DHEAS Levels Research Articles

A Study of the Association between Dehydroepiandrosterone and Frailty in Elderly

The biological basis for Frailty remains unclear. It is hypothesized that loss of bone mass, decline in protein synthesis, sarcopenia and immune dysfunction influence the onset of frailty. Studies show that low serum DHEA levels are associated with increased rates of morbidity and mortality. Serum levels of DHEA decline with age, and this decline is paralleled by a decrease in muscle and bone mass. Hence we take up this study to test the hypothesis that declining serum DHEA is associated with the frailty phenotype. AIMS & OBJECTIVES: To evaluate the association between Dehydroepiandrosterone (DHEA) and Frailty in the elder population. METHODS: The study group includes elderly subjects > 65 yrs, in the Geriatric ward of Rajiv Gandhi Govt. General Hospital, Chennai, who complied with the inclusion and exclusion criteria. Anthropometric evaluation was done. Fried’s criteria was employed to assess the frailty phenotype. Patients were categorized into 3 groups based on the number of frailty components - FRAIL (≥ 3 characteristics); INTERMEDIATE FRAIL (1-2 characteristics); NON-FRAIL (no characteristic). Blood samples of patients from each group were collected for estimating serum DHEA-s level (using CLIA method) and analysis was performed by appropriate statistical methods. RESULTS: In a study conducted in 100 participants, a significant association between Frailty phenotype and DHEA level was observed (p < 0.0004). Ordinal logistic regression was used to model the relationship between frailty and DHEA, adjusting for age, gender and BMI. A significant DHEA–BMI interaction (OR=1.09; 95% CI; p = 0.0001) suggested that, in general, the relationship between higher levels of frailty decreased relative to higher levels of DHEA, but the magnitude of decrease was larger at lower BMI values and smaller at higher BMI values. A BMI >29 kg/m² attenuated the association between DHEA levels and frailty. CONCLUSION: This study found an inverse association between frailty and DHEA-s levels, similar to other studies that have found associations between DHEA-s and physical function. Whether the inverse association is due to similar conditions resulting in lower DHEA levels and more susceptibility to frailty or whether lower DHEA levels have an impact on increasing frailty cannot be addressed by this cross-sectional

DHEA Modulates Immune Function: A Review of Evidence.

DHEA and DHEA-S have numerous associations with multiple aspects of immune function and are often characterized as beneficial and supportive of immunocompetence. However, closer inspection of these studies reveals confusion regarding the immunological components modified, the mechanisms of action, and degree of impact, and even whether these hormones even have direct action or are mediated by metabolites and interactions with other hormones and hormone receptors. Additionally, much of the research is conducted on rodent models using very high concentrations of hormone supplements, which may not be representative of the effects of these hormones in natural circulating concentrations, or may not translate to human physiology in a meaningful way. Here, we review the effects of DHEA and DHEA-S on immune function and examine the potential roles these hormones play on specific components of immune function. Drawing from the literature on hormone supplementation, as well as studies examining the natural circulating levels of DHEA and DHEA-S on specific immunological components and disease processes, we argue that DHEA has differential actions on human immune function, and that its effects are further shaped by concentrations of other hormones. Of particular interest is the role of DHEA as an antiglucocorticoid, and for its actions on both androgen and estrogen receptors. With additional research, DHEA may be useful as a therapeutic, particularly in diseases with high levels of inflammation, or where adrenal production is altered. The convoluted nature of DHEA-immune interactions makes direct effects difficult to interpret, and future research needs to consider direct, intracrine, and downstream effects of these hormones.

Dehydroepiandrosterone and Bone.

