Hormonal changes in non-endocrine disease

Differentials in sex ratio at birth among natives and immigrants in Greece: an analysis employing nationwide micro-data

This study uses micro-level information on the live births registered in Greece for 2006 to assess differentials in the propensity to have a male offspring between natives and immigrants. The sex ratio at birth for the whole population is 106.3 but it is considerably higher among immigrants (110.9) than among natives (105.4). Relatively high sex ratios at birth are observed for several migrant groups; differentials between natives, on the one hand, and Albanians (109.5) and Asians (129.0), on the other, are significant. The high sex ratio at birth for Albanians seems typical of that population. For Asians, the result is consistent with international findings though it may also be partly related to the small number of observations.

Effect of the Lebanese civil war on sex ratio

Sex ratio is a subject of scientific interest but little is known about the factors that affect the sex ratio of humans. The aim of this study was to assess the effect of the Lebanese civil war on sex ratio. Data on all live births delivered at a large university hospital for the years 1977-2005 were used in this study. Study periods were defined as wartime (1977-1992) and post-war (1993-2005). The sex ratio in the study time period was calculated as the male proportion, i.e. males/males + females in live-born infants. Sex ratio during the war was compared with that of the post-war period. The sex ratio was similar in the war and post-war period (0.515 versus 0.513; OR = 1.007; 95% CI 0.98-1.04). The annual variation in the sex ratio during the study period did not show any significant change in any of the years. In conclusion, the Lebanese civil war did not cause a detectable change in sex ratio at birth. Factors that might have affected the sex ratio include the nature of the study population (civilians), the variable intensity of war in different periods, and the effect of stress and environmental toxins.

Total body potassium, fat and water during total parenteral nutrition in Crohn's disease

The body composition was studied by measurement of body weight (BW) and total body potassium (TBK), fat and water in 13 patients with Crohn's disease (CD), who were given altogether 18 courses of total parenteral nutrition (TPN) with nil by mouth each lasting at least 3 weeks. At the start of TPN, one group of steroid-free patients displayed intracellular potassium depletion, as reflected by the ratio TBK/lean body mass (LBM) (group 1). Another group of steroid-free patients showed no depletion of intracellular potassium (group 2). The patients given prednisolone all showed intracellular potassium depletion and were assigned to a separate group (group 3). During the initial 19-44 days of TPN, TBK, LBM and BW increased in group 1. All patients with intracellular potassium depletion (groups 1 + 3) showed an increase in TBK and TBK/LBM during the initial 19-51 days of TPN. For steroid-free patients (groups 1 + 2) there were linear relationships between the rate of energy supply per kg LBM and the 24 h change in BW during the third and fourth weeks of TPN (r = 0.79) and between the 24 h change in BW and LBM during the first 19-44 days of TPN (r = 0.59). A steady state in BW was found on administering 53 kcal/kg LBM/24 h. It is concluded that CD patients with intracellular potassium depletion are likely to be improved in terms of TBK and TBK/LBM by at least 3 weeks of TPN as given in the present study. Steroid-free CD patients with intracellular potassium depletion are, moreover, likely to show an improvement in LBM by at least 3 weeks of TPN, and an increase in their BW during the initial 3-6 weeks of TPN will probably reflect an increase in LBM. The pre-TPN TBK/LBM ratio may be a predictor of the repletion rate of the LBM compartment during TPN of steroid-free wasted CD patients.

Offspring sex ratios at birth as markers of paternal endocrine disruption

There is good evidence that paternal (and maternal) hormone levels at the time of conception are associated with offspring sex ratios (proportions male) at birth. The mechanisms underlying this association (pre- or postzygotic) are not of primary relevance here. When people are exposed to endocrine-disrupting agents, these agents may have different hormonal effects on men and women. So, if endocrine disruption is to be revealed by offspring sex ratios, it is necessary to categorize the sexes of subsequent offspring by the four possible parental mating classes, viz. exposed/unexposed mothers/fathers. In general, substantially altered sex ratios may reveal endocrine disruption, but the tiny (admittedly significant) secular meanderings of national live birth sex ratios across the 20th Century (and before) are not now readily interpretable.

