Objective: The objective of this study is to investigate the impact of metabolic status on associations of serum vitamin D with hypogonadism and lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH).
Patients and methods: A total of 612 men underwent physical examination, biochemical/hormonal blood testing, and transrectal prostate ultrasound. Moreover, the subjects filled out standard questionnaires for identification and grading of LUTS and hypogonadism symptoms. Parameters were statistically compared with independent t-tests and correlation analyses.
Results: Vitamin D levels positively correlated with total testosterone (TT) but not with prostate volume or International Prostate Symptom Score (IPSS). Patients with metabolic syndrome had significantly lower vitamin D levels, which were not correlated with TT, prostate volume, or IPSS. However, vitamin D was positively correlated with TT, and negatively correlated with prostate volume and quality-of-life IPSS in subjects without metabolic syndrome.
Conclusion: The clinical usefulness of vitamin D for treatment of hypogonadism or LUTS/BPH varies according to metabolic status. 相似文献
Gap times between recurrent events are often of primary interest in medical and observational studies. The additive hazards model, focusing on risk differences rather than risk ratios, has been widely used in practice. However, the marginal additive hazards model does not take the dependence among gap times into account. In this paper, we propose an additive mixed effect model to analyze gap time data, and the proposed model includes a subject-specific random effect to account for the dependence among the gap times. Estimating equation approaches are developed for parameter estimation, and the asymptotic properties of the resulting estimators are established. In addition, some graphical and numerical procedures are presented for model checking. The finite sample behavior of the proposed methods is evaluated through simulation studies, and an application to a data set from a clinic study on chronic granulomatous disease is provided. 相似文献
Drawing on 55 interviews with older Taiwanese immigrants who relocated to the United States at an earlier life stage, the author argues that changing contextual features involved in the processes of international migration encourage and even demand aging immigrants to reconstruct cultural logics of aging and geriatric care. He develops the concept of reconfigured reciprocity to demonstrate how aging migrant populations transform cultural logics of intergenerational responsibility, obligation, and entitlement to reconcile the tension between ethnic tradition and modernity. First, he reveals how many of the respondents' lack of caregiving for their own parents undermines their sense of entitlement to receive care from younger generations. Furthermore, he highlights how the structural squeeze among work, family, and caregiving with which the younger generation struggles further discourages the respondents from relying on their children. Finally, the author underscores how aging immigrants evoke the concept of Americanization to reconstruct expectations of how they should be taken care of in their twilight years. 相似文献