Healthy Middle-aged Men Research Articles

Association between serum total testosterone and Body Mass Index in middle aged healthy men.

Objective:To determine correlation of serum total testosterone with body mass index (BMI) and waist hip ratio (WHR) in healthy adult males.Methods:A cross sectional study was conducted on 200 nonsmoker healthy males (aged 30-50 years) university employees. They were selected by convenience sampling technique after a detailed medical history and clinical examination including BMI and Waist Hip Ratio (WHR) calculation. Blood sampling was carried out to measure serum total testosterone (TT) using facilities of Chemiluminescence assay (CLIA) technique in Dow Chemical Laboratory. Independent sample T test was used for mean comparisons of BMI and WHR in between low and normal testosterone groups. (Subjects having < 9.7 nmol/L of total testosterone in blood were placed in low testosterone group and subjects having ≥ 9.7 nmol/L of total testosterone in blood were placed in normal testosterone group). Correlation of testosterone with BMI and WHR was analyzed by Pearson Correlation.Results:Mean (± SD) age of the subjects included in this study was 38.7 (± 6.563) years mean (± SD) total testosterone was 15.92 (±6.322)nmol/L. The mean (± SD) BMI, and WHR were 24.95 (±3.828) kg/m2 and 0.946 (±0.0474) respectively. Statistically significant differences were observed in the mean values of BMI and WHR for the two groups of testosterone. Significant inverse correlation of serum total testosterone with BMI(r = -0.311, p = 0.000) was recorded in this study. However testosterone was not significantly correlated with waist/hip ratio.(r = -0.126, p = 0.076)Conclusion:Middle age men working at DUHS who have low level of serum total testosterone are more obese than individuals with normal total testosterone level.

The exercise heart rate profile in master athletes compared to healthy controls.

Endurance exercise protects the heart via effects on autonomic control of heart rate (HR); however, its effects on HR indices in healthy middle-aged men are unclear. This study compared HR profiles, including resting HR, increase in HR during exercise and HR recovery after exercise, in middle-aged athletes and controls. Fifty endurance-trained athletes and 50 controls (all male; mean age, 48·7±5·8years) performed an incremental symptom-limited exercise treadmill test. The electrocardiographic findings and HR profiles were evaluated. Maximal O2 uptake (52·6±7·0 versus 34·8±4·5mlkg(-1) min(-1) ; P<0·001) and the metabolic equivalent of task (15·4±1·6 versus 12·2±1·5; P<0·001) were significantly higher in athletes than in controls. Resting HR was significantly lower in athletes than in controls (62·8±6·7 versus 74·0±10·4 beats per minute (bpm), respectively; P<0·001). Athletes showed a greater increase in HR during exercise than controls (110·1±11·0 versus 88·1±15·4bpm; P<0·001); however, there was no significant between-group difference in HR recovery at 1min after cessation of exercise (22·9±5·6 versus 21·3±6·7bpm; P=0·20). Additionally, athletes showed a lower incidence of premature ventricular contractions (PVCs) during exercise (0·0% versus 24·0%; P<0·001). Healthy middle-aged men participating in regular endurance exercise showed more favourable exercise HR profiles and a lower incidence of PVCs during exercise than sedentary men. These results reflect the beneficial effect of endurance training on autonomic control of the heart.

A possible role of serum uric acid as a marker of metabolic syndrome.

The association between serum uric acid (SUA) levels and metabolic syndrome (MetS) has recently been reported in several cross-sectional and longitudinal studies. We investigated SUA as a biomarker to predict future development of MetS in healthy Korean men without diabetes or hypertension and determined the optimal cut-off levels of SUA. A retrospective cohort study was conducted using data from healthy men who received a general health check-up in 2003. A total of 1809 participants free of MetS, diabetes and hypertension was enrolled. Participants were classified into three groups based on SUA levels: group 1 (<5.5 mg/dL), group 2 (5.5-6.9 mg/dL) and group 3 (≥7.0 mg/dL). During 13,802 person-years of follow up, 127 participants developed MetS. After adjusting for multiple associated parameters, SUA was significantly associated with incident MetS (hazard ratios comparing groups 2 and 3 vs group 1, 2.45 and 3.47 respectively; P < 0.001). In receiver operating characteristic curve analysis, the optimal cut-off level for SUA to predict the development of MetS was 6.5 mg/dL. Our results indicate that an increased level of SUA, even within the normal range, is associated with future development of MetS in healthy middle-aged men.

