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Wang G, Wang Z, Zhang J, Shen Y, Hou X, Su L, Chen W, Chen J, Guo X, Song H. Treatment of androgenetic alopecia by exosomes secreted from hair papilla cells and the intervention effect of LTF. J Cosmet Dermatol 2023; 22:2996-3007. [PMID: 37553912 DOI: 10.1111/jocd.15890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/25/2023] [Accepted: 06/14/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Androgenetic alopecia (AGA) is the most common cause of chronic progressive hair loss in men, and AGA has a severe negative impact on the quality of life and physical and mental health of patients. METHODS Four female C57BL/6 mice were isolated from DP cells in culture (≤4 generations) after stimulation of DPC proliferation by herbal concentrations obtained by the CCK-8 method, and exosomes were isolated by differential centrifugation at low temperature. Testosterone propionate and topical hair removal treatments were used together to establish the C57BL/6 mouse AGA model, which was treated with LTF, 5% minoxidil, and LTF-DPC-EXO, respectively. ELISA was used to detect serum hormone levels, in vivo tracing was used to observe dynamic changes in exosomes, H&E staining showed changes in mouse hair follicle tissue, and (q) RT-PCR and WB were used to detect dorsal skin VEGF, AKT1, and CASP3 expression in dorsal skin tissues. RESULTS Hair regeneration was significant in the LTF group, minoxidil group, and LTF-DPC-EXO group mice, and the hair growth was only seen in the local skin in the model group. The hormone T in all treatment groups was lower than that in the model group, and e2 was higher than that in the model group. (q) RT-PCR and western blot showed that VEGF and AKT1 expressions were upregulated and Caspase3 expression was downregulated in the skin sections of mice in the treatment groups. CONCLUSION DPC-EXO obtained through LTF may activate AKT1 and VEGF in the PI3K/AKT signaling pathway to inhibit CASP3, thereby protecting DPC to restore the hair growth.
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Affiliation(s)
- Guiyue Wang
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhili Wang
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiaqi Zhang
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yan Shen
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xin Hou
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Lin Su
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Wen Chen
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiahao Chen
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiang Guo
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Hong Song
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
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Matta RA, Farrage HM, Saedii AA, Abdelrahman MM. Male subclinical hypogonadism and late-onset hypergonadotrophic hypogonadism: mechanisms, endothelial function, and interplay between reproductive hormones, undercarboxylated osteocalcin, and endothelial dysfunction. Aging Male 2022; 25:72-87. [PMID: 35291927 DOI: 10.1080/13685538.2022.2049744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Pathogenesis and endothelial function in subclinical hypogonadism (SCH) remain unclear. Undercarboxylated osteocalcin (ucOC) participates in atherosclerosis and reproduction. We explored the underlying mechanisms and interplay of endothelial dysfunction, unOC and reproductive hormones in SCH and primary late-onset hypogonadism (LOH). METHODS In the SCH, LOH, and healthy eugonadal male groups, we measured serum unOC, calculated luteinizing hormone/testosterone (LH/T), LH.T product, and estradiol/T (E/T) as indicators of impaired Leydig cells, androgen sensitivity index (ASI), and aromatase activity, respectively (LH set-point regulators), and assessed flow-mediated dilation of the brachial artery (FMD%), carotid-intima media thickness (CIMT), and aortic stiffness (AS). RESULTS ↑LH/T, ↑ASI, ↓aromatase activity, normal T, follicle-stimulating hormone (FSH) and sex hormone-binding globulin (SHBG) levels, ↑unOC, and enhanced atherosclerotic markers (↓FMD%, ↑CIMT, ↑AS) are characteristics of SCH. Testosterone was positively correlated with FMD% in SCH. The independent predictors were: SHBG and LH for FMD% and CIMT, respectively, and LH/T, ucOC, FSH, estradiol, and E/T ratio for AS in the LOH group; and LH for FMD% & AS and LH and LH/T for CIMT in all study subjects. CONCLUSIONS SCH is a distinct clinical entity characterized by impaired androgen sensitivity and aromatase activity, compensatory elevated unOC, endothelial dysfunction, and anti-atherogenic role of testosterone.
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Affiliation(s)
- Ragaa Abedelshaheed Matta
- Diabetes and Endocrinology Unit, Department of Internal Medicine, Faculty of Medicine, Minia University, Minia, Egypt
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3
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Hanssen H. Sex hormones and cardiovascular health: differentiation of the vascular bed is a key piece of the puzzle. Eur J Prev Cardiol 2021; 28:1588-1589. [PMID: 33624087 DOI: 10.1093/eurjpc/zwaa101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Henner Hanssen
- Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320B, 4052 Basel, Switzerland
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4
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Huang ZX, Chen LH, Xiong R, He YN, Zhang Z, Zeng J, Cai Q, Liu Z. Essen Stroke Risk Score Predicts Carotid Atherosclerosis in Chinese Community Populations. Healthc Policy 2020; 13:2115-2123. [PMID: 33116991 PMCID: PMC7568636 DOI: 10.2147/rmhp.s274340] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 09/28/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Carotid atherosclerosis (CA) is closely related to stroke, and Framingham Risk Score (FRS) has been used for CA risk evaluation. However, FRS could only be used for subjects of up to 74 years old. The present study was to determine if Essen Stroke Risk Score (ESRS) could be used to estimate CA risk in community populations without age limits. METHODS In the present prospective multi-community screening study, we evaluated the prevalence of CA using high-resolution ultrasound in 521 males and 1039 females (35 to 91 years old). Both FRS and ESRS were calculated for the subjects. Multivariate logistic regression analysis was used to determine the predictive values of FRS and ESRS for CA in these subjects. RESULTS Ultrasound data showed that CA was present in 56.2% of the participants (total of 1560). Multivariate logistic regression analysis showed that ESRS was associated with CA with odds ratio (OR): 1.34 (95% confidence interval (CI), 1.12-1.60, p=0.001). Central obesity (OR: 1.40, CI: 1.07-1.83, p=0.015), female (OR: 0.55, CI: 0.39-0.77, p <0.001) and age (OR: 2.63, CI: 2.27-3.06, p <0.001) were also associated with CA. Based on the estimated area under curve (AUC), FRS (AUC 0.775) was better than ESRS (AUC 0.693) (z statistic 6.774, p <0.001) for CA prediction for individuals of ≤74 years old. However, receiver operating characteristic analysis showed ESRS was a good CA predictor for all subjects (AUC of 0.715). CONCLUSION ESRS could be used as an alternative to FRS to predict CA in community population of all age.