In humans, dehydroepiandrosterone (DHEA), secreted mainly from the adrenal cortex, and its sulfate ester, DHEAS, are the most abundant circulating steroids. DHEA/DHEAS possess pleiotropic effects in human aging, bone, metabolic diseases, neurologic function/neurodegenerative diseases, cancer, immune system and disorders, cardiovascular diseases, diabetes, muscle function, sexual dysfunction, and other health conditions. The age-related reduced levels of DHEA and DHEAS are associated with bone mineral density measures of osteopenia and osteoporosis. Clinical, epidemiological, and experimental studies indicate that DHEA replacement therapy may be beneficial for bone health through its inhibition of skeletal catabolic IL-6 and stimulation of osteoanabolic IGF-I-mediated mechanisms. Studies with primary cultures of human bone marrow-derived mesenchymal stem cells (hMSCs) were used to show that DHEA stimulates osteoblastogenesis. The in vitro stimulation of both osteoblastogenesis and IGF-I gene expression by DHEA in hMSCs requires IGF-I receptor, PI3K, p38 MAPK, or p42/44 MAPK signaling pathways. The in vitro inhibition of IL-6 secretion in hMSCs by DHEA was more consistent and extensive than by estradiol or dihydrotestosterone. In summary, evidence from us and others indicates that DHEA may be useful for treating bone diseases through its inhibition of skeletal catabolic IL-6 and stimulation of anabolic IGF-I-mediated mechanisms.

Human Liver Fatty Acid Binding Protein‐1 T94A Variant, Nonalcohol Fatty Liver Disease, and Hepatic Endocannabinoid System

Hepatic endocannabinoids (EC) and their major binding/"chaperone" protein (i.e., liver fatty acid binding protein-1 [FABP1]) are associated with development of nonalcoholic fatty liver (NAFLD) in animal models and humans. Since expression of the highly prevalent human FABP1 T94A variant induces serum lipid accumulation, it is important to determine its impact on hepatic lipid accumulation and the EC system. This issue was addressed in livers from human subjects expressing only wild-type (WT) FABP1 T94T (TT genotype) or T94A variant (TC or CC genotype). WT FABP1 males had lower total lipids (both neutral cholesteryl esters, triacylglycerols) and phospholipids than females. WT FABP1 males' lower lipids correlated with lower levels of the N-acylethanolamide DHEA and 2-monoacylglycerols (2-MAG) (2-OG, 2-PG). T94A expression in males increased the hepatic total lipids (triacylglycerol, cholesteryl ester), which is consistent with their higher level of CB1-potentiating 2-OG and lower antagonistic EPEA. In contrast, in females, T94A expression did not alter the total lipids, neutral lipids, or phospholipids, which is attributable to the higher cannabinoid receptor-1 (CB1) agonist arachidonoylethanolamide (AEA) and its CB1-potentiator OEA being largely offset by reduced potentiating 2-OG and increased antagonistic EPEA. Taken together, these findings indicate that T94A-induced alterations in the hepatic EC system contribute at least in part to the hepatic accumulation of lipids associated with NAFLD, especially in males.

THE EFFECTS OF OPIUM ADDICTION ON THYROID AND SEX HORMONES IN DIABETIC AND NON-DIABETIC MALE AND FEMALE RATS.

Opium is a narcotic drug that is commonly abused. The prescription of pharmaceutical derivatives of opium is limited due to their possible harmful effects on the body's metabolism and tolerability by patients. The aim of the present study was to evaluate the effects of chronic opium consumption on some sexual and thyroid hormones in diabetic and non-diabetic male and female rats. This experimental study was conducted on 56 Wistar rats. The animals were divided into diabetic addicted (DA), diabetic non-addicted (DNA), non-diabetic addicted (NDA) and non-diabetic non-addicted (NDNA) groups of male and female rats. Peripheral blood samples were collected to measure the thyroid and sex hormone levels. Student's t-test was used to compare the mean values of the hormones between two groups. T3 serum level in male addicted groups significantly increased in comparison with non-addicted ones in both diabetic and non-diabetic groups. The testosterone level of male rats decreased due to the consumption of opium while it was significantly increased in diabetic and NDNA female rats in comparison with non-addicts. In DNA female animals, the mean level of 17-hydroxyprogesterone increased significantly compared with non-diabetic groups, however, it decreased in addicted females (diabetic and non-diabetic) in comparison with non-addicts. The level of DHEA-S increased significantly in diabetic and NDA male rats as compared with the non-addicted group. Opium affects the endocrine system in a sex-dependent manner, and opium could have different effects in diabetic and non-diabetic conditions.

Effect of Surgical-Site, Multimodal Drug Injection on Pain and Stress Biomarkers in Patients Undergoing Plate Fixation for Clavicular Fractures.

