Effect of 12-months testosterone replacement therapy on bone mineral density and markers of bone turnover in testicular cancer survivors - results from a randomized double-blind trial

BACKGROUND

Testicular cancer survivors (TCS) are at risk of Leydig cell insufficiency, which is a condition characterized by elevated luteinising hormone (LH) in combination with low levels of testosterone. It has been suggested that this condition is associated with impaired metabolic profile and low bone mineral density (BMD). The primary aim of the randomized double-blind trial NCT02991209 was to evaluate metabolic profile after 12-months testosterone replacement therapy (TRT) in TCS with mild Leydig cell insufficiency. Here we present the secondary outcomes of changes in BMD and markers of bone turnover.

METHODOLOGY

In total, 69 TCS with mild Leydig cell insufficiency were randomized 1:1 to 12 months TRT (n = 35) (Tostran, gel, 2%, applied transdermally, with a maximum daily dose of 40 mg) or placebo (n = 34). BMD and markers of bone turnover were evaluated at baseline, after 6- and 12-months TRT, and 3-months post-treatment. Linear mixed effects models were used to analyse changes in BMD, N-terminal propeptide of type 1 procollagen (P1NP) and C-terminal telopeptide of type I collagen (CTX).

RESULTS

After 12 months treatment, TRT was not associated with a statistically significant difference in BMD compared to placebo; total body BMD: 0.01 g/cm2 (95% confidence interval (CI): -0.01 - 0.02), BMD of the lumbar spine: 0.01 g/cm2, (95% CI: -0.01-0.03), BMD of the left femoral neck: 0.00, (95% CI: -0.01-0.02). TRT was associated with a small but statistically significant increase in P1NP: 11.65 µg/L (95% CI: 3.96, 19.35), while there was no difference in CTX.

CONCLUSION

12 months of TRT did not change BMD, while there was as small and clinically irrelevant increase in P1NP compared to placebo in TCS with mild Leydig cell insufficiency. The findings need validation in a larger cohort.

Bipolar disorder and regretted behavior in relation to use of social media and online dating

OBJECTIVES

Individuals with bipolar disorder are prone to risk-taking behavior that is subsequently regretted. Here, we investigated whether this also occurs in relation to the use of social media and online dating.

METHODS

A questionnaire-based survey focusing on the use of social media and online dating was conducted among individuals attending an outpatient clinic for bipolar disorder, and among individuals attending two general practices in the same region (controls). The association between bipolar disorder and self-reported regretted behavior on social media/online dating sites was investigated using logistic regression with adjustment for age and sex.

RESULTS

A total of 124 individuals with bipolar disorder and 196 individuals without affective disorder from the general practices (controls) formed the study sample. Among the individuals with bipolar disorder who used social media, 66% reported regretted behavior as a consequence of this use, whereas only 31% of the controls reported such behavior. The corresponding numbers for individuals who used online dating were 65% for those with bipolar disorder and 31% for the controls. Following adjustment for age and sex, bipolar disorder was associated with elevated risk of regretted behavior in relation to the use of both social media (adjusted odds ratio: 3.6, 95% CI: 2.2, 5.9) and online dating (adjusted odds ratio: 4.1, 95% CI: 2.1, 8.0).

CONCLUSIONS

These findings suggest that risk-taking behavior and subsequent regret among individuals with bipolar disorder extend to social media and online dating. Cautious use of these platforms may be particularly relevant for individuals with bipolar disorder.

Quality of life and clinical characteristics in a nonselected sample of patients with schizophrenia

BACKGROUND

Patients with schizophrenia experience low quality of life (QOL).

AIMS

To examine QOL in these patients and the relation between QOL and illness duration, adjusted daily doses (ADDs) of antipsychotics, body mass index (BMI), waist circumference and smoking.

METHODS

In this naturalistic, cross-sectional study, 82 patients were interviewed about smoking habits. Patients completed a QOL questionnaire (World Health Organization Quality of Life-Bref) consisting of physical, psychological, social and environmental domains and had height, weight and waist circumference measured. The characteristics and QOL were correlated using multiple regression analysis.

RESULTS

QOL was significantly lower in the patients than in the general population (p < .01). In first-ever diagnosed patients, QOL was associated with BMI (regression coefficient (RC): physical -0.73, psychological -1.44 and environmental -0.55; all p < .05), ADD (RC: physical 3.71, psychological 4.37 and environmental 2.94; all p < .10) and smoking (RC: physical -0.69; p < .01). In the long-term ill patients, QOL was associated with BMI (RC: physical -1.19 and psychological -1.28; all p < .05) and illness duration (RC: physical 1.38; p < .05).

CONCLUSION

Patients experienced low QOL. Lower QOL was associated with high BMI, low ADD and smoking in first-ever diagnosed patients and with high BMI and short illness duration in long-term ill patients.