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Affiliation(s)
- Zhi-Xin Huang
- Department of Neurology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People's Republic of China.,Department of Neurology, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Li-Hua Chen
- Department of Neurology, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Ran Xiong
- Department of Ultrasonography, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People's Republic of China
| | - Yan-Ni He
- Department of Ultrasonography, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People's Republic of China
| | - Zhu Zhang
- Department of Neurology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People's Republic of China.,Department of Neurology, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Jie Zeng
- Department of Center for Clinical Epidemiology and Methodology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People's Republic of China
| | - Qiankun Cai
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, People's Republic of China
| | - Zhenguo Liu
- Center for Precision Medicine and Division of Cardiovascular Medicine, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USA
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5
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Cortés YI, Barinas-Mitchell E, Suder Egnot N, Bhasin S, Jasuja R, Santoro N, Thurston RC. Associations of Endogenous Sex Hormones with Carotid Plaque Burden and Characteristics in Midlife Women. J Clin Endocrinol Metab 2020; 105:5695920. [PMID: 31900485 PMCID: PMC7077951 DOI: 10.1210/clinem/dgz327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 01/01/2020] [Indexed: 12/22/2022]
Abstract
CONTEXT Endogenous sex hormones may be involved in the pathogenesis of cardiovascular disease (CVD) in women. Carotid plaque characteristics, such as echogenicity, an ultrasound measure that reflects plaque composition, may identify unstable plaques that are more likely to rupture, precipitating a CVD event. However, few studies have considered sex steroids in relation to carotid plaque and its characteristics. OBJECTIVE To evaluate estrone (E1), estradiol (E2), testosterone (T), sex hormone binding globulin (SHBG), and free T (FT) in relation to carotid plaque in women. DESIGN, SETTING, AND PARTICIPANTS In MsHeart, a cross-sectional study of 304 women aged 40 to 60 years, participants underwent a carotid artery ultrasound assessment. The current analysis included MsHeart participants with carotid plaque (n = 141, 46%). E1, E2, and T were assayed using liquid chromatography-tandem mass spectrometry; FT was estimated using ensemble allostery models. Regression models were adjusted for sociodemographic characteristics and CVD risk factors. MAIN OUTCOMES Carotid plaque burden (number of plaques, total plaque area [TPA]) and characteristics (calcification, echogenicity) were determined using semi-automated software. RESULTS SHBG was inversely related to TPA (odds ratio [OR] 0.39; 95% confidence interval [CI] 0.21, 0.74; multivariable) and higher FTs were associated with greater TPA (OR 2.89; 95% CI 1.31, 6.37; multivariable). Higher E1 was related to echogenicity (OR 2.31; 95% CI 1.26, 4.33; multivariable), characteristic of more stable plaque. CONCLUSIONS SHBG and FT are related to TPA while E1 is related to plaque echogenicity, suggesting these hormones have different roles in the development of carotid plaque. Our findings highlight the importance of sex hormones in the development of carotid plaque in midlife women.
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Affiliation(s)
- Yamnia I Cortés
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Correspondence and Reprint Requests: Yamnia I. Cortés, PhD, MPH, FNP-BC, University of North Carolina at Chapel Hill, School of Nursing, Carrington Hall, Campus Box 7460, Chapel Hill, NC 27599-7460. E-mail:
| | - Emma Barinas-Mitchell
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | | | - Shalender Bhasin
- Research Program in Men’s Health: Aging and Metabolism, Boston Claude D. Pepper Older Americans Independence Center, Harvard Medical School, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Ravi Jasuja
- Research Program in Men’s Health: Aging and Metabolism, Boston Claude D. Pepper Older Americans Independence Center, Harvard Medical School, Brigham and Women’s Hospital, Boston, Massachusetts
- Function Promoting, LLC, Waltham, Massachusetts
| | - Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Denver, Colorado
| | - Rebecca C Thurston
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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6
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Chang Y, Kim JH, Noh JW, Cho YS, Park HJ, Joo KJ, Ryu S. Prostate-Specific Antigen Within the Reference Range, Subclinical Coronary Atherosclerosis, and Cardiovascular Mortality. Circ Res 2020; 124:1492-1504. [PMID: 30885050 DOI: 10.1161/circresaha.118.313413] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
RATIONALE Although PSA (prostate-specific antigen)-a tumor marker for prostate cancer-has been reported to be associated with cardiovascular disease (CVD) risk factors, studies on the association of PSA with subclinical and clinical CVD remain limited. OBJECTIVE We examined the association of total serum PSA within the reference range with coronary artery calcium (CAC) score and CVD mortality. METHODS AND RESULTS A cross-sectional study was performed in 88 203 Korean men who underwent a health checkup exam including cardiac tomography estimation of CAC score. Logistic regression model was used to calculate odds ratios with 95% CIs for prevalent CAC. PSA levels were inversely associated with the presence of CAC. After adjusting for potential confounders, multivariable-adjusted odds ratio (95% CIs) for prevalent CAC comparing PSA quartiles 2, 3, and 4 to the first quartile were 0.96 (0.90-1.01), 0.88 (0.83-0.93), and 0.85 (0.80-0.90), respectively ( P for trend, <0.001). A cohort study was performed in 243 435 Korean men with a mean age of 39.3 years, PSA values of <4.0 ng/mL, and without known CVD or prostate disease who were followed up with for ≤14 years for CVD mortality (median, 7.3 years). CVD deaths were ascertained through linkage to national death records. Hazard ratios and 95% CIs for CVD mortality were estimated using Cox proportional hazards regression analyses. During 1 829 070.1 person-years of follow-up, 336 CVD deaths were identified. After adjustment for potential confounders, multivariable-adjusted hazard ratios (95% CIs) for CVD mortality comparing PSA quartiles 2, 3, and 4 to the lowest quartile were 0.90 (0.66-1.22), 0.79 (0.58-1.08), and 0.69 (0.51-0.93), respectively. CONCLUSIONS Serum total PSA levels within the reference range showed an inverse association with subclinical atherosclerosis and CVD mortality in young and middle-aged Korean men, indicating a possible role of PSA as a predictive marker for subclinical and clinical CVD.
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Affiliation(s)
- Yoosoo Chang
- From the Center for Cohort Studies, Total Healthcare Center (Y.C., S.R.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Occupational and Environmental Medicine (Y.C., S.R.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea (Y.C., S.R.)
| | - Jae Heon Kim
- Department of Urology, and Urological Biomedicine Research Institute, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, South Korea (J.H.K)
| | - Jin-Won Noh
- Department of Healthcare Management, Eulji University, Seongnam, Republic of Korea (J.-W.N.).,Global Health Unit, Department of Health Sciences, University Medical Centre Groningen, University of Groningen, the Netherlands (J.-W.N.)
| | - Young-Sam Cho
- Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.-S.C., H.J.P., K.J.J.)
| | - Heung Jae Park
- Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.-S.C., H.J.P., K.J.J.)
| | - Kwan Joong Joo
- Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea (Y.-S.C., H.J.P., K.J.J.)
| | - Seungho Ryu
- From the Center for Cohort Studies, Total Healthcare Center (Y.C., S.R.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Occupational and Environmental Medicine (Y.C., S.R.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea (Y.C., S.R.)
