussien Mohammed
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences-International Campus, Tehran, Iran
| | - Meysam Zarezadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Shahab Alizadeh
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Van de Velde F, Deventer K, Van Gansbeke W, Van Eenoo P, Van Renterghem P, Fiers T, Reyns T, Kaufman JM, Van Nieuwenhove Y, Lapauw B. Metabolism of testosterone during weight loss in men with obesity. J Steroid Biochem Mol Biol 2021; 209:105851. [PMID: 33610798 DOI: 10.1016/j.jsbmb.2021.105851] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 01/29/2021] [Accepted: 02/04/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Men with obesity often have low total and, with increasing adiposity, also low free testosterone (T) levels, which can partially restore during weight loss. Although this is partly explained by lower sex hormone binding globulin (SHBG) production and hypothalamic-pituitary downregulation, it is still not unravelled whether changes in androgen metabolism contribute to this phenomenon. Therefore, early changes in urinary excretion of T and its metabolites, during weight loss, in men with obesity are investigated. DESIGN Longitudinal study. METHODS Fourteen men with obesity (age 52(45-60)years, BMI 42.6(41.8-44.8)kg/m²) underwent gastric bypass surgery (GBS). Before surgery and 3 weeks, 6 weeks, 6 months and 1 year thereafter, 24 h urine and fasting serum samples were collected. Serum T and estradiol (E2) levels were analyzed using LC-MS/MS and urinary metabolites of T with GC-MS/MS. RESULTS Already three weeks after GBS, serum SHBG and total T levels increased and remained increased as compared to baseline (all,p < 0.0125). Gonadotropins and (free) E2 levels were unchanged, serum E2/T ratio decreased (p < 0.0125). Total amount of urinary T increased non-significantly with mean increases of 53 % one year after GBS (p = 0.026). Urinary E2/T, estrone/T, 3α-androstanediol/T and androsterone/T ratios decreased after GBS (p < 0.0125). CONCLUSIONS Restoration of circulating T levels during weight loss in this population is not only brought about by normalization of circulating SHBG levels, but increased production of and alterations in T metabolism also contribute. More specifically, relative decreases in aromatization and lower 5α-reductase activity might also be involved in restoring T levels in men with obesity.
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Affiliation(s)
| | - Koen Deventer
- Doping Control Laboratory, Ghent University, Zwijnaarde, Belgium
| | - Wim Van Gansbeke
- Doping Control Laboratory, Ghent University, Zwijnaarde, Belgium
| | - Peter Van Eenoo
- Doping Control Laboratory, Ghent University, Zwijnaarde, Belgium
| | | | - Tom Fiers
- Department of Clinical Biology, Ghent University Hospital, Ghent, Belgium
| | - Tim Reyns
- Department of Clinical Biology, Ghent University Hospital, Ghent, Belgium
| | - Jean Marc Kaufman
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Yves Van Nieuwenhove
- Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium
| | - Bruno Lapauw
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
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The Low-Carbohydrate Diet: Short-Term Metabolic Efficacy Versus Longer-Term Limitations. Nutrients 2021; 13:nu13041187. [PMID: 33916669 PMCID: PMC8066770 DOI: 10.3390/nu13041187] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 03/28/2021] [Accepted: 03/31/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Diets have been a central component of lifestyle modification for decades. The Low-Carbohydrate Diet (LCD), originally conceived as a treatment strategy for intractable epilepsy (due to its association with ketogenesis), became popular in the 1970s and since then has risen to prominence as a weight loss strategy. Objective: To explore the efficacy, limitations and potential safety concerns of the LCD. Data Sources: We performed a narrative review, based on relevant articles written in English from a Pubmed search, using the terms ‘low carbohydrate diet and metabolic health’. Results: Evidence supports the efficacy of the LCD in the short-term (up to 6-months) for reduction in fat mass and remission of Type 2 Diabetes Mellitus (T2D). However, the longer-term efficacy of the LCD is disappointing, with diminishment of weight loss potential and metabolic benefits of the LCD beyond 6-months of its adoption. Furthermore, practical limitations of the LCD include the associated restriction of food choices that restrict the acceptability of the LCD for the individual, particularly over the longer term. There are also safety concerns of the LCD that stem from nutritional imbalances (with a relative excess of dietary fat and protein intake with associated dyslipidaemia and increased risk of insulin resistance and T2D development) and ketotic effects. Finally, the LCD often results in a reduction in dietary fibre intake, with potentially serious adverse consequences for overall health and the gut microbiota. Conclusions: Although widely adopted, the LCD usually has short-lived metabolic benefits, with limited efficacy and practicality over the longer term. Dietary modification needs tailoring to the individual, with careful a priori assessments of food preferences to ensure acceptability and adherence over the longer term, with avoidance of dietary imbalances and optimization of dietary fibre intake (primarily from plant-based fruit and vegetables), and with a posteriori assessments of the highly individual responses to the LCD. Finally, we need to change our view of diets from simply an excipient for weight loss to an essential component of a healthy lifestyle.
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Leyden E, Hanson P, Halder L, Rout L, Cherry I, Shuttlewood E, Poole D, Loveder M, Abraham J, Kyrou I, Randeva HS, Lam FT, Menon V, Barber TM. Older age does not influence the success of weight loss through the implementation of lifestyle modification. Clin Endocrinol (Oxf) 2021; 94:204-209. [PMID: 33089545 PMCID: PMC7821294 DOI: 10.1111/cen.14354] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 10/14/2020] [Accepted: 10/14/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Age is sometimes a barrier for acceptance of patients into a hospital-based obesity service. Our aim was to explore the effect of age on the ability to lose weight through lifestyle interventions, implemented within a hospital-based obesity service. DESIGN Retrospective study. PATIENTS We included a cohort of randomly selected patients with morbid obesity (n = 242), who attended our hospital-based obesity service during 2005-2016 and received only lifestyle weight loss interventions. MEASUREMENTS Primary outcome measures were percentage weight loss (%WL) and percentage reduction in body mass index (%rBMI) following implemented lifestyle interventions. Data were stratified according to patient age at referral: group 1 (age < 60 years, n = 167) and group 2 (age ≥ 60 years, n = 75). Weight loss was compared between groups, and correlations with age at referral were explored. RESULTS The duration of hospital-based weight loss interventions ranged between 1 and 143 months (mean: 38.9 months; SD: 32.3). Baseline BMI at referral differed significantly between groups 1 and 2 (49.7 kgm-2 [SD: 8.7] vs 46.9 kgm-2 [SD: 6.1], respectively; P < .05). Following implemented lifestyle interventions, between groups 1 and 2 there were no differences in %WL (6.9% [SD: 16.7] vs 7.3% [SD: 11.60], respectively; P = NS) or %rBMI (8.1% [SD: 14.9] vs 7.8% [SD: 11.7], respectively; p = NS). Overall, there was no significant correlation between patient age at referral and %WL (r = -.13, p = NS). CONCLUSIONS Older age does not influence the success of weight loss through the implementation of lifestyle modification within a hospital-based obesity service. Therefore, age per se should not influence clinical decisions regarding acceptance of patients to hospital-based obesity services.