BackgroundSurgical-site, multimodal drug injection has recently evolved to be a safe and useful method for multimodal pain management even in patients with musculoskeletal trauma.MethodsFifty consecutive patients who underwent plating for mid-shaft and distal clavicular fractures were included in the study. To evaluate whether surgical-site injections (SIs) have pain management benefits, the patients were divided into two groups (SI and no-SI groups). The injection was administered between the deep and superficial tissues prior to wound closure. The mixture of anesthetics consisted of epinephrine hydrochloride (HCL), morphine sulfate, ropivacaine HCL, and normal saline. The visual analogue scale (VAS) pain scores were measured at 6-hour intervals until postoperative hour (POH) 72; stress biomarkers (dehydroepiandrosterone sulfate [DHEA-S], insulin, and fibrinogen) were measured preoperatively and at POH 24, 48, and 72. In patients who wanted further pain control or had a VAS pain score of 7 points until POH 72, 75 mg of intravenous tramadol was administered, and the intravenous tramadol requirements were also recorded. Other medications were not used for pain management.ResultsThe SI group showed significantly lower VAS pain scores until POH 24, except for POH 18. Tramadol requirement was significantly lower in the SI group until POH 24, except for POH 12 and 18. The mean DHEA-S level significantly decreased in the no-SI group (74.2 ± 47.0 µg/dL) at POH 72 compared to that in the SI group (110.1 ± 87.1 µg/dL; p = 0.046). There was no significant difference in the insulin and fibrinogen levels between the groups. The correlation values between all the biomarkers and VAS pain scores were not significantly different between the two groups (p > 0.05).ConclusionsAfter internal fixation of the clavicular fracture, the surgical-site, multimodal drug injection effectively relieved pain on the day of the surgery without any complications. Therefore, we believe that SI is a safe and effective method for pain management after internal fixation of a clavicular fracture.

Dehydroepiandrosterone Research: Past, Current, and Future.

The discovery of "oestrus-producing" hormones was a major research breakthrough in biochemistry and pharmacology during the early part of the 20th century. The elucidation of the molecular weight and chemical structure of major oxidative metabolites of dehydroepiandrosterone (DHEA) led to the award of the Nobel Prize in 1939 to Adolf Frederick Johann Butenandt and Leopold Ruzicka. Considered a bulk androgen in the circulation, DHEA and its sulfated metabolite DHEA-S can be taken up by most tissues where the sterols are metabolized to active androgenic and estrogenic compounds needed for growth and development. Butenandt's interactions with the German pharmaceutical company Schering led to production of gram quantities of these steroids and other chemically modified compounds of this class. Sharing chemical expertise allowed Butenandt's laboratory at the Kaiser Wilhelm Institute to isolate and synthesize many steroid compounds in the elucidation of the pathway leading from cholesterol to testosterone and estrogen derivatives. As a major pharmaceutical company worldwide, Schering AG sought these new biological sterols as pharmacological agents for endocrine-related diseases, and the European medical community tested these compounds in women for conditions such as postmenopausal depression, and in men for increasing muscle mass. Since it was noted that circulating DHEA-S levels decline as a function of age, experimental pathology experiments in animals were performed to determine how DHEA may protect against cancer, diabetes, aging, obesity, immune function, bone density, depression, adrenal insufficiency, inflammatory bowel disease, diminished sexual function/libido, AIDS/HIV, chronic obstructive pulmonary disease, coronary artery disease, chronic fatigue syndrome, and metabolic syndrome. While the mechanisms by which DHEA ameliorates these conditions in animal models have been elusive to define, even less is known about its role in human disease, other than as a precursor to other sterols, e.g., testosterone and estradiol. Our groups have shown that DHEA and many of its oxidative metabolites serve as a low-affinity ligands for hepatic nuclear receptors, such as the pregnane X receptor, the constitutive androstane receptor, and estrogen receptors α/β (ERα/ERβ) as well as G protein-coupled ER (GPER1). This chapter highlights the founding research on DHEA from a historical perspective, provides an overview of DHEA biosynthesis and metabolism, briefly summarizes the early work on the beneficial effects attributed to DHEA in animals, and summarizes the human trials addressing the action of DHEA as a therapeutic agent. In general, most human studies involve weak correlations of circulating levels of DHEA and disease outcomes. Some support for DHEA as a therapeutic compound has been demonstrated for postmenopausal women, in vitro fertilization, and several autoimmune disorders, and adverse health effects, such as, acne, embryo virilization during pregnancy, and possible endocrine-dependent cancers.