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7
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Cobeta P, Osorio A, Cuadrado-Ayuso M, García-Moreno F, Pestaña D, Galindo J, Botella-Carretero JI. Sleeve Gastrectomy and Gastric Bypass Decrease the Carotid Intima-Media Thickness in Obese Men: Association with Weight Loss, Cardiovascular Risk Factors, and Circulating Testosterone. Obes Surg 2020; 30:851-859. [DOI: 10.1007/s11695-020-04405-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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8
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Lorigo M, Mariana M, Oliveira N, Lemos MC, Cairrao E. Vascular Pathways of Testosterone: Clinical Implications. J Cardiovasc Transl Res 2019; 13:55-72. [DOI: 10.1007/s12265-019-09939-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 11/15/2019] [Indexed: 12/17/2022]
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9
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Zhu L, Zhou J, Pan Y, Lv J, Liu Y, Yu S, Zhang Y. Glucagon-like peptide-1 receptor expression and its functions are regulated by androgen. Biomed Pharmacother 2019; 120:109555. [DOI: 10.1016/j.biopha.2019.109555] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/11/2019] [Accepted: 10/11/2019] [Indexed: 11/27/2022] Open
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Cadegiani FA, Kater CE. Novel causes and consequences of overtraining syndrome: the EROS-DISRUPTORS study. BMC Sports Sci Med Rehabil 2019; 11:21. [PMID: 31548891 PMCID: PMC6751688 DOI: 10.1186/s13102-019-0132-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 08/22/2019] [Indexed: 12/22/2022]
Abstract
Background Hormonal physiology in athletes, dysfunctional paths leading to overtraining syndrome (OTS), and clinical and biochemical behaviors that are independently modified by the presence of OTS remain unclear. Although multiple markers of OTS have recently been identified, the independent influence of OTS on hormones and metabolism have not been assessed. Hence, the objective of the present study was to uncover the previously unrecognized independent predictors of OTS and understand how OTS independently modifies the behaviors of clinical and biochemical parameters. Methods In a total of 39 athletes (OTS-affected athletes (OTS) = 14 and healthy athletes (ATL) = 25), we performed two clusters of statistical analyses using the full data of the Endocrine and Metabolic Responses on Overtraining Syndrome (EROS) study, in a total of 117 markers. We first used logistic regression to analyze five modifiable parameters (carbohydrate, protein, and overall caloric intake, sleep quality, and concurrent cognitive effort) as potential additional independent risk factors for OTS, and OTS as the outcome. We then used multivariate linear regression to analyze OTS as the independent variable and 38 dependent variables. Training patterns were found to be similar between OTS and ATL, and therefore excessive training was not a risk, and consequently not a predictor, for OTS. Results Each of the three dietary patterns (daily carbohydrate, daily protein, and daily overall calorie intake) were found to be the independent triggers of OTS, while sleeping, social, and training characteristics depended on other factors to induce OTS. Once triggered, OTS independently induced multiple changes, including reductions of cortisol, late growth hormone and adrenocorticotropic hormone responses to stimulations, testosterone-to-estradiol ratio, neutrophils, neutrophil-to-lymphocyte ratio, vigor levels, hydration status, and muscle mass, while increase of tension levels and visceral fat. Conclusions OTS can be independently triggered by eating patterns, regardless of training patterns, while the occurrence of OTS reduced late hormonal responses and the testosterone-to-estradiol ratio, worsened mood, and affected the immunology panel. These novel findings may explain underperformance, which is the key characteristic of OTS.
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Affiliation(s)
- Flavio A Cadegiani
- Adrenal and Hypertension Unit, Division of Endocrinology and Metabolism, Department of Medicine, Federal University of São Paulo (Unifesp/EPM), Rua Pedro de Toledo 781 - 13th floor, São Paulo, SP 04039-032 Brazil
| | - Claudio E Kater
- Adrenal and Hypertension Unit, Division of Endocrinology and Metabolism, Department of Medicine, Federal University of São Paulo (Unifesp/EPM), Rua Pedro de Toledo 781 - 13th floor, São Paulo, SP 04039-032 Brazil
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11
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Yeap BB. Testosterone and its metabolites: differential associations with cardiovascular and cerebrovascular events in men. Asian J Androl 2019; 20:109-114. [PMID: 29199649 PMCID: PMC5858092 DOI: 10.4103/aja.aja_50_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
As men grow older, circulating testosterone declines while the incidence of cardiovascular disease increases. Thus, the role of sex hormones as biomarkers, and possibly contributing factors to clinical manifestations of cardiovascular disease in the increasing demographic of aging men, has attracted considerable interest. This review focuses on observational studies of endogenous androgens, namely circulating testosterone and dihydrotestosterone, which have examined their associations with cardiovascular events such as myocardial infarction and stroke. Studies which have examined the associations of endogenous estrogens, namely circulating estradiol, with these outcomes are also discussed. In large prospective cohort studies of predominantly middle-aged and older men, lower circulating testosterone consistently predicts higher incidence of cardiovascular events. Of note, both lower circulating testosterone and lower dihydrotestosterone are associated with higher incidence of stroke. These associations are less apparent when myocardial infarction is considered as the outcome. Results for estradiol are inconsistent. Lower circulating testosterone has been shown to predict higher cardiovascular disease-related mortality, as has lower circulating dihydrotestosterone. It is possible that the relationship of circulating androgens to cardiovascular events or mortality outcomes may be U-shaped rather than linear, with an optimal range defining men at lowest risk. Epidemiological studies are observational in nature and do not prove causality. Associations observed in studies of endogenous androgens need not necessarily translate into similar effects of exogenous androgens. Rigorous randomized controlled trials are needed to clarify the effects of testosterone treatment on cardiovascular risk in men.