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Affiliation(s)
- Eimear Leyden
- Division of Biomedical SciencesWarwick Medical SchoolClinical Sciences Research LaboratoriesUniversity Hospitals Coventry and WarwickshireCoventryUK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and MetabolismUniversity Hospitals Coventry and WarwickshireCoventryUK
| | - Petra Hanson
- Division of Biomedical SciencesWarwick Medical SchoolClinical Sciences Research LaboratoriesUniversity Hospitals Coventry and WarwickshireCoventryUK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and MetabolismUniversity Hospitals Coventry and WarwickshireCoventryUK
| | - Louise Halder
- Warwickshire Institute for the Study of Diabetes, Endocrinology and MetabolismUniversity Hospitals Coventry and WarwickshireCoventryUK
| | - Lucy Rout
- Warwickshire Institute for the Study of Diabetes, Endocrinology and MetabolismUniversity Hospitals Coventry and WarwickshireCoventryUK
| | - Ishbel Cherry
- Warwickshire Institute for the Study of Diabetes, Endocrinology and MetabolismUniversity Hospitals Coventry and WarwickshireCoventryUK
| | - Emma Shuttlewood
- Warwickshire Institute for the Study of Diabetes, Endocrinology and MetabolismUniversity Hospitals Coventry and WarwickshireCoventryUK
| | - Donna Poole
- Warwickshire Institute for the Study of Diabetes, Endocrinology and MetabolismUniversity Hospitals Coventry and WarwickshireCoventryUK
| | - Mark Loveder
- Warwickshire Institute for the Study of Diabetes, Endocrinology and MetabolismUniversity Hospitals Coventry and WarwickshireCoventryUK
| | - Jenny Abraham
- Warwickshire Institute for the Study of Diabetes, Endocrinology and MetabolismUniversity Hospitals Coventry and WarwickshireCoventryUK
| | - Ioannis Kyrou
- Division of Biomedical SciencesWarwick Medical SchoolClinical Sciences Research LaboratoriesUniversity Hospitals Coventry and WarwickshireCoventryUK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and MetabolismUniversity Hospitals Coventry and WarwickshireCoventryUK
- Aston Medical Research InstituteAston Medical SchoolAston UniversityBirminghamUK
| | - Harpal S. Randeva
- Division of Biomedical SciencesWarwick Medical SchoolClinical Sciences Research LaboratoriesUniversity Hospitals Coventry and WarwickshireCoventryUK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and MetabolismUniversity Hospitals Coventry and WarwickshireCoventryUK
| | - FT Lam
- Warwickshire Institute for the Study of Diabetes, Endocrinology and MetabolismUniversity Hospitals Coventry and WarwickshireCoventryUK
| | - Vinod Menon
- Division of Biomedical SciencesWarwick Medical SchoolClinical Sciences Research LaboratoriesUniversity Hospitals Coventry and WarwickshireCoventryUK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and MetabolismUniversity Hospitals Coventry and WarwickshireCoventryUK
| | - Thomas M. Barber
- Division of Biomedical SciencesWarwick Medical SchoolClinical Sciences Research LaboratoriesUniversity Hospitals Coventry and WarwickshireCoventryUK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and MetabolismUniversity Hospitals Coventry and WarwickshireCoventryUK
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Barber TM, Kyrou I, Randeva HS, Weickert MO. Mechanisms of Insulin Resistance at the Crossroad of Obesity with Associated Metabolic Abnormalities and Cognitive Dysfunction. Int J Mol Sci 2021; 22:ijms22020546. [PMID: 33430419 PMCID: PMC7827338 DOI: 10.3390/ijms22020546] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 12/19/2022] Open
Abstract
Obesity mediates most of its direct medical sequelae through the development of insulin resistance (IR). The cellular effects of insulin occur through two main postreceptor pathways that are the phosphatidylinositol 3-kinase (PI3-K) and the mitogen-activated protein kinase (MAP-K) pathways. Obesity-related IR implicates the PI3-K pathway that confers the metabolic effects of insulin. Numerous and complex pathogenic pathways link obesity with the development of IR, including chronic inflammation, mitochondrial dysfunction (with the associated production of reactive oxygen species and endoplasmic reticulum stress), gut microbiota dysbiosis and adipose extracellular matrix remodelling. IR itself plays a key role in the development of metabolic dysfunction, including hypertension, dyslipidaemia and dysglycaemia. Furthermore, IR promotes weight gain related to secondary hyperinsulinaemia, with a resulting vicious cycle of worsening IR and its metabolic sequelae. Ultimately, IR underlies obesity-related conditions such as type 2 diabetes mellitus (T2D) and polycystic ovary syndrome (PCOS). IR also underlies many obesity-related malignancies, through the effects of compensatory hyperinsulinaemia on the relatively intact MAP-K insulin pathway, which controls cellular growth processes and mitoses. Furthermore, the emergent data over recent decades support an important role of obesity- and T2D-related central IR in the development of cognitive dysfunction, including effects on hippocampal synaptic plasticity. Importantly, IR is largely reversible through the optimisation of lifestyle factors that include regular engagement in physical activity with the avoidance of sedentariness, improved diet including increased fibre intake and sleep sufficiency. IR lies at the key crossroad between obesity and both metabolic and cognitive dysfunction. Given the importance of IR in the pathogenesis of many 21st century chronic diseases and its eminent reversibility, it is important that we all embrace and facilitate optimised lifestyles to improve the future health and wellbeing of the populace.
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Affiliation(s)
- Thomas M. Barber
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; (T.M.B.); (I.K.); (H.S.R.)
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK
| | - Ioannis Kyrou
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; (T.M.B.); (I.K.); (H.S.R.)
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK
- Aston Medical Research Institute, Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
| | - Harpal S. Randeva
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; (T.M.B.); (I.K.); (H.S.R.)
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK
- Aston Medical Research Institute, Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
| | - Martin O. Weickert
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; (T.M.B.); (I.K.); (H.S.R.)