Mutation of HSD3B2 Gene and Fate of Dehydroepiandrosterone.

3βHSD2 enzyme is crucial for adrenal and gonad steroid biosynthesis. In enzyme deficiency states, due to recessive loss-of-function HSD3B2 mutations, steroid flux is altered and clinical manifestations result. Deficiency of 3βHSD2 activity in the adrenals precludes normal aldosterone and cortisol synthesis and the alternative backdoor and 11-oxygenated C19 steroid pathways and the flooding of cortisol precursors along the Δ5 pathway with a marked rise in DHEA and DHEAS production. In gonads, it precludes normal T and estrogen synthesis. Here, we review androgen-dependent male differentiation of the external genitalia in humans and link this to female development and steroidogenesis in the developing adrenal cortex. The molecular mechanisms governing postnatal adrenal cortex zonation and ZR development were also revised. This chapter will review relevant clinical, hormonal, and genetic aspects of 3βHSD2 deficiency with emphasis on the significance of alternate fates encountered by steroid hormone precursors in the adrenal gland and gonads. Our current knowledge of the process of steroidogenesis and steroid action is derived from pathological conditions. In humans the 3βHSD2 deficiency represents a model of nature that reinforces our knowledge about the role of the steroidogenic alternative pathway in sex differentiation in both sexes. However, the physiological role of the high serum DHEAS levels in fetal life as well as after adrenarche remains to be elucidated.

Kisspeptin and polycystic ovary syndrome - is there any connection?

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. It is known that kisspeptin stimulates activity of GnRH neurons and secretion of FSH and LH, thus disruption of interaction between kisspeptin and its receptor leads to anovulation. The aim of the study was to investigate the role kisspeptin in the pathogenesis of polycystic ovary syndrome. Materials and methods. The study included 14 patients with classic phenotype of PCOS and 11 healthy women of the control group. All the patients underwent laparoscopy and hysteroscopy with histological examination of ovarian tissue and endometrium. Determination of kisspeptin, FSH, LH, prolactin, AMH, estradiol, estrone, androgens (free testosterone and dehydroepiandrosterone sulfate) levels in peripheral blood in healthy women and patients with PCOS was performed by ELISA on the 2d and 8th days of menstrual cycle. Progesterone levels were investigated on the 18th-22d days of menstrual cycle. Expression of kisspeptin and its receptor in ovarian tissue and endometrium was estimated using immunohistochemical method. Results. Level of kisspeptin in peripheral blood of patients with PCOS tends to increase compared to its level in the control group, but the found difference was not reliable. Direct correlation between serum level of kisspeptin and levels of LH, free testosterone and DHEA-S was revealed in patients with PCOS. Immunohistochemical study in patients with PCOS showed a significant increase in the area of expression of КІЅЅ1 and KISS1R receptor in endometrium and in ovarian biopsies compared to these values in the control group. Conclusion. The obtained data show a definite role of kisspeptin in pathogenesis of polycystic ovary syndrome, but further research is needed.

Triple-A syndrome: a wide spectrum of adrenal dysfunction

Triple-A or Allgrove syndrome is an autosomal recessive disorder due to mutations in the AAAS gene, which encodes a nucleoporin named ALADIN. It is characterized by a classical clinical triad: alacrima, achalasia and adrenal insufficiency, the canonic symptoms that are associated with progressive peripheral neuropathy. Only a few cohorts have been reported. The objective of the present study was to characterize the various spectra of adrenal function in Triple-A patients. A retrospective clinical and biological monitoring of 14 patients (10 families) was done in a single multidisciplinary French center. All had AAAS gene sequenced and adrenal function evaluation. Nine different AAAS mutations were found, including one new mutation: c.755G>C, p.(Trp252Ser). Regarding adrenal function, defects of the zona fasciculata and reticularis were demonstrated by increased basal ACTH levels and low DHEAS levels in all cases regardless of the degree of glucocorticoid deficiency. In contrast, mineralocorticoid function was always conserved: i.e., normal plasma renin level associated with normal aldosterone level. The main prognostic feature was exacerbation of neuropathy and cognitive disorders. These data suggest that, in Triple-A patients, adrenal function can be deficient, insufficient or compensated. In our cohort after the first decade of life, there does not appear to be any degradation of adrenal function over time. However, patients with compensated adrenal function should be informed and educated to manage a glucocorticoid replacement therapy in case of stressful conditions, with no need for systematic long-term treatment.

