Testosterone deficiency and the metabolic syndrome

Evidence is presented to link components of the metabolic syndrome to testosterone deficiency and obesity. Testosterone deficiency in hypogonadism or testosterone deprivation in normo-gonadotropic men increases fat mass as well as fasting insulin levels. Testosterone supplementation (TS) in a dose dependent manner, increase lean body mass (LBM), reduces fat mass, body mass index (BMI) and waist hip ratio in both young and elderly hypogonadal men. A negative association between T and insulin resistance as well as impaired glucose intolerance has been demonstrated and in type 2 diabetic men TS improves metabolic parameters. TS improves most components of the metabolic syndrome and also reduces inflammatory cytokines.     

Impact of metabolic syndrome and its components on kidney stone in aging Taiwanese males

Objectives: Metabolic syndrome (MtS) and kidney stone are two common aging diseases with male dominant. This is the first study regarding the potential impact of MtS and its components on kidney stone in aging Chinese population.

Methods: A total of 694 males with a mean age of 55.6 years were enrolled. The definition of MtS was according to the modified criteria developed by the Bureau of Health Promotion in Taiwan. Subjects were classified as having a disease of kidney stones according to diagnosis by a physician with available medical records or evidence from ultrasonography judged by an investigator of urologist.

Results: Using age-adjusted multivariate logistic regression analysis, our results showed that subjects with kidney stone had significantly higher prevalence of MtS (p?=?0.04, OR?=?1.74, 95% CI: 1.0 1–3.00). The presence of MtS had significant correlation with kidney stone (p?=?0.01, OR?=?1.83, 95% CI: 1.1 4–2.93), which were associated with the increment of MtS components (p?p?Conclusions: In aging Taiwanese males, the presence of MtS and its components are strongly associated with kidney stone. Abnormal BP is the most significant risk component of MtS for kidney stone.     

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.     

Increased prevalence of premature ejaculation in men with metabolic syndrome

This prospective study aimed to investigate the relationship between metabolic syndrome (Met S) and premature ejaculation (PE) among men. The study included 300 consecutive male patients (53.6 y?±?8.7) who attended the urology clinic (December 2013–September 2014), mostly complaining of renal/ureteric calculi. A diagnostic approach was undertaken to include demographics, clinical features and laboratory investigations of the study subjects. Both erectile function and PE were evaluated using the International Index of Erectile Function (abridged form, IIEF-5) and Premature Ejaculation Diagnostic Tool (PEDT) questionnaires, respectively. Results identified 182 (60.7%) men had Met S. Prevalence of PE was significantly higher in the subjects with Met S than the controls (35.2% vs 7.6%, p?< 0.001). Patients with Met S and PE had significantly higher PEDT scores (15.4 vs 6.7), smaller waist circumference (108.3?cm vs 111.5?cm) and higher fasting blood sugar (187?mg% vs 161?mg%) than those with no PE (p?p?=?0.047 and <0.001, respectively) with PE in Met S. In conclusion, PE has a high prevalence in Met S. Patients with Met S should be questioned about PE. Both ED and systolic hypertension may be associated with PE. Prevention of Met S should be considered, and this may be of help to decrease the prevalence of PE.     

Prevalence of the metabolic syndrome and its relationship with diabetes mellitus by aging

Abstract

Introduction.?It is important to make a prompt diagnosis of metabolic syndrome (MetS) in order to prevent the development of cardio-/cerebro- vascular diseases and diabetes mellitus (DM). The authors estimated the risk of development of DM by the presence/absence of MetS and age groups.

Methods.?A cross-sectional study of subjects undergoing intensive health examination was conducted (3149 men aged 30–69 years). Diagnosis of MetS was based on the criteria of the National Cholesterol Education Program Expert Panel (NCEP).

Results.?The prevalence of DM occurring in association with MetS increased with age; it was 11.9% in subjects with MetS in their 30s, it was 19.8% in subjects with MetS in their 60s. The prevalence of DM among subjects who had one or two components of MetS also increased with age. There was a significant progressive increase of the odds ratio in subjects in their 30s, 40s, 50s and 60s who were judged as having MetS; significant increase of the odds ratio was seen in subjects in their 60s, even in those who were not judged as having MetS.

Conclusions.?Subjects with MetS show a high prevalence of DM, and the prevalence increased with age in the subjects.     