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK
- Centre for Sport, Exercise and Life Sciences, Faculty of Health & Life Sciences, Coventry University, Coventry CV1 5FB, UK
- Correspondence:
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Whon TW, Kim HS, Shin N, Jung ES, Tak EJ, Sung H, Jung M, Jeong Y, Hyun D, Kim PS, Jang YK, Lee CH, Bae J. Male castration increases adiposity via small intestinal microbial alterations. EMBO Rep 2021; 22:e50663. [PMID: 33225575 PMCID: PMC7788444 DOI: 10.15252/embr.202050663] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 01/21/2023] Open
Abstract
Castration of young males is widely used in the cattle industry to improve meat quality, but the mechanism linking hypogonadism and host metabolism is not clear. Here, we use metataxonomic and metabolomic approaches to evaluate the intestinal microbiota and host metabolism in male, castrated male (CtM), and female cattle. After pubescence, the CtM cattle harbor distinct ileal microbiota dominated by the family Peptostreptococcaceae and exhibit distinct serum and muscle amino acid profiles (i.e., highly abundant branched-chain amino acids), with increased extra- and intramuscular fat storage. We also evaluate the causative factor(s) that underpin the alteration of the intestinal microbiota and host metabolic phenotype in response to hypogonadism. Castration of male mice phenocopies both the intestinal microbial alterations and obese-prone metabolism observed in cattle. Antibiotic treatment and fecal microbiota transplantation experiments in a mouse model confirm that the intestinal microbial alterations associated with hypogonadism are a key contributor to the obese phenotype in the CtM animals. Collectively, targeting the gut microbiota is a potential therapeutic strategy for the treatment of both hypogonadism and obesity.
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Affiliation(s)
- Tae Woong Whon
- Department of Life and Nanopharmaceutical Sciences and Department of BiologyKyung Hee UniversitySeoulKorea
- Present address:
Microbiology and Functionality Research GroupWorld Institute of KimchiGwangjuKorea
| | - Hyun Sik Kim
- Department of Life and Nanopharmaceutical Sciences and Department of BiologyKyung Hee UniversitySeoulKorea
| | - Na‐Ri Shin
- Department of Life and Nanopharmaceutical Sciences and Department of BiologyKyung Hee UniversitySeoulKorea
- Present address:
Biological Resource CenterKorea Research Institute of Bioscience and BiotechnologyJeongeup‐si, Jeollabuk‐doKorea
| | - Eun Sung Jung
- Department of Bioscience and BiotechnologyKonkuk UniversitySeoulKorea
| | - Euon Jung Tak
- Department of Life and Nanopharmaceutical Sciences and Department of BiologyKyung Hee UniversitySeoulKorea
| | - Hojun Sung
- Department of Life and Nanopharmaceutical Sciences and Department of BiologyKyung Hee UniversitySeoulKorea
| | - Mi‐Ja Jung
- Department of Life and Nanopharmaceutical Sciences and Department of BiologyKyung Hee UniversitySeoulKorea
| | - Yun‐Seok Jeong
- Department of Life and Nanopharmaceutical Sciences and Department of BiologyKyung Hee UniversitySeoulKorea
| | - Dong‐Wook Hyun
- Department of Life and Nanopharmaceutical Sciences and Department of BiologyKyung Hee UniversitySeoulKorea
| | - Pil Soo Kim
- Department of Life and Nanopharmaceutical Sciences and Department of BiologyKyung Hee UniversitySeoulKorea
| | - Yu Kyung Jang
- Department of Bioscience and BiotechnologyKonkuk UniversitySeoulKorea
| | - Choong Hwan Lee
- Department of Bioscience and BiotechnologyKonkuk UniversitySeoulKorea
| | - Jin‐Woo Bae
- Department of Life and Nanopharmaceutical Sciences and Department of BiologyKyung Hee UniversitySeoulKorea
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Serwaa D, Bello FA, Osungbade KO, Nkansah C, Osei-Boakye F, Appiah SK, Antwi MH, Danquah M, Buckman TA, Owusu E. Prevalence and determinants of low testosterone levels in men with type 2 diabetes mellitus; a case-control study in a district hospital in Ghana. PLOS GLOBAL PUBLIC HEALTH 2021; 1:e0000052. [PMID: 36962255 PMCID: PMC10021198 DOI: 10.1371/journal.pgph.0000052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 10/18/2021] [Indexed: 11/18/2022]
Abstract
Diabetes mellitus, an endocrine disorder, has been implicated in many including hypogonadism in men. Given the fact that diabetes mellitus is becoming a fast-growing epidemic and the morbidity associated with it is more disabling than the disease itself. This study sought to assess the prevalence of low testosterone levels and predictors in type 2 diabetes mellitus patients and non-diabetic men in a district hospital in Ghana. This hospital-based case-control study comprised 150 type 2 diabetics and 150 healthy men. A pre-structured questionnaire and patient case notes were used to document relevant demographic and clinical information. Venous blood sample of about 6 ml was taken to measure FBS, HbA1c, FSH, LH, and testosterone levels. All data were analyzed using STATA version 12 (STATA Corporation, Texas, USA). The overall hypogonadism in the study population was 48% (144/300). The prevalence of hypogonadism in type 2 diabetic subjects was almost three times more than in healthy men (70.7% vs 25.3%). The odds of having hypogonadism was lower in the men with normal weight and overweight with their underweight counterparts (AOR = 0.33, 95% CI; 0.12-0.96, p = 0.042) and (AOR = 0.29, 95% CI; 0.10-0.84, p = 0.023) respectively. Also, the odds of suffering from hypogonadism was lower in non-smokers compared with smokers (AOR: 0.16, 95% CI; 0.05-0.58, p = 0.005). Participants who were engaged in light (AOR: 0.29, 95% CI; 0.14-0.61, p = 0.001), moderate (AOR: 0.26, 95% CI; 0.13-0.54, p<0.001) and heavy (AOR: 0.25, 95% CI; 0.10-0.67, p = 0.006) leisure time activities had lower odds hypogonadal compared to those engaged in sedentary living. Type 2 diabetic men have high incidence of hypogonadism, irrespective of their baseline clinical, lifestyle or demographic characteristics. Smoking and sedentary lifestyle and BMI were associated with hypogonadism in the study population. Routine testosterone assessment and replacement therapy for high risk patients is recommended to prevent the detrimental effect of hypogonadism in diabetic men.