Heart rate reserve predicts cardiovascular death among physically unfit but otherwise healthy middle-aged men: a 35-year follow-up study.

Heart rate reserve (HRR) has been reported to be inversely associated with cardiovascular (CV) disease and death. The impact of physical fitness (PF) on this relationship has not, however, been described in detail. We investigated how different levels of PF influenced the association between HRR and CV death during a 35-year follow-up. HRR and PF were measured in 2014 apparently healthy, middle-aged men during a symptom-limited bicycle exercise test in 1972-75. The men were divided into tertiles (T1-T3) by age-adjusted HRR. Morbidity and mortality data were registered from hospital charts through 2007 and the Norwegian Cause of Death Registry. Adjusted Cox proportional hazard regression models were used to calculate risks. Incidence of CV death was 528 (26%) during median 30 years of follow-up. Men with the lowest HRR had 41% (HR 1.41 [1.14-1.75]) increased risk of CV death compared with the men with the highest. We found a significant interaction between age-adjusted PF and HRR. After stratifying the men by PF, results were statistically significant only among men with the lowest PF, where the men with lowest HRR had a 70% (HR 1.70 [1.12-2.67]) increased risk of CV death compared with the men with the highest. Low HRR was independently associated with increased risk of CV death in apparently healthy, middle-aged men. The predictive impact of HRR on CV death risk was, however, confined to unfit men.

Male sexual function can be maintained without aromatization: randomized placebo-controlled trial of dihydrotestosterone (DHT) in healthy, older men for 24 months.

Male sexual function is highly androgen dependent but whether aromatization of testosterone (T) to estradiol is required remains contentious. This study aims to investigate the effects of selective estrogen deficiency induced by a nonaromatizable androgen, dihydrotestosterone (DHT), on sexual function of healthy middle-aged and older men. Randomized clinical trial of daily transdermal DHT (70 mg) or placebo gel treatment in 114 healthy middle-aged and older (>50 years, mean 60.5 years) men without known prostate disease maintaining selective estrogen deficiency for 24 months. The end points were responses to a psychosexual and mood questionnaire completed before, at 3 months, then at 6 monthly intervals during and 3 months after study. Data were analyzed by mixed model analysis of variance for repeated measures using age and body mass index (BMI) as covariates and including interactions of treatment with age and time-on-study. DHT treatment increased serum DHT with complete suppression of serum T, luteinizing hormone, follicle stimulating hormone, and estradiol throughout the 24-month study resulting in reduced spinal bone density. There were no spontaneous complaints, or discontinuations for, adverse effects on sexual function during the study. DHT administration had no effects on any of 33 measures of sexual function and mood, apart from a mild, but significant decrease in overall sexual desire, which was reversible after cessation of treatment. Increasing age and less often increasing BMI were associated with significant decreases in most aspects of sexual function. We conclude that aromatization plays only a minimal role in maintenance of sexual function in healthy eugonadal middle-aged or older men, but age and obesity are significantly associated with decreases in most aspects of self-reported sexual function and satisfaction. The dependence of male sexual function on aromatization may be conditional on age and obesity and can be overcome by a nonaromatizable androgen.

Cardiac Autonomic Function and High-Intensity Interval Training in Middle-Age Men

The effects of short-term high-intensity interval training (HIT) on cardiac autonomic function are unclear. The present study assessed cardiac autonomic adaptations to short-term HIT in comparison with aerobic endurance training (AET). Twenty-six healthy middle-age sedentary men were randomized into HIT (n = 13, 4-6 × 30 s of all-out cycling efforts with 4-min recovery) and AET (n = 13, 40-60 min at 60% of peak workload) groups, performing six sessions within 2 wk. The participants underwent a 24-h ECG recording before and after the intervention and, additionally, recorded R-R interval data in supine position (5 min) at home every morning during the intervention. Mean HR and low-frequency (LF) and high-frequency (HF) power of R-R interval oscillation were analyzed from these recordings. Peak oxygen consumption (V˙O2peak) increased in both groups (P < 0.001). Compared with AET (n = 11), HIT (n = 13) increased 24-h LF power (P = 0.024), tended to increase 24-h HF power (P = 0.068), and increased daytime HF power (P = 0.038). In home-based measurements, supine HF power decreased on the days after HIT (P = 0.006, n = 12) but not AET (P = 0.80, n = 9) session. The acute response of HF power to HIT session did not change during the intervention. In conclusion, HIT was more effective short-term strategy to increase R-R interval variability than aerobic training, most probably by inducing larger increases in cardiac vagal activity. The acute autonomic responses to the single HIT session were not modified by short-term training.

