Soy protein based supplementation supports metabolic effects of resistance training in previously untrained middle aged males

Abstract

Objective.?To determine changes in body composition, physical performance, metabolic and hormonal parameters induced by lifestyle counselling, resistance training and resistance training with soy protein based supplemention in middle aged males.

Design.?Randomised controlled study consisting of resistance training without (RT-G) or with (RTS-G) a soy protein based supplement and a control group with lifestyle education only (LE-G).

Subjects.?Forty healthy middle aged men (50–65 years, BMI 25–29.9 kg/m²).

Measurements.?Changes in body weight (BW) and waist circumference (WC) were measured and body composition (BC), fat mass (FM), lean body mass (LBM) were measured by skin fold anthropometry at baseline and after 12 weeks of intervention. In addition, changes in physical fitness, metabolic and hormonal parameters (lipids, glucose, fructosamines, insulin, insulin-like growth factor-1, Leptin, human growth hormone, dehydroepiandrosterone, testosterone, hs-CRP, Il-6) were evaluated.

Results.?Thirty-five participants completed the 12 week study. No significant changes in BW were noted although RM and WC dropped and LBM increased after training, particularly in the RTS group (FM 22.6?±?5.5?kg to 21.2?±?4.7?kg; LBM 68.5?±?7.2?kg to 70.1?±?7.4; p?<?0.01). Subjects in the RTS group experienced more pronounced improvements in the strength measurements than the RT group. After the training intervention there were significant changes in hormonal and metabolic parameters as well as in glycemic control, particularly in the RTS group.

Conclusions.?Our data suggest that resistance training, particularly in combination with a soy protein based supplement improves body composition and metabolic function in middle aged untrained and moderately overweight males.     

Effects of testosterone replacement therapy on hypogonadal men with osteopenia or osteoporosis: a subanalysis of a prospective randomized controlled study in Japan (EARTH study)

Objective: We investigated the effects of testosterone replacement therapy (TRT) on bone mineral density (BMD) among hypogonadal men with osteopenia/osteoporosis.

Methods: From our previous EARTH study population, 74 patients with a clinical diagnosis of osteopenia or osteoporosis and hypogonadism were included in this study, as the TRT (n?=?35) and control (n?=?34) groups. The TRT group was administered 250?mg of testosterone enanthate injection every 4 weeks for 12 months. The BMD, waist circumference, body mass index, body fat percentage, and muscle volume were measured at baseline and at 12 months. Blood biochemical data, including total cholesterol, triglycerides, HDL-cholesterol, hemoglobin A1c, and adiponectin values were also evaluated.

Results: At the 12-month visit, BMD significantly increased in both groups. However, comparisons on changes of parameter values from baseline to the 12-month visit between the TRT and control groups were significantly different in BMD (5.0?±?5.0 vs. 3.0?±?3.2; p?=?.0434) and in adiponectin value (?0.90?±?3.33 vs. 0.10?±?2.04; p?=?.0192). There were no significant changes in other parameters.

Conclusions: TRT for 12 months could improve BMD with a decrease in adiponectin levels among hypogonadal men with osteopenia/osteoporosis.     

A randomized,double-blind,placebo-controlled trial of testosterone gel on body composition and health-related quality-of-life in men with hypogonadal to low-normal levels of serum testosterone and symptoms of androgen deficiency over 6 months with 12 months open-label follow-up

Introduction: The clinical significance of low to low-normal testosterone (T) levels in men remains debated. Aim: To analyze the effects of raising serum T on lean body mass (LBM), fat mass (FM), total body mass, and health-related quality-of-life (HRQoL). Methods: Randomized, double-blind, placebo-controlled study. Men, aged 50–80 years, with serum total T<15 nmol/L and bioavailable T < 6.68 nmol/L, and a Aging Males’ Symptoms (AMS) total score >36, received 6 months treatment with transdermal 1% T gel (5–7.5?mg/day; n =183) or placebo gel (n =179), followed by 12 months open-label with T in all. Results: After 6 months, LBM increased in T- treated patients by 1.28?±?0.15?kg (mean ± SE) and FM decreased by 1.16?±?0.16?kg, with minor changes with placebo (LBM +0.02?±?0.10?kg and FM ?0.14?±?0.12?kg; all p < 0.001, T group vs. placebo). Changes were largely similar across subgroups of age, baseline total testosterone, and baseline BMI. Total HRQoL improved compared with placebo (p < 0.05, T group vs. placebo). Conclusions: Six months 1% T gel improved body composition and HRQoL in symptomatic men with low to low-normal T, with further improvements over the following 12 months.     