Basal blood DHEA-S/cortisol levels predicts EMDR treatment response in adolescents with PTSD

Objective: In literature, recent evidence has shown that the hypothalamic–pituitary–adrenal (HPA) axis can be dysregulated in patients with post-traumatic stress disorder (PTSD) and HPA axis hormones may predict the psychotherapy treatment response in patients with PTSD. In this study, it was aimed to investigate changing cortisol and DHEA-S levels post-eye movement desensitization and reprocessing (EMDR) therapy and the relationship between treatment response and basal cortisol, and DHEA-S levels before treatment.Method: The study group comprised 40 adolescents (age, 12–18 years) with PTSD. The PTSD symptoms were assessed using the Child Depression Inventory (CDI) and Child Post-traumatic Stress Reaction Index (CPSRI) and the blood cortisol and DHEA-S were measured with the chemiluminescence method before and after treatment. A maximum of six sessions of EMDR therapy were conducted by an EMDR level-1 trained child psychiatry resident. Treatment response was measured by the pre- to post-treatment decrease in self-reported and clinical PTSD severity.Results: Pre- and post-treatment DHEA-S and cortisol levels did not show any statistically significant difference. Pre-treatment CDI scores were negatively correlated with pre-treatment DHEA-S levels (r: −0.39). ROC analysis demonstrated that the DHEA-S/cortisol ratio predicts treatment response at a medium level (AUC: 0.703, p: .030, sensitivity: 0.65, specificity: 0.86).Conclusion: The results of this study suggested that the DHEA-S/cortisol ratio may predict treatment response in adolescents with PTSD receiving EMDR therapy. The biochemical parameter of HPA-axis activity appears to be an important predictor of positive clinical response in adolescent PTSD patients, and could be used in clinical practice to predict PTSD treatment in the future.

Association Between Cortisol to DHEA-s Ratio and Sickness Absence in Japanese Male Workers

This study aimed to investigate the association between serum levels of cortisol and dehydroepiandrosterone sulfate (DHEA-s) and sickness absence over 2years in Japanese male workers. A baseline survey including questions about health behavior, along with blood sampling for cortisol and DHEA-s, was conducted in 2009. In total, 429 men (mean ± SD age, 52.9 ± 8.6years) from whom blood samples were collected at baseline were followed until December 31, 2011. The hazard ratios (HR) and 95% confidence intervals (CI) for sickness absence were calculated using a Cox proportional hazard model, adjusted for potential confounders. Among 35 workers who took sickness absences, 31 had physical illness. A high cortisol to DHEA-s ratio increased the risk of sickness absence (crude HR = 2.68, 95% CI 1.12-6.41; adjusted HR = 3.33, 95% CI 1.35-8.20). The cortisol to DHEA-s ratio was linearly associated with an increased risk of sickness absence (p for trend < .050). Single effects of cortisol and DHEA-s levels were not associated with sickness absences. This trend did not change when limited to absences resulting from physical illness. Hormonal conditions related to the hypothalamus-pituitary-adrenocortical axis and adrenal function should be considered when predicting sickness absence. The cortisol to DHEA-s ratio may be more informative than single effects of cortisol and DHEA-s levels.

Leydig cell tumor of testis- a rare case report

Leydig cell tumors(LCTs) of testis are rare testicular tumors of male gonadal interstitium. Although rare, they are most common sex cord stromal tumors and comprise 1-3 % of all testicular neoplasms. They usually occur in fourth to sixth decade. In young patients, they are mostly benign and in adults it can be malignant in about 10 % cases. The incidence of Leydig cell tumors is gradually increasing every year which might be attributed to increased use of radiological techniques and subsequent early detection of tumors that have not been found in historical series. Here we report a case of benign Leydig cell tumor testis in a 45-year-old male who presented with left sided testicular mass. The patient subsequently underwent high inguinal orchidectomy. Histopathological examination showed benign pure Leydig cell tumor. Serological investigations revealed normal testosterone levels, DHEA and androstenedione levels. Immunohistochemical staining for inhibin showed fine granular cytoplasmic positivity and diffuse positive staining for Melan-A which further confirmed the diagnosis. The endocrine profile and imaging investigations of such patients might be normal and patients can be totally asymptomatic. However periodic follow up of endocrine profile and imaging must be done as many cases have been reported which had deranged endocrine levels and appearance of atypical symptoms even after years of unilateral orchidectomy. Our case also presents with normal hormonal levels, henceforth for a better prognosis we must identify benign LCTs and do long term follow up.