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Affiliation(s)
- Dorcas Serwaa
- Department of Obstetrics and Gynecology, College of Medicine, Pan African University, Yaoundé, Cameroun
- Institute of Life and Earth Sciences, University of Ibadan, Ibadan, Nigeria
| | - Folasade Adenike Bello
- Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Oyo State, Nigeria
- Department of Obstetrics and Gynaecology, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Kayode O Osungbade
- Department of Community Medicine, College of Medicine, University College Hospital, Oyo State, Nigeria
| | - Charles Nkansah
- Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Felix Osei-Boakye
- Department of Medical Laboratory Technology, Faculty of Applied Science and Technology, Sunyani Technical University, Sunyani, Ghana
| | - Samuel Kwasi Appiah
- Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | | | - Mark Danquah
- Department of Medical Laboratory Technology, Faculty of Applied Science and Technology, Sunyani Technical University, Sunyani, Ghana
| | - Tonnies Abeku Buckman
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ernest Owusu
- Department of Nursing and Midwifery, Methodist Health Training Institute, Afosu, Eastern Region, Ghana
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Martínez-Montoro JI, Molina-Vega M, Asenjo-Plaza M, García-Ruiz MC, Varea-Marineto E, Plaza-Andrade I, Álvarez-Millán JJ, Cabezas-Sánchez P, Tinahones FJ, Fernández-García JC. Adiposity is Associated with Decreased Serum 17-Hydroxyprogesterone Levels in Non-Diabetic Obese Men Aged 18-49: A Cross-Sectional Study. J Clin Med 2020; 9:jcm9123873. [PMID: 33260786 PMCID: PMC7760398 DOI: 10.3390/jcm9123873] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/24/2020] [Accepted: 11/26/2020] [Indexed: 02/05/2023] Open
Abstract
Obesity is associated with decreased circulating testosterone levels, the main male sex hormone. However, there are a number of different male sex hormones whose dynamics remain poorly understood regarding this pathology. In this regard, 17 hydroxyprogesterone (17-OH progesterone), as an important precursor of testosterone synthetized in testes and adrenal glands, could play an essential role in testosterone deficiency in male obesity. Moreover, similarly to testosterone, 17-OH progesterone could be closely associated with visceral fat distribution and metabolic dysfunction. Thus, the aim of this study was to assess serum 17-OH progesterone levels in non-diabetic obese young men and to evaluate their relationship with clinical, analytical, and anthropometric parameters. We conducted a cross-sectional study including 266 non-diabetic men with obesity (BMI ≥ 30 kg/m2) aged 18-49 years; 17-OH progesterone and total testosterone (TT) were determined by high-performance liquid chromatography mass spectrometry. 17-OH progesterone levels were significantly lower in tertile 3 of body fat percentage in comparison with tertile 1 (0.74 ng/mL vs. 0.94 ng/mL, p < 0.01; Bonferroni correction) and in comparison with tertile 2 (0.74 ng/mL vs. 0.89 ng/mL, p = 0.02; Bonferroni correction). 17-OH progesterone levels correlated negatively with weight, BMI, waist circumference, insulin, homeostatic model assessment of insulin resistance (HOMA-IR), and visceral fat, and positively with TT, free testosterone (FT), luteinizing hormone, and fat-free mass percentage. Multivariate linear-regression analysis showed that body fat percentage and HOMA-IR were inversely associated with 17-OH progesterone levels, while FT and ACTH were positively linked to circulating 17-OH progesterone levels. In conclusion, in a population of non-diabetic obese young men, 17-OH progesterone levels were inversely associated with adiposity. Body fat percentage and insulin resistance were negatively related to 17-OH progesterone levels, whereas FT and ACTH levels were positively associated with 17-OH progesterone levels.
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Affiliation(s)
- José Ignacio Martínez-Montoro
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (J.I.M.-M.); (J.C.F.-G.)
| | - María Molina-Vega
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (J.I.M.-M.); (J.C.F.-G.)
- Laboratorio de Investigación, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain;
- Correspondence: (M.M.-V.); (F.J.T.); Tel.: +34951034016 (M.M.-V. & F.J.T.); Fax: +34951924651 (M.M.-V. & F.J.T.)
| | - Maite Asenjo-Plaza
- Cruz de Humilladero Primary Care Centre, 29006 Málaga, Spain; (M.A.-P.); (M.C.G.-R.); (E.V.-M.)
| | | | - Enrique Varea-Marineto
- Cruz de Humilladero Primary Care Centre, 29006 Málaga, Spain; (M.A.-P.); (M.C.G.-R.); (E.V.-M.)
| | - Isaac Plaza-Andrade
- Laboratorio de Investigación, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain;
| | | | | | - Francisco J. Tinahones
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (J.I.M.-M.); (J.C.F.-G.)
- Laboratorio de Investigación, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain;
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Correspondence: (M.M.-V.); (F.J.T.); Tel.: +34951034016 (M.M.-V. & F.J.T.); Fax: +34951924651 (M.M.-V. & F.J.T.)
| | - José Carlos Fernández-García
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (J.I.M.-M.); (J.C.F.-G.)
- Laboratorio de Investigación, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain;
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Endocrinology and Nutrition Department, Regional University Hospital of Malaga, 29010 Malaga, Spain
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Cinnamomum zeylanicum alleviate testicular damage induced by high fat diet in albino rats; histological and ultrastructural studies. Heliyon 2020; 6:e05584. [PMID: 33294709 PMCID: PMC7695915 DOI: 10.1016/j.heliyon.2020.e05584] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/06/2020] [Accepted: 11/20/2020] [Indexed: 12/14/2022] Open
Abstract
Hyperlipidemia has been related to sever health outcome include cardiovascular complication, metabolic disorders and infertility. Moreover, obesity has also been linked to dangerous effects on testicular morphology, spermatogenesis and sperm malformation. Many studies using different herbal medicines exert protective and therapeutic effect on the testes, spermatogenesis and fertility in animals fed high fat diet. Objective: this study aimed to find out the protective effect of cinnamon on testes of albino rat fed high fat diet (HFD). Forty adult male albino rats were selected and equally divided into 4 groups. Group 1: animals of this group were fed standard diet. Group 2: rats were fed standard diet and cinnamon "15% weight by weight, w/w" for 8 weeks. Group 3: animals in this group were fed HFD (2% cholesterol, 15 % sucrose, 15% corn, 15% cocoa butter, starch and 4.7% cellulose) for 8 weeks. Group 4: animals in this group were fed HFD and cinnamon. At the end of 4 weeks half animals were sacrificed and the rest of animals were sacrificed at the end of 8 weeks and blood samples were collected to assay the testosterone level. As well as testes were taken and prepared for both histological and ultrastructure studies. Histological examination of testicular tissue of HFD-fed animals revealed many pathological changes include degenerated seminiferous tubules, distorted germinal layers and interstitial tissue appeared degenerated with intertubular hemorrhage. Ultrastructural observations showed severe degenerated features including both different types of spermatogonia and interstitial tissue. On the other hand, both histological and ultrastructural alterations were substantially but not completely protect in obese animals fed HFD and cinnamon for 4 weeks while advanced degree of improvement tissue appeared after 8 weeks of the same treatment. As well as, significantly increase in the level of testosterone was recorded when compared with HFD-fed animals. The present work concluded that cinnamon dietary uptake may improve testicular damage induced by HFD as it has anti-inflammatory, anti-obesity and antioxidant activities.