Low skeletal muscle mass index is associated with function and nutritional status in residents in a Turkish nursing home

Introduction: To determine the prevalence of low muscle mass (LMM) and the relationship between LMM with functional and nutritional status as defined using the LMM evaluation method of European Working Group on Sarcopenia in Older People (EWGSOP) criteria among male residents in a nursing home.

Methods: Male residents aged?>60 years of a nursing home located in Turkey were included in our study. Their body mass index (BMI) kg/m², skeletal muscle mass (SMM-kg) and skeletal muscle mass index (SMMI-kg/m²) were calculated. The participants were regarded as having low SMMI if they had SMMI?<9.2?kg/m² according to our population specific cut-off point. Functional status was evaluated with Katz activities of daily living (ADL) and Lawton Instrumental Activities of Daily Living (IADL). Nutritional assessment was performed using the Mini Nutritional Assessment (MNA). The number of drugs taken and chronic diseases were recorded.

Results: One hundred fifty-seven male residents were enrolled into the study. Their mean age was 73.1?±?6.7 years with mean ADL score of 8.9?±?2.0 and IADL score of 8.7?±?4.6. One hundred twelve (71%) residents were aged?>70 years. Thirty-five men (23%) had low SMMI in group aged?>60 years, and twenty-eight subjects (25%) in the group aged?>70 years. MNA scores were significantly lower in residents with low SMMI compared with having normal SMMI (17.1?±?3.4 versus 19.6?±?2.5, p?=?0.005). BMI was significantly lower in the residents with low SMMI compared with normal SMMI (19.6?±?2.7 versus 27.1?±?4.1, p70 years (8.1?±?2.6 versus 9.1?±?1.6, p?=?0.014). In regression analyses, the only factor associated with better functional status was the lower age (p?=?0.04) while the only factor associated with better nutrition was higher SMMI (p?=?0.01).

Conclusions: Low SMMI detected by LMM evaluation method of EWGSOP criteria is prevalent among male nursing home residents. There is association of low SMMI with nutritional status and probably with functional status within the nursing home setting using the EWGSOP criteria with Turkish normative reference cut-off value.     

Interleukin-18 and testosterone levels in men with metabolic syndrome

Objective: Interleukin 18 (IL-18) is an adipokine associated with obesity. Data about the relationship of IL-18 to the metabolic syndrome (MS) are still scarce. Low testosterone (T) levels are common in men with MS, but we did not find data about the levels of IL-18 in men with low T. The aim of this study was to determine the levels of IL-18 in men with MS with or without low T.

Patients and methods: A total of 251 men were included in the study. Of them 218 had MS (IDF 2005) and they were divided according to their morning total testosterone (TT) level (cutoff 10.4?nmol/l) into two groups: MS-low T (N?=?84) and MS-normal T (N?=?134). The control group consisted of 33 men without MS and low T. IL-18 was determined in serum using enzyme-linked immunosorbent assay. A small group of eight men with MS and low T levels received testosterone therapy for three months and physical and laboratory parameters were monitored at the end of that period.

Results: MS men were at mean age (±SD)?=?53.77?±?9.59 years; body mass index (BMI)?=?34.0?±?6.3?kg/m²; and TT?=?12.59?±?5.66?nmol/l. The control group was at age?=?52.12?±?5.2 years (NS); BMI?=?25.6?±?2.4?kg/m² (p?p?p?p?p?p?Conclusions: In this study, higher IL-18 levels were found in the presence of MS compared to healthy men, but they did not differ between men having MS with or without LOH.     