A work in progress: the metabolic syndrome

Metabolic syndrome refers to a constellation of risk factors for cardiovascular disease. They include elevated plasma glucose concentrations, dyslipidemia, hypertension, and abdominal obesity. These conditions typically occur during middle age or later in life. Although there is no clear consensus on the diagnosis of metabolic syndrome, it is a potentially important entity to recognize and manage once traditional cardiovascular risk factors, such as smoking, hypertension, dyslipidemia, and diabetes, have been treated individually. This Perspective summarizes our current knowledge of the metabolic syndrome. Lifestyle change, including diet and exercise, is probably the best available option for treating the metabolic syndrome. However, rigorous lifestyle interventions are difficult to implement outside of a clinical trial setting, especially among elderly patients.     

The impact of metabolic syndrome on serum total testosterone level in patients with erectile dysfunction

Abstract

Objectives: To determine the association between metabolic syndrome (MetS) and serum testosterone levels (TT) in patients with erectile dysfunction (ED).

Methods: This study included 280 ED patients above 40-years-of-age. Participants were divided into two groups according to 2005 criteria of International Diabetes Federation. The severity of ED was determined according to the International Index of Erectile Function-EF (IIEF-EF score; 0–10 severe ED, 11–25 mild to moderate ED). The severity of ED, serum TT levels and other MetS components were compared between the groups.

Results: The mean age of the patients was 55.7?±?8.2 years. One hundred eighteen patients (%42.1) had MetS. Sixty-eight patients with MetS (57.6%) and 71 patients without MetS (43.8%) had severe ED (p?=?0.031). A total of 46 (16.4%) patients had hypogonadism. Hypogonadism was seen more prevalent in patients with MetS (22.9% vs. 11.7%, p?=?0.013). Logistic regression analyses for ED risk factors demonstrated that abnormal FBG increased the relative risk of severe ED up to 10.7-fold (p?<?0.001) but not presence of hypogonadism (p?=?0.706).

Conclusion: Metabolic syndrome was seen in almost half of the patients with ED. ED was more severe among MetS patients. Hypogonadism alone is a not risk factor for severe ED.     

Generational affinities and discourses of difference: a case study of highly skilled information technology workers

Sociologists theorizing the concept of 'generation' have traditionally looked to birth cohorts sharing major social upheavals such as war or decolonization to explain issues of generational solidarity and identity affiliation. More recently, theorists have drawn attention to the cultural elements where generations are thought to be formed through affinities with music or other types of popular culture during the 'coming of age' stage of life. In this paper, we ask whether developments in computer technology, which have both productive and cultural components, provide a basis for generational formation and identity and whether generational discourse is invoked to create cultures of difference in the workplace. Qualitative data from a sample of Information Technology workers show that these professionals mobilize 'generational' discourse and draw upon notions of 'generational affinity' with computing technology (e.g. the fact that people of different ages were immersed to varying degrees in different computing technologies) in explaining the youthful profile of IT workers and employees' differing levels of technological expertise.     

Reflective ability,empathy, and emotional intelligence in undergraduate social work students: a cross-sectional study from India

The extant literature indicates that social work is a high stress profession owing to multifarious and complex demands of practice. There is also evidence of stress experienced by student trainees who aspire for a career in social work. Working with service users and the distressing life scenarios encountered on placement often involves negotiating complex emotions and requires reflective skills. Effective practice requires rapport building skills and the ability to demonstrate empathy is a core skill for effective practice. While there is a plethora of Western literature on these issues, the Indian literature has not adequately explored them. Framed against this background, this quantitative study collected data from students of all three years of their undergraduate social work course from a ‘women only’ college in India. Standardised instruments to assess empathy, reflective ability and emotional intelligence were administered. Statistical tests revealed a higher manifestation of these dimensions in final-year students than those in the first year. Further it was seen that the total emotional intelligence and empathy scores were positively correlated. Implications of these findings for the education and training of social work students has also been discussed in this article.     

Androgen deficiency in the adult male

Introduction. The purpose of this study was to investigate the association between severity of lower urinary tract symptoms (LUTS), erectile dysfunction (ED) and metabolic syndrome.