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Öncel HF, Salar R, Özbay E, Elkan H. Changes in the sexual functions of male patients and their partners after obesity surgery. Andrologia 2020; 53:e13873. [PMID: 33108823 DOI: 10.1111/and.13873] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/09/2020] [Accepted: 09/15/2020] [Indexed: 11/30/2022] Open
Abstract
Sexual functionality significantly contributes to health-related quality of life and can decrease with obesity. In this study, we aimed to prospectively evaluate the changes that occur in the erection function, sexual function and testosterone level of male patients scheduled to undergo bariatric surgery, as well as the changes in the sexual function of their partner. A total of 40 patients and their partners were included. International Index of Erectile Function-5 (IIEF-5) questionnaire and the Arizona Sexual Experience Scale (ASEX) were filled before and 6 months after surgery by the male patients. The ASEX form was also completed by the partners before and 6 months after the procedure. The height and weight measurements and testosterone values were measured before and after surgery. A statistically significant difference was found between the preoperative and post-operative IIEF-5 scores of the patients (p = 0.000 < 0.01). There was also a statistically significant difference between the patients and their partners' preoperative and post-operative ASEX scores. We can conclude that the partners of men with preoperative erection complaints also experience sexual dysfunction, and with the post-operative decrease in or disappearance of erection complaints, the sexual function of both male patients and their partners improves.
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Affiliation(s)
- Halil F Öncel
- Urology Department, Mehmet Akif İnan Training & Research Hospital, Şanlıurfa, Turkey
| | - Remzi Salar
- Urology Department, Mehmet Akif İnan Training & Research Hospital, Şanlıurfa, Turkey
| | - Engin Özbay
- Urology Department, Mehmet Akif İnan Training & Research Hospital, Şanlıurfa, Turkey
| | - Hasan Elkan
- General Surgery Department, Şanlıurfa Training & Research Hospital, Şanlıurfa, Turkey
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36
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Lima TFN, Nackeeran S, Rakitina E, Lima GFN, Arora H, Kargi AY, Ramasamy R. Association of Leptin with Total and Free Testosterone: Results from the National Health and Nutrition Examination Surveys. ACTA ACUST UNITED AC 2020; 1:94-100. [PMID: 33179018 PMCID: PMC7654971 DOI: 10.1089/andro.2020.0007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introduction Obese men can have testosterone deficiency (TD) but the etiology is uncertain. Leptin is a 16-kDa protein produced primarily by adipose tissue and, therefore, is positively associated with the amount of body fat and can affect testosterone (T) production. We hypothesized that increased leptin can be independently associated with low T. Materials and Methods We performed a cross-sectional analysis of men from National Health and Nutrition Examination III database to evaluate the association of leptin with serum T and calculated free testosterone (cFT). Linear regression was performed with leptin, age, waist circumference, hypertension, and diabetes as independent variables predicting cFT/T. Multiple linear regression was used to determine predictors for cFT and T using variables previously significant in the univariate analysis. Results A total of 1193 men were analyzed. As expected, older and obese men were associated with having lower T. Interestingly, increasing leptin levels were an independent predictor of decreasing T and cFT on multivariable analysis. Increasing 1ng/mL in leptin resulted in a decrease of 5.13 and 0.11 ng/dL of T and cFT, respectively (p < 0.05). Also, every additional year of life led to a T and cFT reduction of 2.87 and 0.13 ng/dL, respectively, and increasing 1 cm in waist circumference corresponded to decrease of 4ng/dL in T (p < 0.05). Conclusions We concluded that increasing leptin, age, and waist circumference were associated with decreasing of T and cFT. Elevated leptin levels could be one of the potential etiologies of TD.
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Affiliation(s)
| | - Sirpi Nackeeran
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Evgeniya Rakitina
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | - Himanshu Arora
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA.,The Interdisciplinary Stem Cell Institute, Miller School of Medicine, University of Miami, Miami, Florida, USA.,Department of Human Genetics, John P Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Atil Y Kargi
- The Interdisciplinary Stem Cell Institute, Miller School of Medicine, University of Miami, Miami, Florida, USA.,Division of Endocrinology, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Ranjith Ramasamy
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA.,The Interdisciplinary Stem Cell Institute, Miller School of Medicine, University of Miami, Miami, Florida, USA
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Li FP, Wang CZ, Huang JM, Yang WT, Lan BY, Ding CZ, Huang CL, Lao GJ, Sun K, Li LL, Li N, Xiao HS, Yan L. Obesity-associated secondary hypogonadism in young and middle-aged men in Guangzhou: A single-centre cross-sectional study. Int J Clin Pract 2020; 74:e13513. [PMID: 32304616 DOI: 10.1111/ijcp.13513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/17/2020] [Accepted: 04/15/2020] [Indexed: 01/08/2023] Open
Abstract
AIM Male obesity-associated secondary hypogonadism (MOSH) is becoming a public health issue. We aimed to know MOSH among young and middle-aged men in our hospital, to analyse their sex hormones and other index, and to determine leptin as a risk factor for MOSH. METHODS In total, 258 men (ages ranging from 20 to 60, mean 38 ± 15) were enrolled in this study, and 242 of these men had their complete data, body mass index (BMI), waist circumference and sex hormones retrospectively investigated. The leptin and lipid levels were also evaluated, and comparisons were made between young (20-39 years old) and middle-aged (40-60 years old) men. RESULTS Among all the participants, 7 were thin, with a BMI < 18.5 kg/m2 , 95 had a normal BMI (18.5 ≤ BMI < 23.9 kg/m2 ), 87 (35.9%) were overweight (24 ≤ BMI ≤ 27.9 kg/m2 ) and 53 (21.9%) were obese (BMI ≥ 28 kg/m2 ), 173 (71.5%) had a waist sized ≥ 85 cm. Among the 242 men, 104 (43%) had hypogonadism (TT ≤ 331.412 ng/dL). Compared with the men of normal weight, the level of testosterone of the obese men decreased (P = .006), while the level of serum lipids (including total cholesterol, TG and low-density lipoprotein cholesterol, P < .05) was elevated, higher UA, FSH and leptin were also present in the obese men. There were 83 (34.2%) men with MOSH. Compared with middle-aged men with MOSH, the FSH in young men was significantly reduced (P < .05); no significant increase in estradiol was observed in the MOSH group. The leptin levels in the MOSH group were significantly higher than those in the hypogonadism only group (P < .001). CONCLUSION Obesity increases the prevalence of hypogonadism. The decrease in testosterone levels in young men maybe due to inhibition of the hypothalamic pituitary gonadal axis. Leptin is an independent risk factor for MOSH.