Prenatal organochlorine pesticide exposure and the disruption of steroids and reproductive hormones in cord blood: The Hokkaido study

Certain organochlorine pesticides (OCPs) are designated as persistent organic pollutants and are regulated in many countries. The effects of OCPs on pediatric endocrinology are a concern; however, only limited data exist from human studies on maternal OCP exposure and its effects on infants' hormone levels. This study was conducted as part of the Hokkaido Study Sapporo Cohort, a prospective birth cohort study in Japan. Participants included 514 women who enrolled at 23–35weeks of gestation between 2002 and 2005; maternal blood samples were collected in late pregnancy, and 29 OCPs were measured. Reproductive and steroid hormone levels in cord blood were also determined. Characteristics of mothers and their infants were obtained from self-administered questionnaires and medical records. Ultimately, 232 samples with both OCP and hormone data were analyzed. Fifteen of 29 investigated OCPs were detected in over 80% of the samples, with p,p′-dichlorodiphenyldichloroethylene showing the highest concentration (median value: 619pg/g-wet). The association between OCPs and sex hormone levels varied by sex. Linear regression models after sex stratification showed that chlordanes, cis-hexachlorobenzene, heptachlor epoxide, Mirex, and toxaphenes in maternal blood were inversely associated with testosterone, cortisol, cortisone, sex hormone-binding globin, prolactin, and androstenedione-dehydroepiandrosterone (DHEA) and testosterone-androstenediones ratios among boys. Furthermore, these OCPs were positively correlated with DHEA, follicle stimulating hormone (FSH), and adrenal androgen-glucocorticoid and FSH-inhibin B ratios among boys. In categorical quartile models, testosterone and DHEA were inversely and positively associated with OCPs, respectively. Estradiol-testosterone and adrenal androgen-glucocorticoid ratios tended to increase with increasing OCP concentrations in the higher quartile, while the testosterone-androstenedione ratio tended to decrease. Sex hormone-binding globulin and prolactin showed an inverse association with OCPs. Among girls, the linear regression model showed that only p,p′-dichlorodiphenyltrichloroethane was inversely associated with the level of DHEA and the adrenal androgen-glucocorticoid ratio, but was positively associated with cortisone levels. However, no associations were observed using the quartile categorical model. These results suggest that prenatal exposure to OCPs disrupt reproductive hormones of fetuses in utero among boys, even at relatively low levels.

Wpływ nawyków żywieniowych na stężenie wybranych hormonów, parametrów biochemicznych i antropometrycznych u pacjentów z łagodnym rozrostem prostaty – badania wstępne