Methods. Our study population included a consecutive series of 190 patients with LUTS (International Prostate Symptom Score-IPSS >7) with or without manifestations of the metabolic syndrome. The diagnoses of diabetes mellitus and hypertension were obtained from the patient's medical history. Data on blood pressure, waist measure, body height and weight were collected and body mass index were calculated. Patients were assessed based on the International Index of Erectile Function (IIEF) for ED and IPSS and IPSS-Quality of Life for LUTS. Blood samples were drawn from fasting patients to determine, fasting blood glucose (FBG), triglycerides, HDL-cholesterol and serum total testosterone levels.

Results. In severe LUTS patient group, IIEF erectile function domain scores were significantly lower than moderate LUTS patient group (p < 0.05). Multiple logistic regression analysis confirmed that presence of ED was the most predictor of severe LUTS. The prevalence of metabolic syndrome was higher in patients with severe LUTS (26%vs. 46%, p = 0.009). The severe form of the LUTS was significantly correlated with waist circumference >102 cm (p < 0.05), blood pressure ≥130/85 mmHg (p < 0.05) and FBG >110 mg/dl (p < 0.01).

Conclusion. Obesity, high plasma level of FBG and hypertension constitute risk factors for the development of severe LUTS. Metabolic syndrome may play a key role in the pathogenesis in both ED and LUTS. Presence of ED is the most predictor of severe LUTS.     

New voices in social work: an explorative study of female Turkish and Moroccan-Dutch professionals in social work in the Netherlands

In social work, the participation of Turkish and Moroccan-Dutch professionals, second and third generation migrant women from a Muslim background, is increasing. In this participative qualitative inquiry, new professionals were actively involved as co-researchers, doing research with peers from the same background. The question addressed is how these professionals deal with identity tensions and if they find positive sources of identification in social work. The new professionals claim a positive identity, connected to what they consider their strength and in particular their faith and ‘otherness’. At the same time, this increases their vulnerability, in a context in which Islam by some is considered a threat to society. The importance of a supportive professional social work identity is advocated.     

Association of general and abdominal obesity with age,endocrine and metabolic factors in Asian men

Objective: This study made use of the percent abdominal fat to define abdominal obesity (AbO) and examined the differential associations of general obesity (GOb) and AbO with age, metabolic and endocrine factors.

Methods: Metabolic, endocrine and anthropometric factors and body composition were measured in 481 Asian men.

Results: A DEXA-derived ≥25% abdominal fat (PAbdF) was used to define men with AbO. Age was directly associated with PAbdF and percent total body fat (PBF). Exercise intensity was negatively associated with PBF. Both PBF and PAbdF were associated with HDL and LDL, but have opposite correlation with triglyceride. Furthermore, both PBF and PAbdF were associated with the number of metabolic syndrome (MetS) risk factors. Men with GOb had lower levels of percent lean mass (PLM), testosterone and bioavailable testosterone, and higher insulin and glucose levels. Men with AbO had lower arm and leg fat, higher insulin levels and triglycerides.

Conclusions: Men with GOb and AbO had different pattern of body composition. Age may be a contributory factor in AbO and a sedentary lifestyle may contribute to GOb. Both GOb and AbO are associated with an increased risk of MetS, with GOb more predispose to risk of diabetes, while AbO more at risk for cardiovascular diseases.     

Increase in the prevalence of metabolic syndrome among workers according to age

Androgen levels decline over a man's lifetime. In a proportion of men (increasing with age), levels fall below values that have been established by conventional laboratory criteria as indicative of hypogonadism. Testosterone has a wide range of non-reproductive actions: it preserves bone and muscle mass, it acts on non-sexual mental functioning and it stimulates red blood cell formation. Long-term androgen deficiency has a great impact on quality of life. The first intervention studies provide indications that androgen treatment of men with true androgen deficiency is helpful. Obviously, only men who are testosterone-deficient will benefit from androgen supplementation. The diag nosis of testosterone deficiency in old age is not unambiguous. Signs and symptoms of aging sometimes clinically overlap with those of testosterone deficiency. The groups that are at higher risk of testosterone deficiency are those men with disease (pulmonary disease, gastrointestinal disease, rheumatoid disease, etc.). Usually, sex hormone binding globulin levels increase with aging, leading to lower levels of free, biologically available testosterone. For the time being, arbitrary criteria for testosterone deficiency in aging men have to be adopted. The best practical approach is to calculate the free testosterone level. The calculation can be found at www.issam.ch under 'Tools'.     