Age influences anthropometric and fitness-related predictors of bone mineral in men

Objective. This study assessed the influence of age on the predictors of bone mineral in men.

Methods. Middle-age (n = 41, 54 ± 4 yrs) and older (n = 40, 69 ± 5 yrs) men underwent grip and knee extensor strength tests, total body dual-energy X-ray absorptiometry with regional analyses and a graded exercise treadmill test.

Results. Bone-free lean mass (BFLM) and, to a lesser extent, fat mass (FM) were correlated with bone mineral variables in middle-age men. In older men, BFLM and, to a lesser extent, FM were related to bone mineral content (BMC) at most sites, but inconsistently to bone mineral density (BMD). Knee extensor strength related to bone mineral (BMC and BMD) at most sites in middle-age men, but none in older men. Grip strength inconsistently related to bone mineral in both groups. Aerobic capacity related to bone mineral in middle-age men, but none in older men. In multiple regression, body weight or BFLM predicted bone mineral in middle-age men (R² = 0.33–0.68) and BMC in older men (R² = 0.33–0.50). Predictors of BMD were inconsistent in older men.

Conclusions. Relationships of body composition, muscular strength and aerobic capacity to bone mineral are stronger in middle-age versus older men.     

Bone mineral density in men with and without the metabolic syndrome

The objective of this study was to measure bone mineral density (BMD) in middle-aged men with and without the metabolic syndrome according to the International diabetes federation (IDF) definition from 2005. We studied 80 men (mean age: 51.9 ± 9.0 y, mean body mass index (BMI): 32.0 ± 1.7 kg/m²) with and 92 men without the metabolic syndrome (mean age: 52.6 ± 15.1 y, mean BMI: 24.9 ± 2.8 kg/m²). Height (cm), weight (kg), waist circumference (cm) and blood pressure were measured. Fasting plasma glucose (FPG) and blood lipids were determined. BMD at the lumbar spine and total hip was measured by dual X-ray absorptiometry on a Hologic QDR 4500 bone densitometer. In men around 59.3% had a waist circumference > 94 cm (abdominal obesity). Among them 58.7% showed abnormal BP values. Around 30.7% had FPG ≥ 5.6 mmol/L and 22.7% had low high density lipoprotein (HDL)-cholesterol and 36.6% had hypertriglyceridemia. In men with the metabolic syndrome, mean lumbar spine BMD was 0.986 ± 0.210 g/cm² and total hip BMD – 1.012 ± 0.209 g/cm². The corresponding values in men without this syndrome were 0.934 ± 0.179 g/cm² and 0.894 ± 0.189 g/cm², respectively. The inter-group BMD difference reached statistical significance only at the hip (p = 0.039). Respectively, the prevalence of osteoporosis at the central sites was significantly higher in men without the metabolic syndrome (MS) (13.2 versus 20.8%, p = 0.03). Our data confirmed the trend for higher BMD in the studied men with the metabolic syndrome.     

Association of testicular p63 expression and spermatogenesis in androgen receptor knockout (ARKO) mice

Objective.?To study changes of testicular p63 expression and its effect on spermatogenic function in seminiferous tubules in androgen receptor knockout (ARKO) mice.

Methods.?A total of 28 ARKO mice (ARKO group) screened by Cre-lox and 28 male Wistar mice without ARKO (controlled group) were enrolled in our study. Route pathology was performed and p63 examination was detected by immunohistochemistry in testes. Linear correlations were used to explore potential associations between p63 protein expression and spermatogenic function (TMS score).