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Affiliation(s)
- Bu B Yeap
- School of Medicine, University of Western Australia, Perth, Western Australia 6009, Australia.,Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia 6150, Australia
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12
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Abstract
The cardiovascular system is particularly sensitive to androgens, but some controversies exist regarding the effect of testosterone on the heart. While among anabolic abusers, cases of sudden cardiac death have been described, recently it was reported that low serum level of testosterone was correlated with increased risk of cardiovascular diseases (CVD) and mortality rate. This review aims to evaluate the effect of testosterone on myocardial tissue function, coronary artery disease (CAD), and death. Low testosterone level is associated with increased incidence of CAD and mortality. Testosterone administration in hypogonadal elderly men and women has a positive effect on cardiovascular function and improved clinical outcomes and survival time. Although at supraphysiologic doses, androgen may have a toxic effect, and at physiological levels, testosterone is safe and exerts a beneficial effect on myocardial function including mechanisms at cellular and mitochondrial level. The interaction with free testosterone and estradiol should be considered. Further studies are necessary to better understand the interaction mechanisms for an optimal androgen therapy in CVD.
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Affiliation(s)
- Vittorio Emanuele Bianchi
- Clinical Center Stella Maris, Laboratory of Physiology of Exercise, Strada Rovereta 42, 47891, Falciano, Republic of San Marino.
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13
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Cadegiani FA, Kater CE. Inter-correlations Among Clinical, Metabolic, and Biochemical Parameters and Their Predictive Value in Healthy and Overtrained Male Athletes: The EROS-CORRELATIONS Study. Front Endocrinol (Lausanne) 2019; 10:858. [PMID: 31920971 PMCID: PMC6914842 DOI: 10.3389/fendo.2019.00858] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 11/22/2019] [Indexed: 12/17/2022] Open
Abstract
Objectives: The Endocrine and Metabolic Responses on Overtraining Syndrome (EROS) study identified multiple hormonal and metabolic conditioning processes in athletes, and underlying mechanisms and biomarkers of overtraining syndrome (OTS). The present study's objective was to reveal independent predictors and linear correlations among the parameters evaluated in the EROS study to predict clinical, metabolic, and biochemical behaviors in healthy and OTS-affected male athletes. Methods: We used multivariate linear regression and linear correlation to analyze possible combinations of the 38 parameters evaluated in the EROS study that revealed significant differences between healthy and OTS-affected athletes. Results: The testosterone-to-estradiol (T:E) ratio predicted the measured-to-predicted basal metabolic rate (BMR) ratio; the T:E ratio and total testosterone level were inversely predicted by fat mass and estradiol was not predicted by any of the non-modifiable parameters. Early and late growth hormone, cortisol, and prolactin responses to an insulin tolerance test (ITT) were strongly correlated. Hormonal responses to the ITT were positively correlated with fat oxidation, predicted-to-measured BMR ratio, muscle mass, and vigor, and inversely correlated with fat mass and fatigue. Salivary cortisol 30 min after awakening and the T:E ratio were inversely correlated with fatigue. Tension was inversely correlated with libido and directly correlated with body fat. The predicted-to-measured BMR ratio was correlated with muscle mass and body water, while fat oxidation was directly correlated with muscle mass and inversely correlated with fat mass. Muscle mass was directly correlated with body water, and extracellular water was directly correlated with body fat and inversely correlated with body water and muscle mass. Conclusions: Hypothalamic-pituitary responses to stimulation were diffuse and indistinguishable between the different axes. A late hormonal response to stimulation, increased cortisol after awakening, and the T:E ratio were correlated with vigor and fatigue. The T:E ratio was also correlated with body metabolism and composition, testosterone was predicted by fat mass, and estradiol predicted anger. Hydration status was inversely correlated with edema, and inter-correlations were found among fat oxidation, hydration, and body fat.
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14
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Cheruiyot I, Olabu B, Kamau M, Ongeti K, Mandela P. Histomorphological changes in the common carotid artery of the male rat in induced hypogonadism. Anat Cell Biol 2018; 51:284-291. [PMID: 30637163 PMCID: PMC6318456 DOI: 10.5115/acb.2018.51.4.284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/02/2018] [Accepted: 07/03/2018] [Indexed: 01/08/2023] Open
Abstract
The role of androgens in the development of cardiovascular diseases remains controversial. The current study therefore sought to determine the changes in the histomorphology of the common carotid artery of the male rat in orchidectomy-induced hypogonadism. Twenty-two Rattus norvegicus male rats aged 2 months were used. The rats were randomly assigned into baseline (n=4), experimental (n=9), and control (n=9) groups. Hypogonadism was surgically induced in the experimental group by bilateral orchiectomy under local anesthesia. At experiment weeks 3, 6, and 9, three rats from each group (experimental and control) were euthanized, their common carotid artery harvested, and routine processing was done for paraffin embedding, sectioning, and staining. The photomicrographs were taken using a digital photomicroscope for morphometric analysis. Orchidectomy resulted in the development of vascular fibrosis, with a significant increase in collagen fiber density and decrease in smooth muscle and elastic fiber density. Moreover, there was development of intimal hyperplasia, with fragmentation of medial elastic lamellae in the common carotid artery of the castrated rats. Orchidectomy induces adverse changes in structure of the common carotid artery of the male rat. These changes may impair vascular function, therefore constituting a possible structural basis for the higher incidences of cardiovascular diseases observed in hypogonadism.
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Affiliation(s)
- Isaac Cheruiyot
- Department of Human Anatomy, University of Nairobi, Nairobi, Kenya
| | - Beda Olabu
- Department of Human Anatomy, University of Nairobi, Nairobi, Kenya
| | - Martin Kamau
- Department of Human Anatomy, University of Nairobi, Nairobi, Kenya
| | - Kevin Ongeti
- Department of Human Anatomy, University of Nairobi, Nairobi, Kenya
| | - Pamela Mandela
- Department of Human Anatomy, University of Nairobi, Nairobi, Kenya
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15
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Chistiakov DA, Myasoedova VA, Melnichenko AA, Grechko AV, Orekhov AN. Role of androgens in cardiovascular pathology. Vasc Health Risk Manag 2018; 14:283-290. [PMID: 30410343 PMCID: PMC6198881 DOI: 10.2147/vhrm.s173259] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Cardiovascular effects of android hormones in normal and pathological conditions can lead to either positive or negative effects. The reason for this variation is unknown, but may be influenced by gender-specific effects of androids, heterogeneity of the vascular endothelium, differential expression of the androgen receptor in endothelial cells (ECs) and route of androgen administration. Generally, androgenic hormones are beneficial for ECs because these hormones induce nitric oxide production, proliferation, motility, and growth of ECs and inhibit inflammatory activation and induction of procoagulant, and adhesive properties in ECs. This indeed prevents endothelial dysfunction, an essential initial step in the development of vascular pathologies, including atherosclerosis. However, androgens can also activate endothelial production of some vasoconstrictors, which can have detrimental effects on the vascular endothelium. Androgens also activate proliferation, migration, and recruitment of endothelial progenitor cells (EPCs), thereby contributing to vascular repair and restoration of the endothelial layer. In this paper, we consider effects of androgen hormones on EC and EPC function in physiological and pathological conditions.
