Endogenous testosterone and brachial artery endothelial function in middle-aged men with symptoms of late-onset hypogonadism

In aging men, serum endogenous testosterone is inversely associated with common carotid intima-media thickness (IMT) and directly with beneficial plasma lipid levels; however, the relationship to endothelial function is poorly characterized. We examined the association between serum testosterone and endothelium-dependent brachial artery flow-mediated dilatation (FMD) in middle-aged to elderly men. A group of 83 men aged 40–69 years (mean 55.9?±?7.5 [SD]) with andropausal symptoms were studied. We measured their serum lipids, testosterone, luteinizing hormone, mean carotid IMT and brachial artery FMD by high resolution B-mode ultrasound. Brachial FMD correlated inversely with vessel diameter (r?=??0.38, p?=?0.0004), alcohol consumption (r?=??0.22, p?=?0.047) and serum testosterone (r?=??0.27, p?=?0.01), but not with luteinizing hormone. In multivariate analysis, FMD was explained by testosterone (β?=??0.17, p?=?0.0226), high density lipoprotein cholesterol (β?=?4.17, p?=?0.0312) and vessel diameter (β?=??4.37, p?<?0.0001) when adjusted for age, body mass index, triglycerides, blood pressure, carotid IMT, smoking, alcohol consumption, cardiovascular diseases and use of lipid lowering medication (HMG-CoA reductase inhibitors). In middle-aged to elderly men, there is an inverse correlation between serum testosterone and brachial FMD. These data suggest that testosterone may have an adverse effect on systemic endothelial function.     

Association between testosterone levels and the metabolic syndrome in adult men

Abstract

Objective: To evaluate the relationship between testosterone levels and the metabolic syndrome (MS) in men older than 45 years.

Methods: Six hundred and sixty men (45–70 years) selected from 2906 participants of a population screening for prostate cancer were included in this study. Testosterone and the components of MS were assessed in all men. MS was diagnosed according to NCEP-ATP III criteria. Triglycerides (TG)/HDL-cholesterol (chol) index was calculated.

Results: The presence of MS was inversely associated with testosterone (χ², p?<?0.001), independently of age (OR 0.802, CI 95%: 0.724–0.887, p?<?0.0001). Hypertension was the most frequent abnormality observed followed by elevated TG and waist circumference (WC). Testosterone correlated positively with HDL-chol (r: 0.14, p?<?0.0001) and negatively with body mass index (BMI)(r: ?0.29, p?<?0.0001), WC (r: ?0.26, p?<?0.0001), TG (r: ?0.20, p?<?0.0001), TG/HDL-chol (r: ?0.20, p?<?0.0001), glucose (r: ?0.11, p?=?0.005) and MS score (r: ?0.23, p?<?0.0001).

Conclusions: Our results show that in men older than 45 years, as long as testosterone levels decline, the prevalence of MS increases, independently of age. The correlations found between testosterone and four of the five components of MS, as well as with BMI and TG/HDL-chol ratio, a surrogate marker of insulin resistance, suggest considering male hypogonadism as a determinant of developmental abnormalities typical of MS.     

Age and total and free prostate-specific antigen levels for predicting prostate volume in patients with benign prostatic hyperplasia

Objectives: To investigate the predictive values of free prostate-specific antigen (fPSA), total PSA (tPSA) and age on the prostate volume.

Methods: The data of 2148 patients with lower urinary tract symptoms were analyzed retrospectively. The patients who had transrectal ultrasonography guided 10 core biopsies owing to the findings obtained on digital rectal examination and presence of high PSA levels (PSA?=?2.5–10?ng/dl), and proven to have BPH histopathologically were included in the study. Age, tPSA, fPSA and the prostate volumes (PV) of the patients were noted.

Results: One thousand patients that fulfilled the inclusion criteria were included in the study. The PV of the patients were significantly correlated with age, tPSA and fPSA (p?r?=?0.307, p?r?=?0.382, p?r?=?0.296, respectively). On linear regression model, fPSA was found as a stronger predictive for PV (AUC?=?0.75, p?p?p?=?0.013).