Muscle p70S6K phosphorylation in response to soy and dairy rich meals in middle aged men with metabolic syndrome: a randomised crossover trial.

BackgroundThe mammalian target of rapamycin (mTOR) pathway is the primary regulator of muscle protein synthesis. Metabolic syndrome (MetS) is characterized by central obesity and insulin resistance; little is known about how MetS affects the sensitivity of the mTOR pathway to feeding.MethodsThe responsiveness of mTOR pathway targets such as p706Sk to a high protein meal containing either dairy or soy foods was investigated in healthy insulin sensitive middle-aged men and those presenting with metabolic syndrome (MetS). Twenty male subjects (10 healthy controls, 10 MetS) participated in a single-blinded randomized cross-over study. In a random sequence, subjects ingested energy-matched breakfasts composed predominately of either dairy-protein or soy-protein foods. Skeletal muscle biopsies were collected in the fasted state and at 2 and 4 h post-meal ingestion for the analysis of mTOR- and insulin-signalling kinase activation.ResultsPhosphorylated Akt and Insulin receptor substrate 1 (IRS1) increased during the postabsorptive period with no difference between groups. mTOR (Ser448) and ribosomal protein S6 phosphorylation increased 2 h following dairy meal consumption only. p70S6K (Thr389) phosphorylation was increased after feeding only in the control subjects and not in the MetS group.ConclusionsThese data demonstrate that the consumption of a dairy-protein rich but not a soy-protein rich breakfast activates the phosphorylation of mTOR and ribosomal protein S6, required for protein synthesis in human skeletal muscle. Unlike healthy controls, subjects with MetS did not increase muscle p70S6K(Thr389) phosphorylation in response to a mixed meal.Trial registrationThis trial was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) as ACTRN12610000562077.

The impact of serum uric acid on the diagnostic of metabolic syndrome in apparently healthy brazilian middle-aged men.

Hyperuricemia is related to Metabolic Syndrome (MetS) and cardiovascular diseases, but the use of serum uric acid (UA) to diagnose MetS is currently ignored in clinical practices. To examine the impact of serum UA on the diagnostic of MetS and the relationship of serum UA with cardiometabolic risk factors in apparently healthy Brazilian middle-aged men residents in a city of Minas Gerais. In a cross-sectional analysis, 289 apparently healthy middle-aged men underwent anthropometric, clinical, sociodemographic and blood serum biochemical evaluation. By using receive operating curve the internal cutoff of serum UA was determined (5.25 mg/dL). Subjects with two or more components of MetS exhibited higher serum UA as compared to those with one or none component. The inclusion of serum UA ≥ 5.25mg/dL as an additional component of MetS increased the occurrence of this syndrome by 13%. Subjects with UA ≥ 5.25mg/dL showed high prevalence for MetS and association with its components (central obesity, hypertriglyceridemia, dyslipidemia and hypertension) as well as atherogenic risk. Serum UA has an important impact on the diagnostic of MetS and is related to cardiometabolic risk factors in apparently healthy Brazilian middle-aged men. Its use in clinical practices could aggregate accuracy to diagnose MetS.