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Affiliation(s)
- Fang-Ping Li
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
- Department of Endocrinology and Metabolism, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, People's Republic of China
| | - Cheng-Zhi Wang
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Jia-Ming Huang
- Department of Endocrinology and Metabolism, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, People's Republic of China
| | - Wen-Tao Yang
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
- Department of Endocrinology, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China
| | - Bi-Yun Lan
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Chen-Zhao Ding
- Department of Endocrinology and Metabolism, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, People's Republic of China
| | - Chu-Lin Huang
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Guo-Juan Lao
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Kan Sun
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Ling-Ling Li
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Na Li
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Hui-Sheng Xiao
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Li Yan
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
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Nonalcoholic Fatty Liver Disease, Male Sexual Dysfunction, and Infertility: Common Links, Common Problems. Sex Med Rev 2020; 8:274-285. [DOI: 10.1016/j.sxmr.2019.01.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/28/2018] [Accepted: 01/14/2019] [Indexed: 12/18/2022]
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39
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Hanson P, Weickert MO, Barber TM. Obesity: novel and unusual predisposing factors. Ther Adv Endocrinol Metab 2020; 11:2042018820922018. [PMID: 32489583 PMCID: PMC7238298 DOI: 10.1177/2042018820922018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 04/05/2020] [Indexed: 12/28/2022] Open
Abstract
To tackle the complexity of the global obesity epidemic, it is important to consider the many predisposing factors that underlie progressive and sustained weight gain. Some of the biological drivers for weight gain following initial weight loss include persistent changes in appetite hormones [including ghrelin and postprandial plasma peptide YY (PYY)], and 'persistent metabolic adaptation'. However, many factors within our busy, stressful modern-day environment seem to conspire towards promotion of weight gain. These include the effects of sleep deprivation on appetite regulation, and the effects of modern-day technology on 'attention competition'. These factors, combined with cultural and societal factors can result in a 'mindless' attitude regarding eating-related behaviour that is likely to predispose to weight gain. In addition to the external environment, our internal environment within the gut has also changed radically within the last few decades, resulting from changes in fibre intake, and increased ingestion of highly refined, sterilised and processed foods. Although contentious, these dietary changes have implications for our gut microbiota, and possible downstream effects on control of appetite and metabolism. In this brief review, we consider some of the novel predisposing factors for weight gain within our modern-day 21st century environments (both external and internal), and explore how legal terminology can help to conceptualise the numerous factors that contribute towards weight gain, and, ultimately the global obesity epidemic.
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Affiliation(s)
- Petra Hanson
- Clinical Sciences Research Laboratories, Warwick
Medical School, University Hospitals Coventry and Warwickshire, Clifford
Bridge Road, Coventry, CV2 2DX
- Warwickshire Institute for the Study of
Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and
Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX
| | - Martin O. Weickert
- Clinical Sciences Research Laboratories, Warwick
Medical School, University Hospitals Coventry and Warwickshire, Clifford
Bridge Road, Coventry, CV2 2DX
- Warwickshire Institute for the Study of
Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and
Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX
- Centre of Applied Biological & Exercise
Sciences (ABES), Faculty of Health & Life Sciences, Coventry University,
Coventry, UK
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40
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The Role of Diet and Weight Loss in Improving Secondary Hypogonadism in Men with Obesity with or without Type 2 Diabetes Mellitus. Nutrients 2019; 11:nu11122975. [PMID: 31817436 PMCID: PMC6950423 DOI: 10.3390/nu11122975] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 11/27/2019] [Accepted: 12/02/2019] [Indexed: 12/11/2022] Open
Abstract
Despite growing recognition of the issue, obesity represents one of the most common public health problems, and its rates are still increasing globally. Among the number of comorbidities and complications associated with obesity, hypogonadism is listed, and this disorder, although frequently neglected, is characterized by a relevant impact on both quality of life and life expectancy. It is generally accepted that hypogonadism secondary to obesity is functional since it is reversible following weight loss. This review summarizes all current research examining the bidirectional relationship between excess body weight and low testosterone levels. Specifically, it evaluates the role that diet, with or without physical activity, plays in improving body weight and hypogonadism in adult and elderly men with obesity, with or without type 2 diabetes mellitus.
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41
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Jansen A, Berg JP, Klungsøyr O, Müller MHB, Lyche JL, Aaseth JO. The Influence of Persistent Organic Pollutants on Thyroidal, Reproductive and Adrenal Hormones After Bariatric Surgery. Obes Surg 2019; 30:1368-1378. [DOI: 10.1007/s11695-019-04273-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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42
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The Complex Relationship Between Erectile Dysfunction and Hypogonadism in Diabetes Mellitus. CURRENT SEXUAL HEALTH REPORTS 2019. [DOI: 10.1007/s11930-019-00216-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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43
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Molina-Vega M, Muñoz-Garach A, Damas-Fuentes M, Fernández-García JC, Tinahones FJ. Secondary male hypogonadism: A prevalent but overlooked comorbidity of obesity. Asian J Androl 2019; 20:531-538. [PMID: 29974886 PMCID: PMC6219298 DOI: 10.4103/aja.aja_44_18] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Male hypogonadism associated with obesity is a very prevalent condition and is increasing in parallel with the epidemic prevalence of obesity. Low testosterone levels promote higher fat mass with reduced lean mass. Male hypogonadism is related to an increase in associated cardiometabolic complications, such as hypertension, type 2 diabetes mellitus, the metabolic syndrome, and cardiovascular disease. Its influence as a comorbidity of obesity is becoming more evident and should be evaluated and treated in at-risk patients. Mechanisms involved in this relationship include body composition changes, the presence of adipokines, insulin resistance, and other factors, some of which are still unknown. Weight loss and treatment to replace testosterone levels improve the metabolic profile and quality of life in patients with obesity and hypogonadism; these beneficial effects depend on treatment modality and duration of therapy. The use of testosterone replacement therapy may be indicated, as it has not been shown to increase cardiovascular risk, and retrospective studies suggest a reduction in events in men with metabolic syndrome and type 2 diabetes.