Conclusions: Although tPSA is an important prognostic factor for predicting PV, the predictive value of fPSA is higher. PV can easily be predicted by using age, and serum tPSA and fPSA levels.     

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.     

Elevated high sensitivity C-reactive protein levels in aging men with low testosterone

Objective.?We examined baseline data from a lipid treatment study to assess the relationship between testosterone (T) and the cardiovascular inflammatory marker, high sensitivity C-reactive protein (hsCRP).

Methods.?The baseline T, hsCRP, lipid, glycemic, and anthropometric data were obtained from 467 men (mean age: 52 years). Inclusion criteria included low-density lipoprotein cholesterol ≥?3.4 to 4.9?mmol/l and triglycerides?≤?4.0?mmol/l. The baseline hsCRP levels were examined across the following T subgroups: <6.9?nmol/l (moderate to severe hypogonadism), 6.9 to <10.4?nmol/l (mild to moderate hypogonadism), 10.4 to <15?nmol/l (low-normal T), and?≥?15?nmol/l (normal T).

Results.?The median hsCRP levels were significantly (p?=?0.041) different across the four T subgroups; patients in the lower T subgroups had higher median hsCRP levels than patients in the higher T subgroups. The percentage of men with elevated hsCRP (>2?mg/l) was also significantly (p?=?0.038) different across the four T subgroups; 83% of men with T < 6.9?nmol/l had elevated hsCRP compared with 40% with T ≥ 15?nmol/l.

Conclusions.?This analysis demonstrated an inverse relationship between serum T and hsCRP in aging men. Urologists need to be aware that low T levels may not only adversely affect sexual function but also may worsen cardiovascular risk in aging, hypogonadal men.     

The imbalance of sex-hormones related to depressive symptoms in obese men

Obese men may present hypogonadothrofic hypogonadism, mainly related to higher insulinemia and aromatase activity. Our objectives were to evaluate the relationship of sex-hormones profiles and frequency of depressive symptoms in 43 obese men, in a cross-sectional study. They had 19–60 years, and body mass index 30–50?kg/m². LH, total and free testosterone (TT and FT), estradiol (E₂), sex hormone binding globulin, estradiol/total testosterone ratio (E₂/T) were analyzed. Depressive symptoms were evaluated by “beck depression inventory” (BDI), and significant depression was considered if BDI?≥?16.Thirty-four (80%) presented low TT levels, but only 4 (14%) had low free testosterone and hypogonadism symptoms; 12 of 43 (28%) presented increased E₂. Forty five (56%) presented depressive symptoms, but 16 (28% of the 45) had significant depression. BDI correlated positively with E₂ (r?=?0.407; p?=?0.001) and E₂/T (r?=?0.473; p?=?0.001), but not TT or FT. Patients with significant depressive showed higher levels of estradiol (136?±?48 versus 103?±?48?pg/ml, p?=?0.02) and E₂/T (16.0?±?9.9 versus 9.8?±?4.6; p?=?0.002) (mean?±?SD).In conclusion, obese men may present relatively excess of estradiol and deficiency in testosterone, leading to an imbalance between these two hormones. The greater this imbalance, the more depressive symptoms had our patients.     

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.     

High-intensity interval training (HIIT) increases insulin-like growth factor-I (IGF-I) in sedentary aging men but not masters’ athletes: an observational study

Introduction: The aim of this investigation was to examine the impact high-intensity interval training (HIIT) on serum insulin-like growth factor-I (IGF-I) in active compared with sedentary aging men.

Methods: 22 lifetime sedentary (SED; 62?±?2 years) and 17 masters’ athletes (LEX; 60?±?5 years) were recruited to the study. As HIIT requires preconditioning exercise in sedentary cohorts, the study required three assessment phases; enrollment (phase A), following preconditioning exercise (phase B), and post-HIIT (phase C). Serum IGF-I was determined by electrochemiluminescent immunoassay.