Results.?In ARKO group, inner diameter of seminiferous tubules was decreased (62?±?1.3?μm vs. 91?±?1.2?μm), thickness of the basal membrane of the tubules (4?±?0.3?μm vs. 2.7?±?0.5?μm), cellular population within tubules was reduced (2?±?0.4 vs. 4?±?0.1 layers), degree of spermatogenesis within the tubules turned to disturbance (3?±?1.0 vs. 5?±?0.1), Testicular Makler score was lower than controlled group (7?±?0.2 vs.15?±?0.3), they had significant differences (p <0.01). P63 expressed significantly lower in ARKO group than that in Wistar group, and was limited at stages from spermatocyte to round spermatid. (Percentage of positive cells ? 68.1?±?3.7 vs. 81.7?±?5.1, p?<0.001). The HSCORE yielded similar results (HSCORE 3.7?±?0.3 vs. 2.0?±?0.2, p?<0.001). p63 protein expression was significantly positively correlated with spermatogenic function (r?=?0.87, p?<0.01).

Conclusions.?p63 developed important effect on spermatogenesis and the regulatory effect of p63 on spermatogenesis mainly occurred in the early stage of spermiogenesis in testis.     

Relation between hand grip strength,respiratory muscle strength and spirometric measures in male nursing home residents

Abstract

Adverse-outcomes related to sarcopenia are mostly mentioned as physical disability. As the other skeletal muscles, respiratory muscles may also be affected by sarcopenia. Respiratory muscle strength is known to affect pulmonary functions. Therefore, we aimed to investigate the relations between extremity muscle strength, respiratory muscle strengths and spirometric measures in a group of male nursing home residents. Among a total of 104 male residents, residents with obstructive measures were excluded and final study population was composed of 62 residents. Mean age was 70.5?±?6.7 years, body mass index: 27.7?±?5.3?kg/m² and dominant hand grip strength: 29.7?±?6.5?kg. Hand grip strength was positively correlated with maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) (r?=?0.35, p?<?0.01 and r?=?0.26, p?<?0.05, respectively). In regression analysis, the only factor related to MIP was hand grip strength; among spirometric measures only parameter significantly related to grip strength was peak cough flow (PCF). The association of PCF with grip strength disappeared when MIP alone or “MIP and MEP” were included in the regression analysis. In the latter case, PCF was significantly associated only with MIP. We found peripheric muscle strength be associated with MIP and PCF but not with MEP or any other spirometric parameters. The relation between peripheral muscle strength and PCF was mediated by MIP. Our findings suggest that sarcopenia may affect inspiratory muscle strength earlier or more than the expiratory muscle strength. Sarcopenia may cause decrease in PCF in the elderly, which may stand for some common adverse respiratory complications.     

Relationship between testosterone serum levels and lifestyle in aging men

Objective.?The aim of this study was to evaluate the association between serum levels of testosterone and free testosterone to lifestyle in aging males.

Methods.?Men between 45 and 85 years were assessed regarding body mass index (BMI), nicotine and alcohol consumption, stress level, physical and social activity, and sleeping quality by a self-administered questionnaire. In parallel, serum levels of testosterone (T), free testosterone (fT), LH, FSH, DHEA-S, E2 and SHBG were obtained.

Results.?In total, 375 men with a mean age of 59.9 years (9.2 ± SD) entered this study; 25.4% and 27.4% had hypogonadal testosterone or free testosterone serum levels, respectively. Nicotine consumption (smokers had higher levels of T and fT; p < 0.01), BMI (negative correlation to T; p < 0.01) and age (negative correlation to fT; p < 0.001) correlated with serum levels of testosterone or free testosterone. Physical and social activity, nicotine and alcohol consumption, stress level and sleep quality did not show a significant association with serum androgen levels.

Conclusion.?This prospective study of 375 men aged 45 to 85 years confirms the correlation between age, BMI and smoking with serum levels of testosterone and free testosterone, whereas the investigated variety of lifestyle factors did not show a significant association to serum androgen levels.     

Complex relationship between sex hormones,insulin resistance and leptin in men with and without prostatic disease

Objectives: To assess sex hormones, leptin and insulin-resistance in men with prostate cancer (PCa) and benign prostatic hyperplasia (BPH) and to study associations between androgens and histologic score of prostate tissue in PCa.