Possible constraints on adaptive variation in sex ratio at birth in humans and other primates

There is general agreement that adaptive variation of sex ratio at birth has not been decisively demonstrated in primates (including human beings). So some workers have questioned whether it actually exists. Others have conjectured that it exists but is subject to as yet unidentified 'constraints' (factors opposing the modifying influences of selection in the phenotype). Meanwhile though most workers have called for research to reveal the proximate causes of sex ratio variation, few (if any) have directed studies toward that end. Here it is argued that hormonal action is responsible both for much adaptive and non-adaptive sex ratio variation, and for constraints on the adaptive variation. My hypothesis proposes that levels of steroid hormones (testosterone and oestrogen) of both parents around the time of conception are positively associated with offspring sex ratio (proportion male at birth) of mammals including man. Testosterone in men and oestrogen in women are also known to be positively associated with the health, attractiveness and fertility of individual human beings. However, high levels of testosterone in women are frequently associated with adverse medical conditions. It is suggested that for these reasons (and contrary to some adaptive theory) some classes of people (particularly women) in suboptimal health ("condition") produce excesses of sons. It seems that gonadal hormones are responsible for adaptive variation; and that maternal adrenal hormones are responsible for maladaptive variation. In evolutionary terms, gonadal hormones precede adrenal hormones.

Hormonal modifications in patients admitted to an internal intensive care unit for acute hypoxaemic respiratory failure

To clarify which endocrine modifications can be observed in acute hypoxaemic respiratory failure, 15 severely ill male patients [PAT; median age: 61 (range: 48 years); median height: 173 (range: 12) cm; median mass: 73 (range 31) kg] were investigated immediately upon admission to an intensive care unit (ICU) for this clinical disorder. Before starting treatment, the blood gases were measured and a number of selected hormones with special relevance for an ICU setting were determined. These are known to be modified by acute hypoxaemia in healthy subjects and to possess glucoregulatory properties, or an influence upon cardiocirculation or the vascular volume regulation: insulin, cortisol, adrenaline, noradrenaline, atrial natriuretic peptide, renin, aldosterone, angiotensin converting enzyme, and endothelin-I (ET). To elucidate whether potential endocrine changes resulted from acute hypoxaemia alone, the underlying disease, or unspecific influences connected with the ICU setting, all measurements were compared to those of a completely healthy reference group (REF) with comparable acute experimental hypoxaemia. The latter state was achieved by having the REF breathe a gas mixture with the oxygen content reduced to 14% (H). In the REF, neither the medians nor the distribution of endocrinologic measurements were modified significantly by acute hypoxaemia. In the PAT, the medians were increased considerably, yet with a slight diminution of ET. The distribution of individual values was considerably broader than in the REF with H. In conclusion, considerable increases in the means of the above hormones, with the exception of ET, can be registered in severely ill patients admitted to ICUs with acute hypoxaemic failure. However, such modifications cannot be considered attributable exclusively to acute arterial hypoxaemia. The underlying clinical disorders, such as septicaemia or an unspecific endocrine epiphenomenon, including severe and not only hypoxaemic stress, seem to be predominant.

Might patients with HLA-B27 related diseases benefit from antiandrogenic treatment?

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Hormonal factors associated with weight loss in patients with advanced breast cancer

Fasting blood samples were collected from 83 patients with histologically proven breast cancer and analysed for plasma glucagon, serum immunoreactive tumour necrosis factor (TNF alpha), insulin, glucose, growth hormone, cortisol and TSH. Samples from patients with known diabetes mellitus or thyroid disease, and those on parenteral nutrition or with evidence of infection were excluded as were patients who had a history of weight loss through dieting or who were anorexic. Fasting plasma glucagon, serum cortisol and immunoreactive TNF alpha concentrations in patients with stage IV breast cancer who had developed weight loss were significantly higher than those in patients with stage IV disease who had not developed weight loss. There were no significant differences in the fasting serum concentrations of insulin, glucose, growth hormone and TSH between the two patient groups. The association between weight loss in stage IV breast cancer and increased concentrations of plasma glucagon, serum cortisol and TNF alpha suggests a possible role for these hormonal factors in the development of cancer cachexia.

Hormonal changes in severely uncontrolled type 1 (insulin-dependent) diabetes mellitus

To investigate endocrinological changes associated with severely uncontrolled type 1 (insulin-dependent) diabetes mellitus 27 patients (19 men, eight women) with ketoacidosis or severe ketonuria (= group 1) were examined on admission and after recovery. For comparison 13 non-ketotic patients (seven men, six women), admitted for adjustment of treatment because of poor diabetic control (= group 2), and 20 healthy controls were studied. On admission, the serum testosterone levels in men were lower in group 1 (15.1 +/- 2.0 nmol l-1) (mean +/- SEM) than in group 2 (27.2 +/- 2.8 nmol l-1) (p less than 0.01) and healthy controls (20.6 +/- 2.0 nmol l-1) (p less than 0.05). During treatment the testosterone levels in group 1 rapidly rose to the control level. The serum oestradiol levels in women were low in group 1 both on admission and discharge. The serum prolactin levels were low in female patients in group 1 (119 +/- 17 mIU l-1) compared with the women in group 2 (315 +/- 75 mIU l-1) (p less than 0.05). On admission the serum cortisol levels were higher and their response to 1 mg of dexamethasone was weaker in group 1 than in group 2 and healthy controls. After recovery the serum cortisol levels fell by 15% (p less than 0.01) and the response to 1 mg of dexamethasone returned to normal in group 1. In group 1 during treatment the serum free T4 and reverse T3 levels fell, and the T3 levels rose, whereas the thyroid stimulating hormone (TSH) levels and their responses to TRH remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