Results: IGF-I was higher in LEX compared to SED at baseline (p?=?0.007, Cohen’s d?=?0.91), and phase B (p?=?0.083, Cohen’s d?=?0.59), with only a small difference at C (p?=?0.291, Cohen’s d?=?0.35). SED experienced a small increase in IGF-I following preconditioning from 13.1?±?4.7 to 14.2?±?6.0?μg·dl^?1 (p?=?0.376, Cohen’s d?=?0.22), followed by a larger increase post-HIIT (16.9?±?4.4?μg·dl^?1), which was significantly elevated compared with baseline (p?=?0.002, Cohen’s d?=?0.85), and post-preconditioning (p?=?0.005, Cohen’s d?=?0.51). LEX experienced a trivial changes in IGF-I from A to B (18.2?±?6.4 to 17.2?±?3.7?μg·dl^?1 [p?=?0.538, Cohen’s d?=?0.19]), and a small change post-HIIT (18.4?±?4.1?μg·dl^?1 [p?=?0.283, Cohen’s d?=?0.31]). Small increases were observed in fat-free mass in both groups following HIIT (p?d?=?0.32–0.45).

Conclusions: In conclusion, HIIT with preconditioning exercise abrogates the age associated difference in IGF-I between SED and LEX, and induces small improvements in fat-free mass in both SED and LEX.     

Testosterone is not associated with mortality in older African-American males

Introduction.?Although testosterone and its association with disease progression and mortality is a widely studied topic, no studies have evaluated mortality risks related to testosterone levels in an older African-American population. The mechanisms for known racial differences in mortality risk for certain cancers and cardiovascular risk factors are largely unknown. Elucidating a mortality risk associated with testosterone levels may give insight into the elevated risk for certain diseases in African-Americans.

Methods and results.?Study data were derived from a cohort 622 African-Americans (age 80.05?±?6.4, range 68–102) from Saint Louis, Missouri that includes 190 males (age 79.38?±?6.2, range 70–102). The eligible sample for this report includes 56 of the 190 males (age 78.89?±?6.9, range 70–102) who donated blood at baseline in 1992–1994 and subsequently tested for total testosterone and bioavailable testosterone. Covariates for adjusted analyses were lower body functional limitations, physician visits and comorbidities, also collected at baseline. Males' mean bioavailable testosterone levels (ng/dl) were 33.33?±?24.4 (n above 70?ng/dl?=?5) and mean total testosterone levels (ng/dl) were 246.63?±?118.7 (n above 300?ng/dl?=?20). Vital status was determined through 2002; 41 males (73%) were deceased and 15 were alive. Mortality did not differ among males with testosterone levels?<300 versus 300+ (p?=?0.42) or with bioavailable testosterone levels?<70 versus > 70 (p?=?0.34). Total testosterone levels did not predict mortality when adjusted for age (Adjusted Hazard Ratio [AHR]?=?0.998; 95% confidence interval [CI] 0.995–1.001; p?=?0.28) or adjusted for age and other covariates (AHR?=?0.099; 95% CI 0.996, 1.002; p?=?0.35). Bioavailable testosterone levels did not predict mortality when adjusted for age (AHR?=?0.992; 95% CI .977–1.007; p?=?0.30) or when adjusted for age and other covariates (AHR 0.991; 95% CI .976–1.006; p?=?0.261).

Conclusion.?In older African-American males, total and bioavailable testosterone levels, with and without adjustment for covariates, are not independently associated with mortality risk.     

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.     

Physical activity is inversely related to drug consumption in elderly patients with cardiovascular events

Elderly patients with cardiovascular events are characterized by high drug consumptions. Whether high drug consumptions are related to physical activity is not known. In order to examine whether physical activity is related to drug consumption in the elderly, patients older than 65 years (n?=?250) with a recent cardiovascular event were studied. Physical activity was analyzed according to the Physical Activity Scale for the Elderly (PASE) score and related to drug consumption. PASE score was 72.4?±?45.0 and drug consumption was 8.3?±?2.2. Elderly patients with greater comorbidity took more drugs (8.7?±?2.1) and are less active (PASE?=?64.4?±?50.6) than patients with Cumulative Illness Rating Scale severity score higher than 1.8 than those with a score lower than 1.8 (76.3?±?41.4, p?<?0.05, and 8.0?±?2.0, p?=?0.006, respectively). Multivariate analysis correlation confirmed that PASE score is negatively associated with drug consumption (β?=??0.149, p?=?0.031), independently of several variables including comorbidity. Thus, physical activity is inversely related to drug consumption in elderly patients with cardiovascular events. This inverse relationship may be attributable to the high degree of comorbidity observed in elderly patients in whom poor level of physical activity and high drug consumption are predominant.     