Young people,social workers and social work education: the role of digital skills

ABSTRACT

This paper addresses a key issue in the development of youth-focused social work: the role of digital skills in the relationship between young people and social workers who work with these native digital users. To this end, we analysed data from the International Digital Economy and Society Index 2019 and Eurostat. Information from the sixth European Working Conditions Survey and a survey conducted by the Social Care Institute for Excellence and the British Association of Social Workers supported the empirical analysis. The main findings reveal a gap between the level of digital skills required in the labour market and the actual level of digital skills in both young people and social workers, despite efforts by both groups to improve their skills. Initiatives to foster digital skills are therefore recommended to bridge this digital divide. Lastly, it was concluded that both groups could act as mutual drivers of digital transformation.     

Evidence-based practice in social work: perceptions and attitudes among Norwegian social workers

Although the concept of evidence-based practice (EBP) eludes precise definition, it is used as a trademark label to ensure that practice is based on science and thereby effective and of high quality. Proponents of EBP have proposed that both education and practice in social work should be transformed according to the principle of EBP. They attribute critical opposition to EBP to a lack of knowledge of what EBP is. In this article, we endeavour to clarify the concept and present results from a survey among social workers (N?=?2060) from Norway. The survey results show that although many have heard of the concept, few have precise knowledge about it. However, the more educated social workers are (master’s level), the clearer their opinions, both critical and non-critical. The results are discussed in relation to neo-liberal governance and development of social work.     

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.     

Retraining programmes in social work: career considerations,factors influencing the decision to study social work and professional preferences among students

The current study sought to examine the differences between retraining programme (RP) students in social work (SW) and mainstream programme (MP) students regarding career considerations, factors influencing the decision to study SW and professional preferences. RPs are similar to fast-track training programmes known in the UK, as they offer graduates from other disciplines a qualification in SW. This study was conducted among 125 SW students in Israel: 56 in the RP, where studying SW was their secondary choice (after graduating in a different academic discipline) and 69 MP students for whom SW was their first choice for a profession. Both groups were examined in their final year of studies. When choosing their profession, RP students attributed greater importance to considerations such as personal development, satisfaction and interest in treating people, while for MP students, working conditions were more important. In addition, RP students also preferred to engage in individual therapy and policy practice. Furthermore, there were several differences between the groups’ preferences regarding types of populations, services and sectors. Correlations were found between various preferences of populations, services and fieldwork training. Lastly, a higher percentage of RP students compared to MP students had expressed their intention to work as social workers once they complete their studies.     

The impact of testosterone replacement therapy on glycemic control,vascular function,and components of the metabolic syndrome in obese hypogonadal men with type 2 diabetes

Objective: This study set out to assess effects of testosterone replacement therapy (TRT) on parameters of metabolic syndrome and vascular function in obese hypogonadal males with type 2 diabetes mellitus (DM2).

Study design: Fifty-five obese hypogonadal diabetic males on oral hypoglycemic treatment were enrolled into this one-year, double-blind, randomized, placebo-controlled clinical study. Group T (n?=?28) was treated with testosterone undecanoate (1000?mg i.m. every 10?weeks) while group P (n?=?27) received placebo.

Methods: Anthropometrical and vascular measurements – flow-mediated dilatation (FMD) and intima media thickness (IMT) – biochemical and hormonal blood sample analyses were performed at the start of the study and after one year. Derived parameters (BMI, HOMA-IR, calculated free testosterone (cFT) and bioavailable testosterone (BT)) were calculated.

Results: TRT resulted in reduction of HOMA-IR by 4.64?±?4.25 (p?p?p?=?.005).

Conclusion: TRT normalized serum testosterone levels, improved glycemic control and endothelial function while exerting no ill effects on the study population.     

Foodwork as re-articulation of women's in/visible work: A study of food allergy blogs

This paper advances our understanding of foodwork as the organization of women's work and racialized, gendered, and classed inequalities in the provisioning, preparation, and consumption of food. Drawing on notions of the in/visibility of women's work, I conceptualize foodwork as the articulation of visible and invisible women's work in the social organization of everyday food practices. The analysis of three blogs, written by women with, or mothers of children with, food allergies, provides a glimpse into the everyday living with food allergy. The investigation of the actual practices of allergy foodwork shows that they are interactive and intersectional patterns of work and make everyday life possible. The paper maps directions for research to explore how foodwork could be organized differently starting from the transformative potential of everyday food practices, blogs, and food allergy.