Higher Testosterone Research Articles

Relationships among Gonadotropins, Sex Hormones, and Vascular Function in Adolescents with Normal Weight or Obesity

Objective: Childhood obesity may lead to premature cardiovascular disease in adulthood. Excess adiposity suppresses gonadotropin [luteinizing hormone (LH), follicle-stimulating hormone (FSH)] production in both adolescent males and females, which act upon the gonads, leading to the release of the sex hormones (estrogen and testosterone). Both estrogen and testosterone have been linked to vascular function. Relationships among gonadotropins, sex hormones, and vascular function are not completely understood in male and female adolescents across the weight-status spectrum. We, therefore, sought to examine associations among gonadotropins, sex hormones, and vascular health in adolescents with normal weight or obesity. We hypothesized that increased levels of gonadotropins would be associated with worsened vascular function, and higher levels of estrogen would be associated with favorable vascular function. Methods and Data: Adolescents (n=58; 12– <18-years of age) were stratified according to body mass index (BMI) percentile into normal weight (5th – <85th BMI percentile; n=25) and obesity (³95th BMI percentile; n=33) categories. Fasting blood samples were collected to measure FSH, LH, testosterone, estradiol, total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL), very-low-density lipoprotein cholesterol (VLDL), high-density lipoprotein cholesterol (HDL), glucose, and insulin. Insulin resistance was calculated using the homeostatic model assessment (HOMA-IR). Vascular function was measured via ultrasonography for measures of carotid artery compliance and distensibility [i.e., diameter compliance (cDC), incremental elastic modulus (cIEM)], and brachial artery flow mediated dilation (FMD). Results: Female adolescents with obesity had a significantly greater ( p=0.009) FMD compared to females with normal weight. Triglycerides, VLDL, total cholesterol-to-HDL ratio, HOMA-IR, and insulin were also significantly greater (all p<0.05) in adolescents with obesity compared to those with normal weight, while HDL was significantly lower ( p<0.0001). FSH, LH, testosterone, and estradiol did not statistically significantly differ between the normal weight and obesity groups in either sex. After adjusting for age, multiple comparisons, and stratifying by sex, higher testosterone was associated with decreased cDC (p=0.018) in females. Additionally in females, higher testosterone was associated with increased cIEM ( p=0.002). In adolescent males, higher estrogen was associated with decreased cDC ( p=0.006) and increased cIEM ( p=0.003). Conclusion: Adding to previous research showing relationships between sex hormones and vascular health in adults, the current study shows associations between sex hormones and cDC and cIEM in adolescents. That said, we found no associations between gonadotropins and measures of vascular function in adolescents with normal weight or obesity. Future studies are needed to confirm these results in a larger cohort and among those with BMI in the overweight (85th - <95th BMI percentile) category and differentiating severe obesity (>120% of the 95th percentile, or >35 kg/m2). Dr. Kelly serves as an unpaid investigator, consultant, and educator for Eli Lilly, Novo Nordisk, and Vivus; an unpaid consultant for Boehringer Ingelheim; receives donated study medication from Novo Nordisk and Vivus for NIDDK-funded clinical trials. Dr. Bomberg has served as a site principal investigator and site co-investigator for Novo Nordisk. His research program is supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH) under award number K23DK125668. The content is solely the responsibility of the authors and does not necessarily represent the offcial views of the NIH. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Cognitive impairment is associated with female sex, low level of education, lack of spousal relationship, and serum testosterone in type 2 diabetes

Abstract Background: Relationship between cognitive impairment, serum testosterone, and body mass index in type 2 diabetes (T2D) is not fully understood. Objectives: To compare cognition between T2D patients and healthy controls. To determine relationship of mild cognitive impairment (MCI) with serum total testosterone and sociodemographic factors. Materials and Methods: The study was a cross-sectional case-control study. About 17 male and female T2D patients and healthy controls were randomly selected. Montreal cognitive assessment-basic (MoCA-B) was used to assess cognition; anthropometric indices were measured using standard protocols, while total testosterone was assayed from serum using competitive ELISA kits. Results: The mean age of the T2D patients and healthy controls was 51.62 and 66.76 years, respectively. About 82.35% of the T2D patients had MCI compared to 58.82% of the healthy controls. MCI was associated with female sex (P = 0.033), lack of spousal relationship (P = 0.016), low level of education (P = 0.014), and normal or high level of total testosterone (P = 0.010). Conclusion: Proportion of MCI in T2D patients is high and is associated with female sex, lack of spousal relationship, low level of education, and normal or high testosterone level.

HSD17B1 Compensates for HSD17B3 Deficiency in Fetal Mouse Testis but Not in Adults.