Subjects and methods: Two hundred ten men older than 45 years selected from 2906 participants of a population screening for PCa were studied: 70 with PCa, 70 with BPH and 70 controls (CG), matched by body mass index and age. Insulin, IGF-1, PSA, leptin, total, free (fT) and bioavailable testosterone (bT) and estradiol were measured. Each group was subdivided into two subgroups considering the presence of metabolic syndrome (MS); androgens and leptin levels were analyzed in the subgroups.

Results: Prostate cancer and BPH patients presented higher total, fT and bT levels than CG. IGF-1, insulin and HOMA index were higher in BPH than in the other two groups. PCa presented higher leptin [median (range) 6.5 (1.3–28.0) versus 4.8 (1.1–12.3) ng/ml; p?p?=?0.025] levels than CG. After dividing men considering the presence of MS, leptin was higher and total testosterone was lower in MS patients in all the groups.

Conclusions: It was observed a coexistence of an altered hormone profile with increased sex hormones and leptin in PCa patients, in accordance with the new perspective of PCa pathogenesis.     

Associations of physical exercise as a lifestyle habit with lean and fat body mass and handgrip strength and age in Asian men

Abstract

Background: We evaluated how the intensity of physical exercise as a lifestyle habit is associated with age, body composition and handgrip strength.

Methods: Total body composition was analyzed using DEXA. Exercise scores were derived from an administered questionnaire and the scoring was calculated using the Metabolic Equivalent of Task (MET). Handgrip strength was measured using a dynamometer.

Results: Age, independent of exercise intensity, was associated with declining lean mass, and handgrip strength and with increasing total body fat. A regular physical exercise regime of intensity greater than 1230 MET-min/week was associated with higher total lean mass and lean mass in the limbs, and handgrip strength and lower fat mass in the limbs.

Discussion: We have shown that age was associated with lower lean mass especially in the limbs and handgrip strength and higher total fat mass. Regular physical exercise as a lifestyle habit of any type and of sufficient intensity could help improve muscle strength in the limbs.     

Association of age and physical exercise with bodyweight and body composition in Asian Chinese men

Background.?The present study sought to examine the association between physical exercise as a lifestyle habit with anthropometric parameters and body composition and aging in men.

Methods.?Intensity of exercise was scored as metabolic equivalent-min/week (MET-min/week) from data of the questionnaire, while anthropometric parameters and body composition were carried out by standard measuring instruments and dual-energy X-ray absorptiometry scanner, respectively.

Results.?Age was associated with decreases in bodyweight, height, total lean mass and bone mass, but an increase in fat mass. The negative association of lean mass with age was predominantly due to the negative association of lean masses in the legs and arm, while the positive association of fat mass with age was primarily due to the positive association of fat masses in the trunk and abdomen. Exercise of intensity greater than 1000 MET-min/week was significantly associated with higher lean and bone masses and lower fat mass. The increase in lean mass was predominantly in the legs, while the decreases in fat mass were in the trunk and abdomen.

Conclusion.?The study showed that the high intensity of physical exercise, equivalent to greater than 1000 MET-min/week, is required to effect beneficial changes in the body composition. Hence, results from the study support the importance of promoting a lifestyle habit of exercise of sufficient intensity in order to mitigate the increase risks of sarcopenia and obesity and their attendant ill effects on health in men as they age.     

Increased visceral adiposity index associated with sexual dysfunction in men

Objective: Visceral adipose index (VAI) is a novel parameter for the evaluation of visceral obesity. As we know that obesity is a risk factor for erectile dysfunction (ED). So, in this study, we compared the VAI levels between the men with ED and without ED.

Materials and method: A total of 177 men were included in the study. Ninety-five men with ED and 82 men without ED (control). All men were evaluated for ED by Index of Erectile Function-5 items (IIEF-5). VAI levels were calculated using body mass index, high density lipoprotein and tryglyceride levels.