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Affiliation(s)
- MarIa Molina-Vega
- Department of Endocrinology and Nutrition, Virgen de la Victoria Universitary Hospital, Malaga 29010, Spain
| | - Araceli Muñoz-Garach
- Department of Endocrinology and Nutrition, Virgen de la Victoria Universitary Hospital, Malaga 29010, Spain.,Institute of Biomedical Research in Málaga (IBIMA), Virgen de la Victoria Universitary Hospital, Malaga 29010, Spain
| | - Miguel Damas-Fuentes
- Department of Endocrinology and Nutrition, Virgen de la Victoria Universitary Hospital, Malaga 29010, Spain
| | - José Carlos Fernández-García
- Department of Endocrinology and Nutrition, Virgen de la Victoria Universitary Hospital, Malaga 29010, Spain.,Institute of Biomedical Research in Málaga (IBIMA), Virgen de la Victoria Universitary Hospital, Malaga 29010, Spain.,CIBER Pathophysiology of Obesity and Nutrition (CB06/003), Institute of Health Carlos III (ISCIII), Madrid 28029, Spain
| | - Francisco J Tinahones
- Department of Endocrinology and Nutrition, Virgen de la Victoria Universitary Hospital, Malaga 29010, Spain.,Institute of Biomedical Research in Málaga (IBIMA), Virgen de la Victoria Universitary Hospital, Malaga 29010, Spain.,CIBER Pathophysiology of Obesity and Nutrition (CB06/003), Institute of Health Carlos III (ISCIII), Madrid 28029, Spain
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44
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Barber TM, Hanson P, Weickert MO, Franks S. Obesity and Polycystic Ovary Syndrome: Implications for Pathogenesis and Novel Management Strategies. CLINICAL MEDICINE INSIGHTS. REPRODUCTIVE HEALTH 2019; 13:1179558119874042. [PMID: 31523137 PMCID: PMC6734597 DOI: 10.1177/1179558119874042] [Citation(s) in RCA: 135] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 08/05/2019] [Indexed: 01/06/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a common female condition typified by reproductive, hyperandrogenic, and metabolic features. Polycystic ovary syndrome is a genetic condition, exacerbated by obesity. There is a close link between obesity and PCOS based on epidemiological data, and more recently corroborated through genetic studies. There are many mechanisms mediating the effects of weight-gain and obesity on the development of PCOS. The metabolic effects of insulin resistance and steroidogenic and reproductive effects of hyperinsulinaemia are important mechanisms. Adipokine production by subcutaneous and visceral fat appears to play a part in metabolic function. However, given the complexity of PCOS pathogenesis, it is important also to consider possible effects of PCOS on further weight-gain, or at least on hampering attempts at weight-loss and maintenance through lifestyle changes. Possible mediators of these effects include changes in energy expenditure, mental ill health, or physical inactivity. In this brief review, we discuss the main mechanisms that underlie the association between obesity and PCOS, from divergent perspectives of weight-gain contributing to development of PCOS and vice versa. We also consider novel management options for women with obesity and PCOS.
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Affiliation(s)
- Thomas M Barber
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Coventry, UK.,Warwick Medical School, University of Warwick, Coventry, UK
| | - Petra Hanson
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Coventry, UK.,Warwick Medical School, University of Warwick, Coventry, UK
| | - Martin O Weickert
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Coventry, UK.,Warwick Medical School, University of Warwick, Coventry, UK.,Centre of Applied Biological and Exercise Sciences, Coventry University, Coventry, UK
| | - Stephen Franks
- Institute of Reproductive Medicine, Imperial College London, London, UK
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45
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Aminuddin A, Salamt N, Ahmad Fuad AF, Chin KY, Ugusman A, Soelaiman IN, Wan Ngah WZ. Vascular Dysfunction among Malaysian Men with Increased BMI: An Indication of Synergistic Effect of Free Testosterone and Inflammation. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E575. [PMID: 31500378 PMCID: PMC6780688 DOI: 10.3390/medicina55090575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/04/2019] [Accepted: 09/04/2019] [Indexed: 12/31/2022]
Abstract
Background and objectives: Obesity is associated with poor vascular function and may lead to future cardiovascular disease (CVD). Obesity is also related to increased inflammation and a low testosterone level. This study was conducted to determine the relationship between inflammation, testosterone level, and vascular function among subjects with an increased body mass index (BMI) and to determine whether both low testosterone and high inflammation have synergistic effects towards vascular dysfunction. Materials and Methods: A total of 303 men aged 40-80 years were recruited from Klang Valley, Malaysia. Their height, weight, blood pressure (BP), lipid, blood glucose level, total testosterone (TT), free testosterone (FT), and C-reactive protein (CRP) were measured. The carotid femoral pulse wave velocity (PWVCF) and augmentation index (AI) were also recorded as markers of vascular function. Results: The mean age of all the subjects was 54.46 ± 9.77 years. Subjects were divided into a low/normal body mass index (BMI) group (BMI < 25 kg/m2; NG, n = 154) and high BMI group (BMI ≥ 25 kg/m2; OG, n = 149). The mean BMI for NG was 22.20 ± 1.94 kg/m2 while for OG was 28.87 ± 3.24 kg/m2 (p < 0.01). The level of TT (OG = 21.13 ± 6.44 versus NG = 16.18 ± 6.16 nmol/L, p < 0.01) and FT (OG = 0.34 ± 0.12 versus NG = 0.39 ± 0.11 nmol/L, p < 0.01) were reduced while the level of CRP [OG = 1.05 (2.80) versus NG = 0.50 (1.50) mmol/L, p = 0.01] was increased in OG compared to NG. PWVCF (OG = 8.55 ± 1.34 versus NG = 8.52 ± 1.42 m/s, p = 0.02) and AI (OG = 16.91% ± 6.00% versus 15.88% ± 5.58%, p < 0.01) were significantly increased in OG after adjustment for other CVD risk factors. The subjects that had both a low FT and an increased CRP had higher AI when compared to those with a high CRP and high FT (p < 0.01). Conclusions: The increased BMI was associated with vascular dysfunction, mediated by a low testosterone level and increased inflammation. Furthermore, having both conditions concurrently lead to higher vascular dysfunction. Weight loss, testosterone supplementation, and the anti-inflammatory agent may be beneficial for men to prevent vascular dysfunction.
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Affiliation(s)
- Amilia Aminuddin
- Department of Physiology, Universiti Kebangsaan Malaysia Medical Center, 56000 Cheras, Kuala Lumpur, Malaysia.
| | - Norizam Salamt
- Department of Physiology, Universiti Kebangsaan Malaysia Medical Center, 56000 Cheras, Kuala Lumpur, Malaysia.
| | - Ahmad Faiz Ahmad Fuad
- Department of Physiology, Universiti Kebangsaan Malaysia Medical Center, 56000 Cheras, Kuala Lumpur, Malaysia.
| | - Kok-Yong Chin
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Center, 56000 Cheras, Kuala Lumpur, Malaysia.
| | - Azizah Ugusman
- Department of Physiology, Universiti Kebangsaan Malaysia Medical Center, 56000 Cheras, Kuala Lumpur, Malaysia.
| | - Ima Nirwana Soelaiman
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Center, 56000 Cheras, Kuala Lumpur, Malaysia.
| | - Wan Zurinah Wan Ngah
- Department of Biochemistry, Universiti Kebangsaan Malaysia Medical Center, 56000 Cheras, Kuala Lumpur, Malaysia.