Improvement of biological age by physical activity

While physical inactivity has been associated with greater mortality [ [1] Huffman M.D. Lloyd-Jones D.M. Ning H. et al. Quantifying options for reducing coronary heart disease mortality by 2020. Circulation. 2013; 127: 2477-2484 Crossref PubMed Scopus (53) Google Scholar ], physical activity leads to a reduction in mortality even when exercise starts relatively late during lifetime [ [2] Byberg L. Melhus H. Gedeborg R. et al. Total mortality after changes in leisure time physical activity in 50 year old men: 35 year follow-up of population based cohort. BMJ. 2009; 338: b688 Crossref PubMed Scopus (183) Google Scholar ]. Telomere shortening and increased p16INK4a expression are markers of biological age and indicate the loss of regenerative capacity. Shorter telomeres are associated with an increased cardiovascular risk [ 3 Krauss J. Farzaneh-Far R. Puterman E. et al. Physical fitness and telomere length in patients with coronary heart disease: findings from the Heart and Soul Study. PLoS One. 2011; 6: e26983 Crossref PubMed Scopus (53) Google Scholar , 4 Willeit P. Willeit J. Brandstatter A. et al. Cellular aging reflected by leukocyte telomere length predicts advanced atherosclerosis and cardiovascular disease risk. Arterioscler Thromb Vasc Biol. 2010; 30: 1649-1656 Crossref PubMed Scopus (221) Google Scholar ] and cardiovascular mortality [ [5] Cawthon R.M. Smith K.R. O'Brien E. Sivatchenko A. Kerber R.A. Association between telomere length in blood and mortality in people aged 60 years or older. Lancet. 2003; 361: 393-395 Abstract Full Text Full Text PDF PubMed Scopus (1347) Google Scholar ]. Cross sectional data suggested that regular physical exercise in male athletes is associated with maintaining longer telomeres [ [6] Werner C. Furster T. Widmann T. et al. Physical exercise prevents cellular senescence in circulating leukocytes and in the vessel wall. Circulation. 2009; 120: 2438-2447 Crossref PubMed Scopus (251) Google Scholar ]. We addressed the question whether physical activity affects telomere length (TL) and p16INK4a expression by investigating 59 healthy middle-aged men (45–65 years old; mean age: 53 ± 6 years) with former sedentary life-style in a prospective longitudinal study. A questionnaire confirmed sedentary lifestyle with an average of 5.1 (±10.2) metabolic equivalent of task (MET)-weighted hours per week for physical activity. Subjects were encouraged to perform 210 min of endurance training per week.

Effect of 1 night of total sleep deprivation on cerebrospinal fluid β-amyloid 42 in healthy middle-aged men: a randomized clinical trial.

Increasing evidence suggests a relationship between poor sleep and the risk of developing Alzheimer disease. A previous study found an effect of sleep on β-amyloid (Aβ), which is a key protein in Alzheimer disease pathology. To determine the effect of 1 night of total sleep deprivation on cerebrospinal fluid Aβ42 protein levels in healthy middle-aged men. The Alzheimer, Wakefulness, and Amyloid Kinetics (AWAKE) study at the Radboud Alzheimer Center, a randomized clinical trial that took place between June 1, 2012, and October 1, 2012. Participants were cognitively normal middle-aged men (40-60 years of age) with normal sleep (n = 26) recruited from the local population. Participants were randomized to 1 night with unrestricted sleep (n = 13) or 1 night of total sleep deprivation (24 hours of wakefulness) (n = 13). Sleep was monitored using continuous polysomnographic recording from 3 pm until 10 am. Cerebrospinal fluid samples were collected using an intrathecal catheter at defined times to compare cerebral Aβ42 concentrations between evening and morning. A night of unrestricted sleep led to a 6% decrease in Aβ42 levels of 25.3 pg/mL (95% CI [0.94, 49.6], P = .04), whereas sleep deprivation counteracted this decrease. When accounting for the individual trajectories of Aβ42 over time, a difference of 75.8 pg/mL of Aβ42 was shown between the unrestricted sleep and sleep deprivation group (95% CI [3.4, 148.4], P = .04). The individual trajectories of evening and morning Aβ42 concentrations differed between the unrestricted sleep and sleep deprivation groups (P = .04) in contrast to stable Aβ40, tau, and total protein levels. Sleep deprivation, or prolonged wakefulness, interferes with a physiological morning decrease in Aβ42. We hypothesize that chronic sleep deprivation increases cerebral Aβ42 levels, which elevates the risk of Alzheimer disease. clinicaltrials.gov Identifier: NCT01194713.

Thyroid hormones and coronary artery calcification in euthyroid men and women.

Overt and subclinical hypothyroidism are risk factors for atherosclerosis. It is unclear whether thyroid hormone levels within the normal range are also associated with atherosclerosis measured by coronary artery calcium (CAC). We conducted a cross-sectional study of 41 403 apparently healthy young and middle-aged men and women with normal thyroid hormone levels. Free thyroxin, free triiodothyronine, and thyroid-stimulating hormone levels were measured by electrochemiluminescent immunoassay. CAC score was measured by multidetector computed tomography. The multivariable adjusted CAC ratios comparing the highest versus the lowest quartile of thyroid hormones were 0.74 (95% confidence interval, 0.60-0.91; P for trend <0.001) for free thyroxin, 0.81 (0.66-1.00; P for trend=0.05) for free triiodothyronine, and 0.78 (0.64-0.95; P for trend=0.01) for thyroid-stimulating hormone. Similarly, the odds ratios for detectable CAC (CAC >0) comparing the highest versus the lowest quartiles of thyroid hormones were 0.87 (0.79-0.96; P for linear trend <0.001) for free thyroxin, 0.90 (0.82-0.99; P for linear trend=0.02) for free triiodothyronine, and 0.91 (0.83-1.00; P for linear trend=0.03) for thyroid-stimulating hormone. In a large cohort of apparently healthy young and middle-aged euthyroid men and women, low-normal free thyroxin and thyroid-stimulating hormone were associated with a higher prevalence of subclinical coronary artery disease and with a greater degree of coronary calcification.