Results: Mean age was 53.5 (38–69) in men who have ED and 53.1 (34–69) in control. The men with ED had higher body mass index (BMI), triglyceride (TG) levels, higher waist circumference (WC) and lower high-density lipoprotein-cholesterol (HDL-C) levels. Mean VAI level was 5.18?±?2.50 in study group and 3.47?±?1.76 in control goup, respectively. VAI levels were statistically higher in men with ED (p?Discussion: The simplicity of WC and BMI measurement and TG and HDL assessment, make VAI an easily applicable index for the evaluation of visceral fat dysfunction. VAI can be useful index for the evaluation and calculation of erectile dysfunction risk.     

Evaluation of sex hormone levels and some metabolic factors in men with coronary atherosclerosis

Background Because of the great controversy over the role of androgens in the pathogenesis of atherosclerosis, we investigated the relationship between serum sex hormone levels and angiographically confirmed coronary artery disease in men.

Material and methods We investigated 86 men aged 40–60 years, 56 with coronary artery disease and 30 healthy men, matched by age, as a control group. Body mass index and waist to hip ratio were calculated and total body fat mass and percentage of abdominal deposit were investigated by dual-energy X-ray absorptiometry (Dpx (?+?) Lunar, USA). The serum levels of sex hormones and insulin were measured using commercial radioimmunoassay and IRMA (by SHBG) kits (DPC, USA). The serum levels of lipids and glucose were assessed by means of enzymatic methods.

Results Men with coronary artery disease had lower total testosterone levels (17.01?±?6.42 vs. 19.37?±?6.58?nmol/l; p?<?0.05), testosterone/estradiol ratio (228.5?±?88.5 vs. 289.8?±?120.1; p?<?0.05) and free androgen index (FAI) (59.49?±?14.79 vs. 83.03?±?25.81; p?<?0.0001), and higher levels of estrone (49.5?±?27.7 vs. 36.6?±?12.7?pg/ml) than men in the control group. Moreover, men with coronary artery disease were more insulin-resistant than controls and had an atherogenic lipid profile. There was an inverse correlation (p?<?0.05) between testosterone level and serum level of glucose (r?=??0.29), triglycerides (r?=??0.37), body mass index (r?=??0.55), waist (r?=??0.43), total body fat mass (r?=??0.3) and fasting insulin resistance index. A significant positive association (p?<?0.05) was found between testosterone and the quantitative insulin sensitivity check index and high density lipoprotein cholesterol level in serum (r?=?0.26).

Conclusions Low levels of total testosterone, testosterone/estradiol ratio and free androgen index and higher levels of estrone in men with coronary artery disease appear together with many features of metabolic syndrome and may be involved in the pathogenesis of coronary atherosclerosis.     

Oral administration: a preferred route of testosterone intake

Objective.?The influence of prostate-specific antigen (PSA) kinetics on the outcome of metastatic prostate cancer (PCa) after androgen-deprivation therapy (ADT) remains poorly characterised. We evaluated the prognostic significance of PSA nadir and time to PSA nadir as well as their interactive effect on prostate cancer-specific mortality (PCSM) and all-cause mortality (ACM) after ADT.

Methods.?A total of 650 men with advanced or metastatic PCa treated with ADT were studied. The prognostic significance of PSA nadir and time to PSA nadir on PCSM and ACM were analysed using Kaplan–Meier analysis and the Cox regression model.

Results.?On multivariate analysis, clinical M1 stage, Gleason Score 8–10, PSA nadir ≥ 0.2 ng/ml and time to PSA nadir < 10 months were independent predictors of PCSM and ACM. The combined analysis showed that patient with higher PSA nadir and shorter time to PSA nadir had significantly higher risk of PCSM and ACM compared to those with lower PSA nadir and longer time to PSA nadir (hazard ratios?=?6.30 and 4.79, respectively, all P < 0.001).

Conclusions.?Our results suggest that higher PSA nadir level and faster time to reach PSA nadir after ADT were associated with shorter survival for PCa.     

Prevalence of low forearm bone mineral density in Bulgarian men: a pilot study

Objective. To determine the prevalence of osteoporosis at the distal forearm in a male cohort referred for bone density testing and to compare it to published data of Bulgarian women.