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Affiliation(s)
- Dimitry A Chistiakov
- Department of Neurochemistry, Division of Basic and Applied Neurobiology, Serbsky Federal Medical Research Center of Psychiatry and Narcology, Moscow, Russia
| | - Veronika A Myasoedova
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, Moscow, Russia,
| | - Alexandra A Melnichenko
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, Moscow, Russia,
| | - Andrey V Grechko
- Federal Scientific Clinical Center for Resuscitation and Rehabilitation, Moscow, Russia
| | - Alexander N Orekhov
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, Moscow, Russia, .,Institute for Atherosclerosis Research, Skolkovo Innovative Center, Moscow, Russia,
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16
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Sadaie MR, Farhoudi M, Zamanlu M, Aghamohammadzadeh N, Amouzegar A, Rosenbaum RE, Thomas GA. What does the research say about androgen use and cerebrovascular events? Ther Adv Drug Saf 2018; 9:439-455. [PMID: 30364888 DOI: 10.1177/2042098618773318] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 03/29/2018] [Indexed: 12/21/2022] Open
Abstract
Many studies have investigated the benefits of androgen therapy and neurosteroids in aging men, while concerns remain about the potential associations of exogenous steroids and incidents of cerebrovascular events and ischemic stroke (IS). Testosterone is neuroprotective, neurotrophic and a potent stimulator of neuroplasticity. These benefits are mediated primarily through conversion of a small amount of testosterone to estradiol by the catalytic activity of estrogen synthetase (aromatase cytochrome P450 enzyme). New studies suggest that abnormal serum levels of the nonaromatized potent metabolite of testosterone, either high or low dihydrotestosterone (DHT), is a risk factor for stroke. Associations between pharmacologic androgen use and the incidence of IS are questionable, because a significant portion of testosterone is converted to DHT. There is also insufficient evidence to reject a causal relationship between the pro-testosterone adrenal androgens and incidence of IS. Moreover, vascular intima-media thickness, which is a predictor of stroke and myocardial symptoms, has correlations with sex hormones. Current diagnostic and treatment criteria for androgen therapy for cerebrovascular complications are unclear. Confounding variables, including genetic and metabolic alterations of the key enzymes of steroidogenesis, ought to be considered. Information extracted from pharmacogenetic testing may aid in expounding the protective-destructive properties of neurosteroids, as well as the prognosis of androgen therapy, in particular their cerebrovascular outcomes. This investigative review article addresses relevant findings of the clinical and experimental investigations of androgen therapy, emphasizes the significance of genetic testing of androgen responsiveness towards individualized therapy in post-IS injuries as well as identifying pertinent questions.
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Affiliation(s)
| | - Mehdi Farhoudi
- Neurosciences Research Center (NSRC), Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masumeh Zamanlu
- Neurosciences Research Center (NSRC), Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nasser Aghamohammadzadeh
- Department of Endocrinology, Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Atieh Amouzegar
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Gary A Thomas
- Penn State Hershey Neurology, Penn State University, PA, USA
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17
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Malan L, de Kock A, Hamer M, Cockeran M, Malan NT. Defensive coping facilitated a smaller cortisol-to-estradiol ratio and a higher hypertension risk: the SABPA study. Blood Press 2018; 27:280-288. [PMID: 29667849 DOI: 10.1080/08037051.2018.1461011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Taxing psychosocial stress and defensive coping have been associated with hypoactivity in cortisol, a vasoconstrictive agent. Estradiol has vasodilatory properties with cardio- and neuroprotective effects. It can however also induce α1-adrenergic vasoconstrictive responsiveness. We aimed to determine whether the cortisol-to-estradiol ratio (Cort:E2) may augment α1-adrenergic responsiveness and hypertension risk when habitually using defensive coping. METHODS African (n = 168) and Caucasian (n = 207) men and women (46 ± 9 years) were included. Preferential use of defensive coping was determined from Coping Strategy Indicator questionnaire scores. 24h Ambulatory blood pressure was obtained. Fasting serum estradiol and cortisol samples were collected before 09h00 and Cort:E2 was calculated. RESULTS Estradiol was higher in ethnic-coping groups. Smaller Cort:E2, higher estradiol levels, self-reported emotional stress (19.05% vs. 9.66%) and 24h blood pressure reaching hypertensive status (65% vs. 24%) were evident in African compared to Caucasian men (p ≤ .05). A smaller Cort:E2 was associated with augmented 24h SBP and 24h DBP in African men [Adj R2 0.21-0.29 (p ≤ .05)], and especially when utilizing defensive coping [Adj R2 0.34-0.38 (p ≤ .001)]. CONCLUSIONS A smaller Cort:E2 was associated with raised blood pressure in defensive coping African men. Defensive coping, possibly via highly activated α1-adrenergic vasoconstrictive responses, may facilitate neuro-endocrine dysfunction and hypertension in African men.
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Affiliation(s)
- Leoné Malan
- a Hypertension in Africa Research Team (HART) , Centre of Excellence, North-West University , Potchefstroom , South Africa
| | - Andrea de Kock
- a Hypertension in Africa Research Team (HART) , Centre of Excellence, North-West University , Potchefstroom , South Africa
| | - Mark Hamer
- a Hypertension in Africa Research Team (HART) , Centre of Excellence, North-West University , Potchefstroom , South Africa.,b National Centre for Sport and Exercise Medicine , Loughborough University , Leicestershire , UK
| | - Marike Cockeran
- c Statistical Consultation Services , North-West University , Potchefstroom , South Africa
| | - Nicolaas Theodor Malan
- a Hypertension in Africa Research Team (HART) , Centre of Excellence, North-West University , Potchefstroom , South Africa
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18
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Abstract
In men, obesity and metabolic complications are associated with lower serum testosterone (T) and dihydrotestosterone (DHT) and an increased risk of, and mortality from, multiple chronic diseases in addition to cardiovascular disease (CVD). The causal interrelationships between these factors remain a matter of debate. In men with untreated congenital and lifelong forms of hypogonadotropic hypogonadism, there appears to be no increased risk. Men with Klinefelter's syndrome have an increased risk of various types of cancers, as well as CVD, which persist despite T therapy. In the absence of pathology of the hypothalamic-pituitary-gonadal axis, the effect of modest reductions in serum T in aging men is unclear. The prevalence of low serum T concentrations is high in men with cancer, renal disease, and respiratory disease and is likely to be an indicator of severity of systemic disease, not hypogonadism. Some population-based studies have found low serum T to be associated with a higher risk of deaths attributed to cancer, renal disease, and respiratory disease, while others have not. Although a meta-analysis of longitudinal studies has shown an association between low serum T and all-cause mortality, marked heterogeneity between studies limited a firm conclusion. Therefore, while a decrease in T particularly occurring later in life may be associated with an increase in all-cause and specific types of mortality in men, the differential effects, if any, of T and other sex steroids as compared to health and lifestyle factors are unknown at the current time.