Biochemical markers of bone metabolism in healthy elderly men. The relationship to physical activity

The purpose of the present study was to examine the serum levels of bone turnover markers and interleukin 1β in healthy elderly men with different levels of habitual physical activity. The study was conducted on 40 healthy men aged between 65 and 85 years (mean 74.0?±?7.55 years). The study population was divided into two groups with respect to the level of physical activity: 22 less active subjects (energy expenditure related to physical activity below 1600?kcal per week) and 18 more active subjects (above 1600?kcal per week). To estimate the physical activity of the study population, weekly energy expenditure was measured in each subject with use of Caltrac accelerometer. In the blood serum levels of bone formation marker – osteocalcin and resorption marker – the C-terminal telopeptide of collagen I (ICTP), and interleukin-1β were determined. Concentrations of osteocalcin and ICTP in less active subjects were significantly higher (by 3.62?ng/ml and by 1.21?μg/l respectively, p?<?0.05), reflecting the higher bone turnover in comparison to values determined in more active subjects. Positive correlations between ICTP and osteocalcin levels (r?=?0.5814 and r?=?0.6526; p?<?0.05), and between ICTP and IL-1β (r?=?0.5823 and r =?0.6040; p?<?0.05) in less and more active men were found. On the ground of the presented study it can be concluded that the decreased bone turnover occurred in men with higher level of habitual physical activity. This study showed the relationship between serum level of IL-1β and bone resorption but the habitual physical activity has no effect on this cytokine activity.     

The effect of aging on pacing strategies of cross-country skiers and the role of performance level

Background

The participation of master cross-country (XC) skiers in training and competition has increased during the last decades; however, little is known yet about whether these athletes differ from their younger counterparts in aspects of performance such as pacing. Therefore, the aim of the present study was to examine the combined effect of age and performance (race time) on pacing in cross-country (XC) skiing. We analyzed all finishers (n?=?79,722) in ‘Vasaloppet’ from 2012 to 2017, the largest cross-country skiing race in the world, classified according to their race time into 10 groups: 3-4 h, 4-5 h, ..., 12-13 h.

Results

A trivial main effect of sex on total pace range was observed (p?<?0.001, η²?=?0.002), where women (44.1?±?10.2%) had larger total pace range than men (40.9?±?11.8%). A large main effect of performance group on total pace range was shown (p?<?0.001, η²?=?0.160), where the smallest total pace range was 21.8?±?1.9% (3-4 h group) and the largest 50.1?±?9.9% (10-11 h group). A trivial sex×performance group interaction on total pace range was found (p?<?0.001, η²?=?0.001) with the largest sex difference in pacing shown in 9-10 h group. A trivial and small main effect of age was found in women (p?<?0.001, η²?=?0.005) and men (p?<?0.001, η²?=?0.011), respectively, where the masters had smaller total pace range than their younger counterparts. A trivial age group×performance group interaction on total pace range was observed in both women (p?<?0.001, η²?=?0.008) and men (p?<?0.001, η²?=?0.006) with smaller differences among age groups in the faster performance groups.

Conclusions

In summary, master XC skiers adopted a relatively even pacing independently from their race time and the differences in pacing from the younger XC skiers were more pronounced in the slower masters. These findings suggest that exercise attenuates the decline of performance in master XC skiers as shown by the similar pacing strategies between fast master XC skiers and their younger counterparts.