The relationship between BPAQ-derived physical activity and bone density of middle-aged and older men.

The bone-specific physical activity questionnaire (BPAQ) accounts for activities that affect bone but has not been used in studies with older adults. Relationships exist between the BPAQ-derived physical activity and bone density in healthy middle-aged and older men but not men with prostate cancer. Disease-related treatments detrimental to bone should be considered when administering the BPAQ. The bone-specific physical activity questionnaire (BPAQ) was developed to account for bone-specific loading. In this retrospective study, we examined the relationship between BPAQ-derived physical activity and bone mineral density (BMD) in middle-aged and older men with and without prostate cancer. Two groups, 36 healthy men and 69 men with prostate cancer receiving androgen suppression therapy (AST), completed the BPAQ and had whole body, total hip, femoral (FN) and lumbar spine BMD assessed by dual-energy X-ray absorptiometry. Past (pBPAQ), current (cBPAQ) and total BPAQ (tBPAQ) scores for the healthy men were related to FN BMD (pBPAQ r = 0.36, p = 0.030; cBPAQ r s = 0.35, p = 0.034; tBPAQ r = 0.41, p = 0.014), and pBPAQ and tBPAQ were related to total hip (r s = 0.35, p = 0.035 and r s = 0.36, p = 0.029, respectively) and whole body BMD (r s = 0.44, p = 0.007 and r s = 0.45, p = 0.006, respectively). In men with prostate cancer, the BPAQ was not significantly associated with BMD. In stepwise regression analyses, body mass and tBPAQ predicted 30 % of the variance in total hip BMD (p = 0.003), cBPAQ predicted 14 % of the variance in FN BMD (p = 0.002), and body mass, age and tBPAQ predicted 47% of the variance in whole body BMD (p < 0.001) in healthy men. In men with prostate cancer, the BPAQ was not an independent predictor of BMD. Although BPAQ-derived estimates of physical activity are related to bone status in healthy middle-aged and older men, the adverse effect of AST on bone appears to obscure this relationship in men with prostate cancer.

Leisure-time physical activity and all-cause mortality.

BackgroundPhysical inactivity is a major public health problem associated with increased mortality risk. It is, however, poorly understood whether vigorous physical activity is more beneficial for reducing mortality risk than activities of lower intensity. The aim of this study was to examine associations of the intensity and volume of leisure-time physical activity with all-cause mortality among middle-aged women and men while considering sociodemographic and health related factors as covariates.MethodsQuestionnaire survey data collected in 2000-02 among 40–60-year-old employees of the City of Helsinki (N = 8960) were linked with register data on mortality (74% gave permission to the linkage) providing a mean follow-up time of 12-years. The analysis included 6429 respondents (79% women). The participants were classified into three groups according to intensity of physical activity: low moderate, high moderate and vigorous. The volume of physical activity was classified into three groups according to tertiles. Cox regression analysis was used to calculate hazard ratios (HR) and 95% confidence intervals (CIs) for all-cause mortality.ResultsDuring the follow up 205 participants died. Leisure-time physical activity was associated with reduced risk of mortality. After adjusting for covariates the vigorous group (HR = 0.54, 95% CI 0.34–0.86) showed a reduced risk of mortality compared with the low moderate group whereas for the high moderate group the reductions in mortality risk (HR = 0.72, 95% CI 0.48–1.08) were less clear. Adjusting for the volume of physical activity did not affect the point estimates. Higher volume of leisure-time physical activity was also associated with reduced mortality risk; however, adjusting for the covariates and the intensity of physical activity explained the differences.ConclusionsFor healthy middle-aged women and men who engage in some physical activity vigorous exercise may provide further health benefits preventing premature deaths.