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Affiliation(s)
- Emily J Meyer
- Endocrine, Diabetes and Metabolic Unit, Royal Adelaide Hospital, Port Road, SA 5000, Australia.,Discipline of Medicine, University of Adelaide, Adelaide, SA 5000 Australia
| | - Gary Wittert
- Endocrine, Diabetes and Metabolic Unit, Royal Adelaide Hospital, Port Road, SA 5000, Australia.,Discipline of Medicine, University of Adelaide, Adelaide, SA 5000 Australia.,Discipline of Medicine and Freemasons Foundation Centre for Men's Health, University of Adelaide, SA 5000, Australia
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19
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Glisic M, Mujaj B, Rueda-Ochoa OL, Asllanaj E, Laven JSE, Kavousi M, Ikram MK, Vernooij MW, Ikram MA, Franco OH, Bos D, Muka T. Associations of Endogenous Estradiol and Testosterone Levels With Plaque Composition and Risk of Stroke in Subjects With Carotid Atherosclerosis. Circ Res 2017; 122:97-105. [PMID: 29097437 DOI: 10.1161/circresaha.117.311681] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 10/27/2017] [Accepted: 11/01/2017] [Indexed: 01/05/2023]
Abstract
RATIONALE Sex steroids may play a role in plaque composition and in stroke incidence. OBJECTIVES To study the associations of endogenous estradiol and testosterone with carotid plaque composition in elderly men and postmenopausal women with carotid atherosclerosis, as well as with risk of stroke in this population. METHODS AND RESULTS Data of 1023 postmenopausal women and 1124 men (≥45 years) with carotid atherosclerosis, from prospective population-based RS (Rotterdam Study), were available. At baseline, total estradiol (TE) and total testosterone (TT) were measured. Carotid atherosclerosis was assessed by ultrasound, whereas plaque composition (presence of calcification, lipid core, and intraplaque hemorrhage) was assessed by magnetic resonance imaging. TE and TT were not associated with calcified carotid plaques in either sex. TE was associated with presence of lipid core in both sexes (in women odds ratio, 1.48 [95% confidence interval [CI], 1.02-2.15]; in men odds ratio, 1.23 [95% CI, 1.03-1.46]), whereas no association was found between TT and lipid core in either sex. Higher TE (odds ratio, 1.58 [95% CI, 1.03-2.40]) and lower TT (odds ratio, 0.82 [95% CI, 0.68-0.98]) were associated with intraplaque hemorrhage in women but not in men. In women, TE was associated with increased risk of stroke (hazard ratio, 1.98 [95% CI, 1.01-3.88]), whereas no association was found in men. TT was not associated with risk of stroke in either sex. CONCLUSIONS TE was associated with presence of vulnerable carotid plaque as well as increased risk of stroke in women, whereas no consistent associations were found for TT in either sex.
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Affiliation(s)
- Marija Glisic
- From the Department of Epidemiology (M.G., B.M., O.L.R.-O., E.A., M.K., M.K.I., M.W.V., M.A.I., O.H.F., D.B., T.M.), Department of Obstetrics and Gynaecology (J.S.E.L.), Department of Neurology (M.K.I., M.A.I.), and Department of Radiology and Nuclear Medicine (M.W.V., M.A.I., D.B.), Erasmus MC, Rotterdam, The Netherlands.
| | - Blerim Mujaj
- From the Department of Epidemiology (M.G., B.M., O.L.R.-O., E.A., M.K., M.K.I., M.W.V., M.A.I., O.H.F., D.B., T.M.), Department of Obstetrics and Gynaecology (J.S.E.L.), Department of Neurology (M.K.I., M.A.I.), and Department of Radiology and Nuclear Medicine (M.W.V., M.A.I., D.B.), Erasmus MC, Rotterdam, The Netherlands
| | - Oscar L Rueda-Ochoa
- From the Department of Epidemiology (M.G., B.M., O.L.R.-O., E.A., M.K., M.K.I., M.W.V., M.A.I., O.H.F., D.B., T.M.), Department of Obstetrics and Gynaecology (J.S.E.L.), Department of Neurology (M.K.I., M.A.I.), and Department of Radiology and Nuclear Medicine (M.W.V., M.A.I., D.B.), Erasmus MC, Rotterdam, The Netherlands
| | - Eralda Asllanaj
- From the Department of Epidemiology (M.G., B.M., O.L.R.-O., E.A., M.K., M.K.I., M.W.V., M.A.I., O.H.F., D.B., T.M.), Department of Obstetrics and Gynaecology (J.S.E.L.), Department of Neurology (M.K.I., M.A.I.), and Department of Radiology and Nuclear Medicine (M.W.V., M.A.I., D.B.), Erasmus MC, Rotterdam, The Netherlands
| | - Joop S E Laven
- From the Department of Epidemiology (M.G., B.M., O.L.R.-O., E.A., M.K., M.K.I., M.W.V., M.A.I., O.H.F., D.B., T.M.), Department of Obstetrics and Gynaecology (J.S.E.L.), Department of Neurology (M.K.I., M.A.I.), and Department of Radiology and Nuclear Medicine (M.W.V., M.A.I., D.B.), Erasmus MC, Rotterdam, The Netherlands
| | - Maryam Kavousi
- From the Department of Epidemiology (M.G., B.M., O.L.R.-O., E.A., M.K., M.K.I., M.W.V., M.A.I., O.H.F., D.B., T.M.), Department of Obstetrics and Gynaecology (J.S.E.L.), Department of Neurology (M.K.I., M.A.I.), and Department of Radiology and Nuclear Medicine (M.W.V., M.A.I., D.B.), Erasmus MC, Rotterdam, The Netherlands
| | - M Kamran Ikram
- From the Department of Epidemiology (M.G., B.M., O.L.R.-O., E.A., M.K., M.K.I., M.W.V., M.A.I., O.H.F., D.B., T.M.), Department of Obstetrics and Gynaecology (J.S.E.L.), Department of Neurology (M.K.I., M.A.I.), and Department of Radiology and Nuclear Medicine (M.W.V., M.A.I., D.B.), Erasmus MC, Rotterdam, The Netherlands
| | - Meike W Vernooij
- From the Department of Epidemiology (M.G., B.M., O.L.R.-O., E.A., M.K., M.K.I., M.W.V., M.A.I., O.H.F., D.B., T.M.), Department of Obstetrics and Gynaecology (J.S.E.L.), Department of Neurology (M.K.I., M.A.I.), and Department of Radiology and Nuclear Medicine (M.W.V., M.A.I., D.B.), Erasmus MC, Rotterdam, The Netherlands
| | - M Arfan Ikram
- From the Department of Epidemiology (M.G., B.M., O.L.R.-O., E.A., M.K., M.K.I., M.W.V., M.A.I., O.H.F., D.B., T.M.), Department of Obstetrics and Gynaecology (J.S.E.L.), Department of Neurology (M.K.I., M.A.I.), and Department of Radiology and Nuclear Medicine (M.W.V., M.A.I., D.B.), Erasmus MC, Rotterdam, The Netherlands