Design and subjects. 315 consecutive Bulgarian men aged 20 to 84 years were included (mean age 53.74 ± 14.67 years). 59% of them were self-referrals. The comparative female group consisted of 8869 Bulgarian women whose forearm bone mineral density (BMD) was measured in another study.

Measurements. BMD was measured by single X-ray absorptiometry at the distal forearm (distal and ultradistal sites) in all men. T-scores were calculated from manufacturer-provided Danish male reference data.

Results. The ratio of female to male patients was 28.2 (8869 to 315). Peak BMD was observed in men aged 30 to 39 years: 0.560 ± 0.065 g/cm² (distal site) and 0.490 ± 0.070 g/cm² (ultradistal site). A steady BMD decline followed reaching 0.492 ± 0.064 g/cm² at the distal and 0.412 ± 0.069 g/cm² at the ultradistal site in age group >70. Age had a rather weak negative impact on forearm BMD described by a linear model. In men aged over 50 years the prevalence of osteoporosis at the distal site was 21.19%, compared to 20.45% in women. Low bone mass was seen in 48.77% of men and 32.50% of women. Normal BMD was more frequent in women (47.05%) than in men (30.04%).

Conclusions. We found a high prevalence of forearm osteoporosis in Bulgarian men which is comparable to that already known in women.     

Body mass index and functional status in community dwelling older Turkish males

Abstract

Objectives: To assess sex hormones in men with obesity and prostate cancer (PCa) and to study association between androgens and the pathogenesis biology of PCa in vitro.

Subjects and methods: One hundred and eighty-one men older than 45?years selected from of a population attending to Urology departments screening for PCa, (78 participants without PCa and 103 patients with PCa). All participants were assessed for body mass index (BMI), age, Gleason score, and PSA. Endocrine profile was determined for LH, total testosterone (TT), 17β-estradiol (E2), prolactin and leptin. Biochemical profile (HbA1c, triacylglycerols and lipoproteins) was also determined. In vitro experiments were also performed, involving the study of 5α-dihydrotestosterone (DHT) and E2 in the presence of adipocyte-conditioned medium (aCM).

Results: All variables were continuous and described a Gaussian distribution unless mentioned. To determine the relation of aggressiveness, variable were transformed into categories. Thus, PCa aggressiveness is associated with the increase of age and BMI (p?<?.0001) but with is decreased with TT and E2 (p?<?.05). Moreover, adipocyte-secreted molecules increase aggressiveness of PCa cells in vitro. Lastly, DTH but not E2 enables invasiveness in vitro.

Conclusions: It was observed a coexistence of hormone axis profile alteration with sex hormones and BMI in PCa patients, in accordance with the new perspective of PCa pathogenesis.     

Androgen replacement therapy contributes to improving lower urinary tract symptoms in patients with hypogonadism and benign prostate hypertrophy: a randomised controlled study

Purpose.?We performed a randomised controlled study regarding the effects of androgen replacement therapy (ART) on lower urinary tract symptoms (LUTS) in hypogonadal men with benign prostate hypertrophy (BPH).

Methods.?Fifty-two patients with hypogonadism and BPH were randomly assigned to receive testosterone (ART group) as 250?mg of testosterone enanthate every 4 weeks or to the untreated control group. We compared International Prostate Symptom Score (IPSS), uroflowmetry data, post-voiding residual volume (PVR) and systemic muscle volume at baseline and 12 months after treatment.

Results.?Forty-six patients (ART group, n?=?23; control, n?=?23) were included in the analysis. At the 12-month visit, IPSS showed a significant decrease compared with baseline in the ART group (15.7?±?8.7 vs. 12.5?±?9.5; p?<?0.05). No significant changes were observed in the control group. The ART group also showed improvement in maximum flow rate and voided volume (p?<?0.05), whereas no significant improvements were observed in the controls. PVR showed no significant changes in either group. In addition, the ART group showed significant enhancement of mean muscle volume (p?<?0.05), whereas no significant changes were seen in the controls.

Conclusion.?ART improved LUTS in hypogonadal men with mild BPH.