The Postprandial Plasma Rye Fingerprint Includes Benzoxazinoid-Derived Phenylacetamide Sulfates

The bioavailability of whole-grain rye-derived phytochemicals has not yet been comprehensively characterized, and different baking and manufacturing processes can modulate the phytochemical composition of breads and other rye products. The aim of our study was to find key differences in the phytochemical profile of plasma after the consumption of 3 breads containing rye bran when compared with a plain white wheat bread control. Plasma metabolite profiles of 12 healthy middle-aged men and women were analyzed using LC quadrupole time-of-flight mass spectrometry metabolomics analysis while fasting and at 60 min, 120 min, 240 min, and 24 h after consuming a meal that contained either 100% whole-grain sourdough rye bread or white wheat bread enriched with native unprocessed rye bran or bioprocessed rye bran. White wheat bread was used as the control. The meals were served in random order after a 12-h overnight fast, with at least 3 d between each occasion. Two sulfonated phenylacetamides, hydroxy-N-(2-hydroxyphenyl) acetamide and N-(2-hydroxyphenyl) acetamide, potentially derived from the benzoxazinoid metabolites, were among the most discriminant postprandial plasma biomarkers distinguishing intake of breads containing whole-meal rye or rye bran from the control white wheat bread. Furthermore, subsequent metabolite profiling analysis of the consumed breads indicated that different bioprocessing/baking techniques involving exposure to microbial metabolism (e.g., sourdough fermentation) have a central role in modulating the phytochemical content of the whole-grain and bran-rich breads.

A Combination of Low-Dose Fluvastatin and Valsartan Decreases Inflammation and Oxidative Stress in Apparently Healthy Middle-Aged Males

We have previously shown that a "short-term, low-dose" treatment approach with statins, angiotensin receptor blockers, and especially their low-dose combination, is effective in improving arterial wall properties in apparently healthy middle-age men. This study was performed to expand investigation of its effects on inflammation and oxidative stress. The study was performed supplementary to 3 previous studies, overall 65 treated participants (25 received fluvastatin 10 mg, 20 valsartan 20 mg, 20 their combination) and 65 participants placebo. The stored blood samples (collected at inclusion and after 30 days of treatment) were used to measure high-sensitivity CRP, interleukin-6, vascular cell adhesion molecule-1, total antioxidant status, glutathione peroxidase, and selenium concentration. A low-dose combination decreased inflammation parameters (high-sensitivity CRP: from 1.2 ± 0.1 to 0.7 ± 0.1 mg/L; P < .001; vascular cell adhesion molecule-1: from 523 ± 21 to 482 ± 12 pg/mL; P < .05; while interleukin-6 did not reach the level of significance). It also increased antioxidant defenses, as measured by total antioxidant status and glutathione peroxidase (from 1.4 ± 0.04 to 1.5 ± 0.04 mmol/L; P < .01, and from 1.2 ± 0.06 to 1.4 ± 0.06 μkat/g hemoglobin; P < .05, respectively), accompanied by decreased selenium levels. Low-dose valsartan was separately less effective than the combination. No changes were observed in the control groups. Low-dose combination of fluvastatin and valsartan and, to a lesser extent low-dose valsartan alone, produced important anti-inflammatory and anti-oxidative effects. These results confirm and extend the potential of the "short-term, low-dose" preventive strategy.

Abstract P008: Ultra-Sensitive Troponin I Strongly Predicts Incident Coronary Heart Disease in the General Population Independently of Traditional Risk Factors. Results From the MONICA/KORA Augsburg Case-Cohort Study

Background: High-sensitive (hs) troponin T and I assays as well as ultrasensitive (us) troponin I enable measurement of troponins in 65% to 98% of the general population. We prospectively investigated whether increased concentrations of us-troponin I are associated with an increased risk of coronary heart disease (CHD) after controlling for traditional risk factors. Methods: We conducted a population-based case cohort study in middle-aged healthy men and women within the MONICA/KORA Augsburg studies. Serum levels of us-troponin I (Single Molecule Counting technology, Singulex) were available in 2,745 men and women including 803 incident CHD cases. Geometric mean us-troponin I was 1.56 ng/L. Mean (SD) follow-up was 16.0 (5.8) years. Results: Baseline concentrations of us-troponin I were higher in cases compared to non-cases (geometric mean 2.56 vs. 1.49 ng/L, p&lt;0.0001) and in men compared to women (geometric mean 1.93 vs. 1.27 ng/L, p&lt;0.0001). After adjustment for variables of the Framingham Risk Score, the hazard ratio (HR) with 95% confidence interval (CI) for a CHD event in the top quartile compared to the bottom quartile was 2.76 (95% CI, 1.87-4.09). After additional adjustment for alcohol intake, physical activity, and body mass index, hazard ratios remained essentially unchanged. Conclusions: Troponin I measured by an us-assay was detectable in almost all subjects. This is the first population-based prospective study with long-term follow-up showing that even modestly increased concentrations of us troponin I are strongly associated with incident CHD independently of a variety of traditional risk factors.