     

Association of vitamin D status and the risk of cardiovascular disease as assessed by various cardiovascular risk scoring systems in patients with type 2 diabetes mellitus

Objective: The aim of the present study was to evaluate the relationship between vitamin D (25[OH]D) status and the risk of cardiovascular disease as assessed by various cardiovascular risk scoring systems such as QRISK2, BNF, ASSING, SCORE, and Framingham in patients with type 2 diabetes mellitus(T2DM).

Methods: The study included 108 patients with vitamin D insufficiency (25[OH]D?≥?10–30?ng/mL) and 100 patients with vitamin D deficiency (25[OH]D?Results: HbA1c levels were significantly higher in patients with vitamin D deficiency. Patients with vitamin D deficiency had significantly higher Framingham risk score (p?p?r?=?0.537) and a weak but statistically significant correlation between 25[OH]D levels and BNF score (r?=?0.295). 25[OH]D levels were significantly higher and HbA1c levels were significantly lower in patients with Framingham cardiovascular risk score ≤10%.

Conclusion: We found a close relationship with Framingham cardiovascular risk score in diabetic patients with very low serum vitamin D levels. Cardiovascular risk as assessed by the Framingham’s scale increases with decreasing 25[OH]D levels. BNF score was negatively correlated with 25[OH]D levels.     

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.     

Circulating testosterone and estradiol,autonomic balance and baroreflex sensitivity in middle-aged and elderly men with heart failure

Abstract

Background: Heart failure (HF) is considered as a cardiogeriatric syndrome. Its fundamental pathophysiological feature is autonomic imbalance (and associated abnormalities within cardiovascular reflex control), but recent evidence suggests the involvement of deranged hormone metabolism. Both these neural and endocrine pathologies have serious clinical and prognostic consequences in patients with HF. We investigated the relations between autonomic status, baroreflex sensitivity (BRS) and hormone status in men with mild systolic HF.

Methods: We examined 46 men with stable systolic HF (age: 62?±?10 years, NYHA class I/II: 10/36 [22%/78%], ischemic aetiology: 72%, left ventricular ejection fraction: 32?±?8%). Serum hormone levels (i.e. total testosterone [TT], dehydroepiandrosterone sulphate [DHEAS], oestradiol [E2], insulin-like growth factor type 1 [IGF-1] and cortisol) were assessed using immunoassays. Estimated free testosterone (eFT) was estimated using the Vermeulen’s equation. Heart rate variability (HRV) was assessed in time and frequency domains, based on 10-min resting recordings. BRS was estimated using the sequence method (BRS-Seq) and the phenylephrine test (BRS-Phe).

Results: Deficiencies in circulating TT, eFT, DHEAS and IGF-1 (defined as a serum hormone ≤the 10th percentile calculated for the adequate age category in the cohort of healthy men) were found in respectively 13%, 30%, 55% and 93% of men with systolic HF. Serum SHBG ≥50?nmol/L and cortisol ≥700?nmol/L characterised, respectively 44% and 29% of men with HF. In multivariable models after the adjustment for clinical variables, the following relationships were found in examined men: DHEAS and SDNN (time domain of HRV defined as a standard deviation of average R–R intervals) (β?=?0.29, p?=?0.03); E2 and: HRV-LF (ms²) (β?=?0.37, p?=?0.01), HRV-HF (ms²) (β?=?0.44, p?=?0.02) and BRS-Phe (β?=?0.51, p?=?0.008); TT and: HRV-HF (%) (β?=?0.35, p?=?0.02), HRV-LF/HF ratio (β?=??0.35, p?=?0.02) and BRS-Seq (β?=?0.33, p?=?0.04).

Conclusions: The observed associations between reduced circulating androgens, oestrogens and lower HRV and depleted BRS, irrespectively of HF severity suggest the pathophysiological links between these two mechanisms. These results constitute the premises to investigate whether the pharmacological supplementation of depleted hormones would enable to restore the autonomic balance and improve the efficacy of reflex control within the cardiovascular system in men with systolic HF.     

Dutasteride improves bone mineral density in male patients with lower urinary tract symptoms and prostatic enlargement: a preliminary study

Introduction: We studied the effect of dutasteride on bone mineral density (BMD) in aging male patients with lower urinary tract symptoms (LUTS) and prostatic enlargement.