Disturbed endocrine function in the psychoses. I: Disordered homeostasis or disease process?

Plasma concentrations of prolactin, growth hormone, cortisol, TSH, and the neurophysins were measured over 17 hours in 98 newly admitted psychiatric patients and 35 control subjects. Seventy patients had been free of psychotropic medication for three months. Patients with schizoaffective mania (SAM) differed significantly from control subjects by increased plasma cortisol concentrations and decreased night-time TSH concentrations. The latter were also significantly lower than in both schizophrenic and manic disorder patients. Plasma cortisol was increased to a lesser extent in other psychotic subgroups, and increases in prolactin were most marked in the affective psychoses. There was little diagnostic specificity for psychoses other than SAM. Higher cortisol and prolactin levels may be due to the stimulatory effect of serotonergic pathways, but the neural mechanisms underlying lower night-time TSH levels in SAM are not known. The findings are not consistent with the view (a) that the hormonal changes of the psychoses simply reflect a non-specific response to stress, or (b) that the biological abnormalities of the psychoses can be accounted for by a single continuum of disturbance.

Circulating hormones and pituitary responsiveness in young epileptic men receiving long-term antiepileptic medication

Impairment of libido and sexual potency are commonly reported by male epileptic patients. This may be partly a consequence of medication. Circulating hormones were measured in 53 postpubertal male epileptic patients less than 45 years of age and in an age-matched control group (n = 40), consisting of 14 untreated epileptic patients and 26 unmedicated healthy subjects. A subgroup also underwent a combined gonadotrophin- and thyrotrophin-releasing hormone (LH-RH/TRH) pituitary stimulation test. Untreated patients did not differ from healthy subjects for any parameter, and their data were combined for comparison with the treated epileptic patients. Total testosterone (T), androstenedione, and basal follicle-stimulating hormone concentrations were similar in all patient groups. Patients receiving more than one drug had higher sex hormone binding globulin (SHBG) (p less than 0.01) and lower free T and dehydroepiandrosterone sulphate (DHAS) levels (both p less than 0.001) than controls. Carbamazepine (CBZ) monotherapy also reduced free T (p less than 0.05) and DHAS (p less than 0.001) and increased basal prolactin (p less than 0.01). In these two groups of patients, basal luteinising hormone (LH) was elevated (p less than 0.01), presumably as a pituitary response to increased T catabolism. There was a negative correlation between free T and circulating CBZ (r = -0.54, p less than 0.05) in the monotherapy patients. Phenytoin (PHT) was associated with a rise in SHBG (p less than 0.01) and a fall in DHAS (p less than 0.001). Basal LH was also elevated, but this just failed to reach statistical significance (p less than 0.1).(ABSTRACT TRUNCATED AT 250 WORDS)

Thyroid screening in elderly hospital patients

A screening programme of thyroid disease in 214 elderly patients attending hospital was undertaken incorporating clinical and biochemical assessment. The prevalence of untreated hypothyroidism was 2.8%, treated hypothyroidism 2.8%, untreated hyperthyroidism 0.9%, sub-clinical hypothyroidism 4.7%, and non-thyroidal illness 3.3%. One patient with hypopituitarism was identified. Clinical judgement alone was poor. The costs of such a screening programme are discussed and the benefits highlighted.

Androgen levels in men with diabetes mellitus

Patients in varying degrees of diabetic ketoacidosis had low serum testosterone levels which rose following recovery (5.4 +/- 1.3----13.7 +/- 1.7 nmol/l, p less than 0.02, mean +/- SE). Blood glucose control of 30 non-ketotic diabetic men (15 insulin-dependent and 15 non-insulin-dependent) did not correlate significantly with serum testosterone concentrations. Although previous authors had suggested that the adrenal androgen status of diabetic patients might be abnormal, adrenal androgens androstenedione and dehydroepiandrosterone sulphate (DHEAS) were similar in our 30 men to age-matched healthy men.