| | - Oscar H Franco
- From the Department of Epidemiology (M.G., B.M., O.L.R.-O., E.A., M.K., M.K.I., M.W.V., M.A.I., O.H.F., D.B., T.M.), Department of Obstetrics and Gynaecology (J.S.E.L.), Department of Neurology (M.K.I., M.A.I.), and Department of Radiology and Nuclear Medicine (M.W.V., M.A.I., D.B.), Erasmus MC, Rotterdam, The Netherlands
| | - Daniel Bos
- From the Department of Epidemiology (M.G., B.M., O.L.R.-O., E.A., M.K., M.K.I., M.W.V., M.A.I., O.H.F., D.B., T.M.), Department of Obstetrics and Gynaecology (J.S.E.L.), Department of Neurology (M.K.I., M.A.I.), and Department of Radiology and Nuclear Medicine (M.W.V., M.A.I., D.B.), Erasmus MC, Rotterdam, The Netherlands
| | - Taulant Muka
- From the Department of Epidemiology (M.G., B.M., O.L.R.-O., E.A., M.K., M.K.I., M.W.V., M.A.I., O.H.F., D.B., T.M.), Department of Obstetrics and Gynaecology (J.S.E.L.), Department of Neurology (M.K.I., M.A.I.), and Department of Radiology and Nuclear Medicine (M.W.V., M.A.I., D.B.), Erasmus MC, Rotterdam, The Netherlands
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20
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Swerdloff RS, Dudley RE, Page ST, Wang C, Salameh WA. Dihydrotestosterone: Biochemistry, Physiology, and Clinical Implications of Elevated Blood Levels. Endocr Rev 2017; 38:220-254. [PMID: 28472278 PMCID: PMC6459338 DOI: 10.1210/er.2016-1067] [Citation(s) in RCA: 135] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 04/20/2017] [Indexed: 02/07/2023]
Abstract
Benefits associated with lowered serum DHT levels after 5α-reductase inhibitor (5AR-I) therapy in men have contributed to a misconception that circulating DHT levels are an important stimulus for androgenic action in target tissues (e.g., prostate). Yet evidence from clinical studies indicates that intracellular concentrations of androgens (particularly in androgen-sensitive tissues) are essentially independent of circulating levels. To assess the clinical significance of modest elevations in serum DHT and the DHT/testosterone (T) ratio observed in response to common T replacement therapy, a comprehensive review of the published literature was performed to identify relevant data. Although the primary focus of this review is about DHT in men, we also provide a brief overview of DHT in women. The available published data are limited by the lack of large, well-controlled studies of long duration that are sufficiently powered to expose subtle safety signals. Nonetheless, the preponderance of available clinical data indicates that modest elevations in circulating levels of DHT in response to androgen therapy should not be of concern in clinical practice. Elevated DHT has not been associated with increased risk of prostate disease (e.g., cancer or benign hyperplasia) nor does it appear to have any systemic effects on cardiovascular disease safety parameters (including increased risk of polycythemia) beyond those commonly observed with available T preparations. Well-controlled, long-term studies of transdermal DHT preparations have failed to identify safety signals unique to markedly elevated circulating DHT concentrations or signals materially different from T.
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Affiliation(s)
- Ronald S Swerdloff
- Division of Endocrinology, Department of Medicine, David Geffen School of Medicine at UCLA, Torrance, California 90502
| | | | - Stephanie T Page
- Division of Metabolism, Endocrinology, and Nutrition, University of Washington School of Medicine, Seattle, Washington 98195
| | - Christina Wang
- Division of Endocrinology, Department of Medicine, David Geffen School of Medicine at UCLA, Torrance, California 90502
- UCLA Clinical and Translational Science Institute, Harbor-UCLA Medical Center, and Los Angeles Biomedical Research Institute, David Geffen School of Medicine at UCLA, Torrance, California 90509
| | - Wael A Salameh
- Division of Endocrinology, Department of Medicine, David Geffen School of Medicine at UCLA, Torrance, California 90502
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21
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Bo L, Yi-Can Y, Qing Z, Xiao-Hui W, Ke H, Chao-Chun Z. Elevated tumour necrosis factor-alpha was associated with intima thickening in obese children. Acta Paediatr 2017; 106:627-633. [PMID: 28036103 DOI: 10.1111/apa.13737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 11/06/2016] [Accepted: 12/28/2016] [Indexed: 11/29/2022]
Abstract
AIM This study investigated the relationship between intima-media thickness (IMT) and immune parameters in obese children from five to 16 years of age. METHODS We enrolled 185 obese children with a mean age of 10.65 ± 2.10 years and 211 controls with a mean age of 10.32 ± 1.81 years. Glycometabolism, lipid metabolism, sex hormones, immune indices and carotid IMT were measured. RESULTS Serum interleukin (IL)-6, IL-10, tumour necrosis factor (TNF)-alpha, white blood cells and common and internal carotid artery IMTs in the obese group were higher than those in the control group (p < 0.05, respectively). Bivariate correlation analysis showed that the common carotid arterial IMT was positively correlated with alanine aminotransferase, triglyceride, uric acid, apolipoprotein B, IL-6, IL-10, TNF-alpha, follicle-stimulating hormone and testosterone. Internal carotid artery IMT was positively correlated with alanine aminotransferase and follicle-stimulating hormone. Both common and internal carotid artery IMTs were inversely correlated with apolipoprotein A1 (p < 0.05, respectively). Stepwise multiple regression analysis showed that testosterone, alanine aminotransferase and TNF-alpha were the independent determinants of common carotid arterial IMT. CONCLUSION Tumour necrosis factor-alpha, alanine aminotransferase and testosterone were associated with intima thickening in the early life in obese children and may increase later risks of premature atherogenicity and adult cardio-cerebrovascular diseases.