Abstract P039: Brachial-ankle Pulse Wave Velocity is Independently Associated with Presence of Coronary Calcification among 1131 Healthy Middle-aged Men. The ERA JUMP Study

Objective: In an international population-based cross-sectional study among men aged 40-49 years, we examined the association between brachial-ankle pulse wave velocity (baPWV): a biomarker of combined arterial stiffness of central and peripheral arteries, and the presence of coronary artery calcification (CAC). Methods: Out of 1,335 men without clinical cardiovascular disease recruited during 2002-06, a total of 204 participants taking anti-hypertensive medications, or having missing data were excluded. Remaining participants were 281 Whites and 83 Blacks in Pittsburgh, 235 Japanese Americans in Honolulu, 280 Koreans in Ansan, South Korea, and 292 Japanese in Kusatsu, Japan. baPWV was measured using automated waveform analyzer (VP2000, Omron, Japan). Intra-class correlations of baPWV within and between technicians were 0.97 and 0.91 respectively. CAC was determined using electron-beam computed tomography (Imatron C-150) at all centers; all images were read at University of Pittsburgh by trained staff. Using logistic regression, presence of CAC (≥ 10 Agatston Units) was evaluated with increasing baPWV as a predictor variable (per 100 cm/s; per 1 SD change). Results: Prevalence of CAC among individual racial groups was Whites (25%), Blacks (16%), Japanese Americans (28%), Japanese (10%), and Koreans (10%). Overall, increased baPWV was significantly associated with presence of CAC in unadjusted model (Odds ratio=1.31, 95% CI 1.20, 1.44) as well as multivariable adjusted model (Odds ratio=1.19, 95% CI 1.06, 1.35). There was no effect-modification by race in the models. Similar odds ratios for presence of CAC with increasing baPWV were seen for individual races, but were statistically non-significant among Japanese American men and Japanese men in Japan, possibly due to inadequate power. Conclusion: Increasing baPWV is associated with presence of CAC, independent of other cardiovascular disease risk factors.

An almond-enriched diet increases plasma α-tocopherol and improves vascular function but does not affect oxidative stress markers or lipid levels

Vascular dysfunction is one of the major causes of cardiovascular (CV) mortality and increases with age. Epidemiological studies suggest that Mediterranean diets and high nut consumption reduce CV disease risk and mortality while increasing plasma α-tocopherol. Therefore, we have investigated whether almond supplementation can improve oxidative stress markers and CV risk factors over 4 weeks in young and middle-aged men.Healthy middle-aged men (56 ± 5.8 years), healthy young men (22.1 ± 2.9 years) and young men with two or more CV risk factors (27.3 ± 5 years) consumed 50 g almond/day for 4 weeks. A control group maintained habitual diets over the same period.Plasma α-tocopherol/cholesterol ratios were not different between groups at baseline and were significantly elevated by almond intervention with 50 g almond/day for 4 weeks (p < 0.05). Plasma protein oxidation and nitrite levels were not different between groups whereas, total-, HDL- and LDL-cholesterols and triglycerides were significantly higher in healthy middle-aged and young men with CV risk factors but were not affected by intake. In the almond-consuming groups, flow-mediated dilatation (FMD) improved and systolic blood pressure reduced significantly after 50 g almonds/day for 4 weeks, but diastolic blood pressure reduced only in healthy men.In conclusion, a short-term almond-enriched diet can increase plasma α-tocopherol and improve vascular function in asymptomatic healthy men aged between 20 and 70 years without any effect on plasma lipids or markers of oxidative stress.