Methods: We prospectively studied 17 patients with LUTS and prostatic enlargement. Before and 1 year after dutasteride (0.5?mg daily), we assessed International Prostate Symptom Score (IPSS), prostatic volume (PV), serum prostatic-specific antigen (PSA) and testosterone. BMD in the lumbar and femur was measured by DEXA method.

Results: Dutasteride significantly reduced PV (from 51?±?24 to 34?±?17?ml, p?p?p?2, p?2, p?2, p?Conclusions: Dutasteride has a potential to improve BMD with elevation of serum testosterone in aging male patients with LUTS and prostatic enlargement.     

Application of multivariate longitudinal models in SIRT6, FBS,and BMI analysis of the elderly

Abstract

Objective: SIRT6 is a main regulator of metabolism and lifespan and its importance has been implicated in the prevention against aging-related diseases. The objective of this study was to examine the application of multivariate longitudinal models in SIRT6, FBS, and BMI analysis in the elderly men after eight weeks concurrent training with supplementation of l-arginine (l-Arg).

Methods: Thirty two elderly men with mean age of 63.09?±?3.71 years were randomly divided into four equal-sized groups (each n?=?8); Exercise?+?supplement (ES) group; exercise?+?placebo (EP) group; supplement (S) group and control (C) group. The ES and EP groups performed the eight weeks of concurrent training, three sessions per week. Group ES and group S consumed 1000?mg of l-Arg per day at 8:00?pm. Measurements of biochemical variables were done by ELISA Reader method. For analytical purposes, we used the paired sample t-test and multivariate longitudinal modeling with generalized estimating equation (GEE) methodology. All analyses have been implemented in R-3.4.1. p Values less than .05 were considered statistically significant.

Results: With respect to significant association between sirt6, FBS, and BMI, this study showed that synergy effect of training and supplementation was greater than the sum of their individual effects on SIRT6 (β?=?0.79, p?<?.001), FBS (β?=??5.56, p?=?.022), and BMI (β?=??3.89; p?=?.041). Also exercise alone had a significantly larger effect than supplementation alone on responses.

Conclusions: It can be concluded that the joint usage of concurrent training and supplement of l-Arg for elderly men could improve the metabolism and body composition.     

The effective tool for self-assessment of adherence to treatment in patients with benign prostatic obstruction and overactive bladder symptoms

Purpose: Study of validity of the Medication Adherence Self-Report Inventory (MASRI) for use in clinical practice to treat patients with benign prostatic obstruction (BPO) accompanied with overactive bladder (OAB) symptoms.

Methods: During 12 weeks of the randomized study, 452 patients with BPO and OAB symptoms (mean age of 61.3 (12.7)) were studied for adherence to the treatment with Tamsulosin, Solifenacin and Trospium using the MASRI. External monitoring instruments included the Brief Medication Questionnaire (BMQ) and the visual remaining pill count. The state of the prostate gland and the lower urinary tract was monitored using questionnaires I-PSS, OAB Awareness Tool, uroflowmetry and voiding diaries.

Result: Correlation between the percentage of men non-adherent to treatment (MASRI) and the percentage of patients having a belief barrier on the screen of the BMQ was r?=?0.89, p?≤0.05, r?=?0.92, p?≤0.01, r?=?0.85, p?≤0.05, a number of missed doses on the Regimen Screen of the BMQ was r?=?0.79; p?≤0.05; r?=?0.81; p?≤0.05; r?=?0.75, p?≤0.05, a number of non-adherent patients according to the BMQ was r?=?0.83 (p?≤0.05), r?=?0.88 (p?≤0.05), r?=?0.79, p?≤0.05, the results of the pill count were r?=?0.65–0.76; p?≤0.05-0.01. These data confirm high validity of the MASRI.

Conclusion: The MASRI is a valid tool for rapid assessment of adherence to treatment of patients with BPO and OAB receiving Tamsulosin and antimuscarinic drugs and may be recommended for use in clinical practice.