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Affiliation(s)
- Luo Bo
- Department of Endocrinology; Children's Hospital of Zhejiang University School of Medicine; Hangzhou China
- Department of Paediatrics; Zhuji People's Hospital; Shaoxing China
| | - Yang Yi-Can
- Department of Endocrinology; Children's Hospital of Zhejiang University School of Medicine; Hangzhou China
| | - Zhou Qing
- Department of Endocrinology; Children's Hospital of Zhejiang University School of Medicine; Hangzhou China
| | - Wu Xiao-Hui
- Department of Endocrinology; Children's Hospital of Zhejiang University School of Medicine; Hangzhou China
| | - Huang Ke
- Department of Endocrinology; Children's Hospital of Zhejiang University School of Medicine; Hangzhou China
| | - Zou Chao-Chun
- Department of Endocrinology; Children's Hospital of Zhejiang University School of Medicine; Hangzhou China
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22
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Kische H, Gross S, Wallaschofski H, Völzke H, Dörr M, Nauck M, Felix SB, Haring R. Serum androgen concentrations and subclinical measures of cardiovascular disease in men and women. Atherosclerosis 2016; 247:193-200. [PMID: 26926599 DOI: 10.1016/j.atherosclerosis.2016.02.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 02/09/2016] [Accepted: 02/17/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Most of the observed associations of androgens and sex hormone-binding globulin (SHBG) with subclinical cardiovascular disease (CVD) stem from selected study samples with immunoassay-based hormone measurements. Thus, we used a large population-based sample with total testosterone (TT) and androstenedione (ASD) concentrations measured by liquid chromatography-tandem mass spectrometry. DESIGN Data of 2140 individuals (mean age: 60,8 years) from the cohort Study of Health in Pomerania were assessed at baseline and 5-year follow-up. METHODS Multivariable regression models were implemented to assess cross-sectional and longitudinal associations of TT, free testosterone (fT), ASD, SHBG and dehydroepiandrosterone-sulphate (DHEAS) with measures of subclinical CVD including intima media thickness (IMT), carotid plaques, left ventricular mass (LVM), fractional shortening (FS), relative wall thickness (RWT), and left ventricular geometry. RESULTS Cross-sectional analyses yielded an association of TT with IMT in women (β-coefficient per log unit increase: 0.02; 95% CI: 0.007; 0.45) and ASD with FS in both sexes (men: β-coefficient: -2.94; 95% CI: -4.75; -1.12; women: β-coefficient: 1.64; 95% CI: 0.55; 2.73). In longitudinal analyses, DHEAS was positively associated with FS change (β-coefficient: 2.34; 95% CI: -0.59; 4.08). In women, SHBG was positively associated with incident plaques (Q1 vs. Q3 (Ref.): β-coefficient: 1.35; 95% CI: 1.04; 1.74). In both sexes, longitudinal analyses showed no consistent association of TT with subclinical CVD. CONCLUSIONS Despite several sex-specific associations of androgens and SHBG with subclinical CVD, the present representative study for the age group ≥45 years among men and women from the general population detected no consistent associations in longitudinal analyses.
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Affiliation(s)
- Hanna Kische
- Institute of Clinical Chemistry and Laboratory Medicine, Germany.
| | - Stefan Gross
- German Centre for Cardiovascular Research (DZHK), Greifswald, Germany; Department of Cardiology, University Medicine Greifswald, Germany
| | - Henri Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine, Germany; German Centre for Cardiovascular Research (DZHK), Greifswald, Germany
| | - Henry Völzke
- German Centre for Cardiovascular Research (DZHK), Greifswald, Germany; Institute for Community Medicine, Germany
| | - Marcus Dörr
- German Centre for Cardiovascular Research (DZHK), Greifswald, Germany; Department of Cardiology, University Medicine Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, Germany; German Centre for Cardiovascular Research (DZHK), Greifswald, Germany
| | - Stephan B Felix
- German Centre for Cardiovascular Research (DZHK), Greifswald, Germany; Department of Cardiology, University Medicine Greifswald, Germany
| | - Robin Haring
- Institute of Clinical Chemistry and Laboratory Medicine, Germany; European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
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23
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Cai JJ, Wen J, Jiang WH, Lin J, Hong Y, Zhu YS. Androgen actions on endothelium functions and cardiovascular diseases. J Geriatr Cardiol 2016; 13:183-196. [PMID: 27168746 PMCID: PMC4854959 DOI: 10.11909/j.issn.1671-5411.2016.02.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 01/12/2016] [Accepted: 01/19/2016] [Indexed: 12/02/2022] Open
Abstract
The roles of androgens on cardiovascular physiology and pathophysiology are controversial as both beneficial and detrimental effects have been reported. Although the reasons for this discrepancy are unclear, multiple factors such as genetic and epigenetic variation, sex-specificity, hormone interactions, drug preparation and route of administration may contribute. Recently, growing evidence suggests that androgens exhibit beneficial effects on cardiovascular function though the mechanism remains to be elucidated. Endothelial cells (ECs) which line the interior surface of blood vessels are distributed throughout the circulatory system, and play a crucial role in cardiovascular function. Endothelial progenitor cells (EPCs) are considered an indispensable element for the reconstitution and maintenance of an intact endothelial layer. Endothelial dysfunction is regarded as an initiating step in development of atherosclerosis and cardiovascular diseases. The modulation of endothelial functions by androgens through either genomic or nongenomic signal pathways is one possible mechanism by which androgens act on the cardiovascular system. Obtaining insight into the mechanisms by which androgens affect EC and EPC functions will allow us to determine whether androgens possess beneficial effects on the cardiovascular system. This in turn may be critical in the prevention and therapy of cardiovascular diseases. This article seeks to review recent progress in androgen regulation of endothelial function, the sex-specificity of androgen actions, and its clinical applications in the cardiovascular system.
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Affiliation(s)
- Jing-Jing Cai
- Department of Cardiology of the Third Xiangya Hospital, Central South University, Changsha, China; The Center of Clinical Pharmacology of the Third Xiangya Hospital, Central South University, Changsha, China
| | - Juan Wen
- Department of Cardiology of the Third Xiangya Hospital, Central South University, Changsha, China; The Center of Clinical Pharmacology of the Third Xiangya Hospital, Central South University, Changsha, China
| | - Wei-Hong Jiang
- Department of Cardiology of the Third Xiangya Hospital, Central South University, Changsha, China
| | - Jian Lin
- Department of Medicine/Endocrinology, Weill Cornell Medical College, NY, USA
| | - Yuan Hong
- Department of Cardiology of the Third Xiangya Hospital, Central South University, Changsha, China; The Center of Clinical Pharmacology of the Third Xiangya Hospital, Central South University, Changsha, China
| | - Yuan-Shan Zhu
- Department of Medicine/Endocrinology, Weill Cornell Medical College, NY, USA; Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China
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