Regional pulse wave velocities and their cardiovascular risk factors among healthy middle-aged men: a cross-sectional population-based study

BackgroundBoth carotid-femoral (cf) pulse wave velocity (PWV) and brachial-ankle (ba) PWV employ arterial sites that are not consistent with the path of blood flow. Few previous studies have reported the differential characteristics between cfPWV and baPWV by simultaneously comparing these with measures of pure central (aorta) and peripheral (leg) arterial stiffness, i.e., heart-femoral (hf) PWV and femoral-ankle (fa) PWV in healthy populations. We aimed to identify the degree to which these commonly used measures of cfPWV and baPWV correlate with hfPWV and faPWV, respectively, and to evaluate whether both cfPWV and baPWV are consistent with either hfPWV or faPWV in their associations with cardiovascular (CV) risk factors.MethodsA population-based sample of healthy 784 men aged 40–49 (202 white Americans, 68 African Americans, 202 Japanese-Americans, and 282 Koreans) was examined in this cross-sectional study. Four regional PWVs were simultaneously measured by an automated tonometry/plethysmography system.ResultscfPWV correlated strongly with hfPWV (r = .81, P < .001), but weakly with faPWV (r = .12, P = .001). baPWV correlated moderately with both hfPWV (r = .47, P < .001) and faPWV (r = .62, P < .001). After stepwise regression analyses with adjustments for race, cfPWV shared common significant correlates with both hfPWV and faPWV: systolic blood pressure (BP) and body mass index (BMI). However, BMI was positively associated with hfPWV and cfPWV, and negatively associated with faPWV. baPWV shared common significant correlates with hfPWV: age and systolic BP. baPWV also shared the following correlates with faPWV: systolic BP, triglycerides, and current smoking.ConclusionsAmong healthy men aged 40 – 49, cfPWV correlated strongly with central PWV, and baPWV correlated with both central and peripheral PWVs. Of the CV risk factors, systolic BP was uniformly associated with all the regional PWVs. In the associations with factors other than systolic BP, cfPWV was consistent with central PWV, while baPWV was consistent with both central and peripheral PWVs.

Correlation between metabolic syndrome and lower urinary tract symptoms

Middle-aged men often have lower urinary tract symptoms (LUTS) resulting from benign prostatic enlargment (BPE). The correlation between metabolic syndrome (MS) and BPE remain debatable. The aim of the present study is to investigate the impact of MS on LUTS in a middle-aged men receiving a health checkup. Males aged > 45 years who voluntary underwent a medical checkup were enrolled in this study. All participants were stratified into 2 groups by the presence of 3 or more risk factors of MS including elevated blood pressure, waist circumference (WC) , serum fasting glucose (SFG), high density lipoproteins cholesterol (HDL-C) and triglyceride (TG. Prostate volume (PV), determinated by TRUS, and PSA level were used for subrgroup analysis, including determination of total International Prostate Symptom Score (IPSS), with voiding and storage score, and quality of life (QOL) score.Three hundred fifty four men, with mean age 55.6 ± 9.72 years, were enrolled into the study. According to reporting criteria of MS, 108 (30.5%) had MS and formed the study group, whereas 246 (69.5%) MS-negative men formed a control group. Antrpometric, metabolic outcoms and percentage of hypertension were significantly higher in MS vs non-MS group. The MS-group had lower mean total IPSS (7.83 ± 6.63 vs 6.85 ± 6.25,p=0.05), lower severity of weak urinary stream (1.24 ± 1.60 vs 0.95 ± 1.50,p=0.021) and lower severity of IPSS grading (p 30 mL), total IPSS, storage score, voiding frequency, urgency and incomplete emptying were lower in the MS group (p 0.93 ng/mL) group men with MS had significantly lower IPSS, voiding score and less reporting of incomplete emptying and weak urinary stream. Men in the MS group were stratified into 3 groups according to the number of MS risk factors (3, 4 and 5) and their LUTS score was compared to that of non-MS group. The negative association between voiding score, storage score, severity of LUTS and MS became particularly pronounced as the number of MS factors increased. The odds ratio (OR) for moderate to severe LUTS was significantly lower in men with 3 (OR 0.61, 95% confidence interval (CI) 0.40-0.94) or 5 ( OR 0.32, 95% CI 0.11-0.95) MS risk factors. Men in the MS group were less likely to experience moderate to severe LUTS (OR 0.58, 95% CI 0.41- 0.83). We confirmed that MS had favorable effects in LUTS, including voiding and storage symptoms in healthy middle-aged men. This beneficial effect was most significant in men with enlarged prostate and/or high PSA level.