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46
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Carrageta DF, Oliveira PF, Alves MG, Monteiro MP. Obesity and male hypogonadism: Tales of a vicious cycle. Obes Rev 2019; 20:1148-1158. [PMID: 31035310 DOI: 10.1111/obr.12863] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 03/20/2019] [Accepted: 03/21/2019] [Indexed: 12/12/2022]
Abstract
Obesity prevalence, particularly in children and young adults, is perilously increasing worldwide foreseeing serious negative health impacts in the future to come. Obesity is linked to impaired male gonadal function and is currently a major cause of hypogonadism. Besides signs and symptoms directly derived from decreased circulating testosterone levels, males with obesity also present poor fertility outcomes, further evidencing the parallelism between obesity and male reproductive function. In addition, males with androgen deficiency also exhibit increased fat accumulation and reduced muscle and mineral bone mass. Thus, compelling evidence highlights a vicious cycle where male hypogonadism can lead to increased adiposity, while obesity can be a cause for male hypogonadism. On the opposite direction, sustained weight loss can attain amelioration of male gonadal function. In this scenario, a thorough evaluation of gonadal function in men with obesity is crucial to dissect the causes from the consequences in order to target clinical interventions towards maximized improvement of reproductive health. This review will address the causes and consequences of the bidirectional relationship between obesity and hypogonadism, highlighting the implicit male reproductive repercussions.
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Affiliation(s)
- David F Carrageta
- Department of Microscopy, Laboratory of Cell Biology, Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Pedro F Oliveira
- Department of Microscopy, Laboratory of Cell Biology, Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal.,i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,Department of Genetics, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Marco G Alves
- Department of Microscopy, Laboratory of Cell Biology, Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Mariana P Monteiro
- Clinical and Experimental Endocrinology, Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
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47
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Fernandez CJ, Chacko EC, Pappachan JM. Male Obesity-related Secondary Hypogonadism - Pathophysiology, Clinical Implications and Management. EUROPEAN ENDOCRINOLOGY 2019; 15:83-90. [PMID: 31616498 PMCID: PMC6785957 DOI: 10.17925/ee.2019.15.2.83] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 07/04/2019] [Indexed: 02/05/2023]
Abstract
The single most significant risk factor for testosterone deficiency in men is obesity. The pathophysiological mechanisms involved in male obesity-related secondary hypogonadism are highly complex. Obesity-induced increase in levels of leptin, insulin, proinflammatory cytokines and oestrogen can cause a functional hypogonadotrophic hypogonadism with the defect present at the level of the hypothalamic gonadotrophin-releasing hormone (GnRH) neurons. The resulting hypogonadism by itself can worsen obesity, creating a self-perpetuating cycle. Obesity-induced hypogonadism is reversible with substantial weight loss. Lifestyle-measures form the cornerstone of management as they can potentially improve androgen deficiency symptoms irrespective of their effect on testosterone levels. In selected patients, bariatric surgery can reverse the obesity-induced hypogonadism. If these measures fail to relieve symptoms and to normalise testosterone levels, in appropriately selected men, testosterone replacement therapy could be started. Aromatase inhibitors and selective oestrogen receptor modulators are not recommended due to lack of consistent clinical trial-based evidence.
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Affiliation(s)
- Cornelius J Fernandez
- Department of Endocrinology & Metabolism, Pilgrim Hospital, United Lincolnshire Hospitals NHS Trust, Boston, UK
| | - Elias C Chacko
- Department of Endocrinology, Jersey General Hospital, St Helier, Jersey
| | - Joseph M Pappachan
- Department of Endocrinology & Metabolism, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
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48
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Sytsma TT, McCoy RG. 37-Year-Old Man With Fatigue and Erectile Dysfunction. Mayo Clin Proc 2019; 94:e85-e90. [PMID: 31272586 DOI: 10.1016/j.mayocp.2018.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 08/29/2018] [Accepted: 09/10/2018] [Indexed: 10/26/2022]
Affiliation(s)
- Terin T Sytsma
- Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Rochester, MN
| | - Rozalina G McCoy
- Advisor to resident and Consultant in Community Internal Medicine, Mayo Clinic, Rochester, MN.
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49
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Rigon FA, Ronsoni MF, Hohl A, van de Sande-Lee S. Effects of Bariatric Surgery in Male Obesity-Associated Hypogonadism. Obes Surg 2019; 29:2115-2125. [DOI: 10.1007/s11695-019-03829-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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50
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Casimiro I, Sam S, Brady MJ. Endocrine implications of bariatric surgery: a review on the intersection between incretins, bone, and sex hormones. Physiol Rep 2019; 7:e14111. [PMID: 31134746 PMCID: PMC6536581 DOI: 10.14814/phy2.14111] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/08/2019] [Accepted: 05/08/2019] [Indexed: 12/25/2022] Open
Abstract
Bariatric surgery is now the most widely used intervention for the treatment of human obesity. A large body of literature has demonstrated its efficacy in sustained weight loss and improvement in its associated comorbidities. Here, we review the effect of bariatric surgery in gut hormone physiology, bone remodeling and the reproductive axis. Rapid improvements in insulin release and sensitivity appear to be weight loss independent and occur immediately after surgery. These effects on pancreatic beta cells are mostly due to increased gut hormone secretion due to augmented nutrient delivery to the small intestine. Bone remodeling is also affected by gut hormones. Phenotypic skeletal changes observed in mice deficient in GLP-1 or GIP suggest that increased incretins may improve bone density. However, these positive effects may be counterbalanced by the association between weight loss and a reduction in bone density. Finally, studies have shown a marked improvement following bariatric surgery in infertility and PCOS in women and hypogonadism in men. Thus, the net effect on endocrine systems after bariatric surgery will likely vary on an individual basis and depend on factors such as comorbidities, peri-menopausal state, amount of weight loss, and likelihood to adhere to vitamin supplementation after surgery.
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Affiliation(s)
- Isabel Casimiro
- Section of Endocrinology, Diabetes & MetabolismUniversity of ChicagoChicagoIllinois
| | - Susan Sam
- Section of Endocrinology, Diabetes & MetabolismUniversity of ChicagoChicagoIllinois
| | - Matthew J. Brady
- Section of Endocrinology, Diabetes & MetabolismUniversity of ChicagoChicagoIllinois
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