Wstęp: Istnieje wiele przyczyn łagodnego rozrostu gruczołu krokowego (BPH), wśród których ważną rolę odgrywają nawyki żywieniowe i związana z tym otyłość, w szczególności wisceralna. Analiza nawyków żywieniowych mężczyzn jest ważnym aspektem w profilaktyce BPH.Celem pracy było porównanie nawyków żywieniowych pacjentów z BPH do nawyków żywieniowych pacjentów bez BPH oraz oznaczenie czynników antropometrycznych, biochemicznych i stężeń wybranych hormonów u pacjentów z BPH.Materiały i metody: W badaniu wzięło udział 93 mężczyzn, których podzielono na 2 grupy. Grupę badaną stanowiło 44 pacjentów hospitalizowanych w Klinice Urologii i Onkologii Urologicznej Samodzielnego Publicznego Szpitala Klinicznego nr 2 Pomorskiego Uniwersytetu Medycznego w Szczecinie oraz grupę kontrolną, do której zakwalifikowano 49 mężczyzn kierowanych z podstawowej opieki zdrowotnej. Ankieta dotyczyła nawyków żywieniowych pacjentów. W badaniu za pomocą metody spektrofotometrycznej oznaczono stężenia parametrów biochemicznych, a za pomocą metody ELISA oznaczono stężenie hormonów w surowicy oraz wykonano pomiary antropometryczne.Wyniki: Jak wynika z wyników badań pacjenci z rozpoznanym BPH charakteryzowali się lepszymi nawykami żywieniowymi oraz większą aktywnością fizyczną w porównaniu z pacjentami bez objawów BPH. Mężczyźni uprawiający aktywność fizyczną więcej niż 3 razy w tygodniu mieli niższe stężenie lipoproteiny o niskiej gęstości (LDL) i cholesterolu całkowitego (TCh). Pacjenci, którzy deklarowali konsumpcję alkoholu częściej niż 3 razy w tygodniu, mieli większy obwód w pasie. Mężczyźni deklarowali także spożywanie słodyczy, picie napojów słodzonych oraz spożywanie słonych przekąsek, jednak nie miało to istotnie statystycznego wpływu na wyniki parametrów biochemicznych i hormonalnych. Osoby, które deklarowały codzienne spożywanie warzyw, wykazały się istotnie niższym stężeniem hormonu luteinizującego, natomiast pacjenci spożywający produkty mleczne naturalne wyższym stężeniem siarczanu dihydrotestosteronu.Wnioski: Zdrowe nawyki żywieniowe mogą mieć wpływ na stężenia TCh, jego frakcji LDL, DHEAS i białka wiążącego hormony płciowe w surowicy, natomiast nie wykazują wpływu na stężenie testosteronu całkowitego u pacjentów z BPH. Częste picie alkoholu może sprzyjać otyłości wisceralnej. Świadomość choroby może mieć wpływ na dbanie o zdrową dietę oraz uprawianie aktywności fizycznej.

Circulating dehydroepiandrosterone-sulphate decreases even with a slight change in oestradiol

The aim of this study was to determine the effect of hormone replacement therapy (HRT) on changes in circulating dehydroepiandrosterone-sulphate (DHEA-S) with focus on the relationship between oestrogen level and change in DHEA-S. Forty-two women were enrolled in this longitudinal study. Nineteen women received oral oestradiol and twenty-three women received transdermal oestradiol continuously. Twenty women received progesterone continuously except for women who had undergone hysterectomy. Circulating oestradiol, follicle-stimulating hormone, luteinising hormone and DHEA-S levels before and at 3 months after commencement of HRT were measured. Circulating DHEA-S level was significantly decreased at 3 months (p < .001). Oestradiol level at 3 months ranged from 6.5 pg/ml to 159 pg/ml. There was no significant correlation of ΔDHEA-S (DHEAS level at 3 months—DHEA-S level at baseline) with Δoestradiol (r = 0.114, p = .471). Circulating DHEA-S level was significantly decreased at 3 months in all the four quartiles and divided according to Δoestradiol, and ΔDHEA-S did not show significant differences. In conclusion, circulating DHEA-S decreases even with a slight increase in oestradiol level. Impact statement What is already known on this subject: A transient increase in DHEA-S in women during the menopausal transition may be involved in the occurrence of menopausal symptoms and/or unfavourable metabolic changes. Hormone replacement therapy decreases circulating DHEA-S level. However, dose dependency of the change in DHEA-S on oestrogen has not been reported. What the results of this study add: Circulating DHEA-S decreases even with a slight increase in oestradiol level. What the implications are of these findings for clinical practice and/or further research: Adrenal function may respond to a small change in oestrogen.

Marked hyperandrogenicity in a 60-year-old woman.

Markedly elevated androgen levels can lead to clinical virilization in females. Clinical features of virilization in a female patient, in association with biochemical hyperandrogenism, should prompt a search for an androgen-producing tumor, especially of ovarian or adrenal origin. We herein report the case of a 60-year-old woman of Pakistani origin who presented with the incidental finding of male pattern baldness and hirsutism. Her serum testosterone level was markedly elevated at 21 nmol/L (normal range: 0.4–1.7 nmol/L), while her DHEAS level was normal, indicating a likely ovarian source of her elevated testosterone. Subsequently, a CT abdomen-pelvis was performed, which revealed a bulky right ovary, confirmed on MRI of the pelvis as an enlarged right ovary, measuring 2.9 × 2.2 cm transaxially. A laparoscopic bilateral salpingo-oophorectomy was performed, and histopathological examination and immunohistochemistry confirmed the diagnosis of a Leydig cell tumor, a rare tumor accounting for 0.1% of ovarian tumors. Surgical resection led to normalization of testosterone levels.Learning points:Hirsutism in postmenopausal women should trigger suspicion of androgen-secreting tumorExtremely elevated testosterone level plus normal DHEAS level point toward ovarian sourceLeydig cell tumor is extremely rare cause of hyperandrogenicity

The impact of peri-operative dexamethasone administration on the normal hypothalamic pituitary adrenal response to major surgical procedures.

Surgical procedures are associated with activation of the hypothalamic-pituitary-adrenal axis (HPA). Studies examining HPA dynamics peri-operatively are limited and the modulating influence of peri-operatively administered glucocorticoids on that is not well established. This investigation examined alterations in HPA function and the impact of dexamethasone (DEX) administration during the peri-operative period. We examined HPA function in 297 patients with normal function who had surgical procedures including pituitary mass resection (n = 191), craniotomy (n = 17) and other thoracic/ abdominal/ pelvic surgeries (n = 89). HPA function was assessed by frequent measurements of parameters defining adrenal function: ACTH, cortisol, DHEA and DHEA-S levels for 48 h. DEX was administered as a single dose (2-10 mg) to 30 and as multiple doses (12-36 mg) to 21 patients. The data of DEX-treated subjects within each group were similar and were combined together. Pre-operative data were similar for patients having different surgical procedures. Without DEX exposure, ACTH increased to 225 ± 100 ng/L at 2-4 h and gradually declined to baseline values by 36 h while cortisol levels peaked (39.2 ± 13.2 ug/dL) at 6-8 h declining gradually thereafter. Cortisol rise was paralleled by an equimolar increase in DHEA and a subsequent increase in DHEA-S levels. Single doses of DEX did not influence ACTH or cortisol secretion but suppressed the expected rise in DHEA and DHEA-S levels. Multiple doses of DEX suppressed ACTH and cortisol after the 15th postoperative hour and completely blocked the expected rise in DHEA and DHEA-S levels. The data provide a detailed overview of HPA function in a large number of subjects who had major surgical procedures. Single and large doses of DEX did not suppress ACTH or cortisol secretion but suppressed adrenal androgen secretion. It took multiple doses of DEX to partially suppress ACTH and cortisol secretion in the peri-operative period.

PTSD-related shifts in HPA axis, DHEA levels in chernobyl nuclear plunt clean-up workers

PTSD-related shifts in HPA axis, DHEA levels in chernobyl nuclear plunt clean-up workers

The effects of eight week yoga training on serum levels of Dehydroepiandrestrone sulfate and prolactin in women with multiple sclerosis

Background: The yoga training can affect positive impact on fatigue due to increase the force of muscle contraction. The aim of this study was to investigate the effects of yoga training on serum levels of dehydroepiandrestrone sulfate and prolactin in women with multiple sclerosis.&#x0D; Methods: For this purpose, 24 female with MS (age of 36.75±6.10 year, weight 68.3± 15.26 kg and BMI 26.88±6.02 kg/m2) and EDSS &lt;3.5 were selected. Subjects were randomly assigned to yoga (n=12) and control (n=12) groups. The experimental group perform eight weeks yoga training and three sessions per week. At the beginning of each session, the subjects perform warm up, stretching and Mvktasana Pavana and at the end of session, shavasana movements that was designed for relaxation. The control group perform only their daily activities. Serum levels of DHEA-S and prolactin assessed by ELISA kits. Statistical analysis of data was performed by ANOVA and independent t test at significance level of p≤0.05. &#x0D; Results: The results of this study showed, a significant increase in prolactin in the experimental group than control group after eight weeks yoga training (p=0.001), But no significant changes in DHEA-S (p≥0.05). &#x0D; Conclusions: Finally, the results of this study showed that yoga training can affect positive impact on fatigue and prolactin and it is possible due to increase the force of muscle contraction and the force developed muscles and hormonal systems of the body. Also serum levels of DHEA-S don’t show significant difference.