Hydroxysteroid (17β) dehydrogenase (HSD17B) enzymes convert 17-ketosteroids to 17beta-hydroxysteroids, an essential step in testosterone biosynthesis. Human XY individuals with inactivating HSD17B3 mutations are born with female-appearing external genitalia due to testosterone deficiency. However, at puberty their testosterone production reactivates, indicating HSD17B3-independent testosterone synthesis. We have recently shown that Hsd17b3 knockout (3-KO) male mice display a similar endocrine imbalance, with high serum androstenedione and testosterone in adulthood, but milder undermasculinization than humans. Here, we studied whether HSD17B1 is responsible for the remaining HSD17B activity in the 3-KO male mice by generating a Ser134Ala point mutation that disrupted the enzymatic activity of HSD17B1 (1-KO) followed by breeding Hsd17b1/Hsd17b3 double-KO (DKO) mice. In contrast to 3-KO, inactivation of both HSD17B3 and HSD17B1 in mice results in a dramatic drop in testosterone synthesis during the fetal period. This resulted in a female-like anogenital distance at birth, and adult DKO males displayed more severe undermasculinization than 3-KO, including more strongly reduced weight of seminal vesicles, levator ani, epididymis, and testis. However, qualitatively normal spermatogenesis was detected in adult DKO males. Furthermore, similar to 3-KO mice, high serum testosterone was still detected in adult DKO mice, accompanied by upregulation of various steroidogenic enzymes. The data show that HSD17B1 compensates for HSD17B3 deficiency in fetal mouse testis but is not the enzyme responsible for testosterone synthesis in adult mice with inactivated HSD17B3. Therefore, other enzymes are able to convert androstenedione to testosterone in the adult mouse testis and presumably also in the human testis.

A Review and a Brief Explanation of the Poly Cystic Ovarian Syndrome

A complicated disorder known as polycystic ovarian syndrome (PCOS) is typified by high testosterone levels, irregular menstruation, and/or tiny cysts on one or both ovaries. According to a study, PCOS is the most common endocrine disorder among women of reproductive age, affecting 5% to 10% of females between the ages of 18 and 44. Poor dietary choices, physical inactivity, and elevated environmental factors have been related to PCOS, including obesity; infectious agents and toxins may also play a role. Although there is currently no pharmaceutical treatment for the illness, several interventive drugs are utilized to alleviate PCOS's clinical symptoms. Early detection of long-term morbidities through appropriate screening and testing is an essential part of the treatment of this disorder. Key Words: PCOS, hormones, vitamins

Selective peripheral tissue response to high testosterone levels in an infertile woman without virilization signs.

Total testosterone, which is peripherally converted to its biologically active form dihydrotestosterone (DHT), is the first-line hormone investigation in hyperandrogenic states and infertility in premenopausal women. Polycystic ovary syndrome (PCOS), the most common cause of hyperandrogenism and infertility in young women, is often associated with mild elevations of total testosterone. Whereas very high levels of total testosterone (>2-3 SD of normal reference), are most often associated with hyperandrogenic signs, menstrual irregularity, rapid onset of virilization, and demand a prompt investigation. Herein, we report a case of a 32-year-old woman who was referred to the endocrinology outpatient clinic due to secondary amenorrhea and extremely high testosterone levels without any virilization signs. We initially suspected pitfalls in the testosterone laboratory test. Total serum testosterone decreased after a diethyl-ether extraction procedure was done prior to the immunoassay, but testosterone levels were still elevated. An ovarian steroid-cell tumor (SCT) was then revealed, which was thereby resected. Twenty-four hours post surgery, the total testosterone level returned to normal, and a month later menstruation resumed. This case emphasizes that any discrepancy between laboratory tests and the clinical scenario deserves a rigorous evaluation to minimize misinterpretation and errors in diagnosis and therapeutic approach. Additionally, we describe a possible mechanism of disease: a selective peripheral target-tissue response to high testosterone levels that did not cause virilization but did suppress ovulation and menstruation. Total testosterone is the most clinically relevant hormone in investigating hyperandrogenic states and infertility in premenopausal women. Very high total testosterone levels in women (>2-3 SD of normal reference) are most often associated with hyperandrogenic signs, menstrual irregularities, and a rapid onset of virilization. In women with very elevated testosterone levels and the absence of clinical manifestations, laboratory interference should be suspected, and diethyl ether extraction is a useful technique when other methods fail to detect it. Ovarian steroid cell tumors (SCT) encompass a rare subgroup of sex cord-stromal tumors and usually secrete androgen hormones. SCTs are clinically malignant in 25-43% of cases. A selective response of peripheral target tissues to testosterone levels, with clinical manifestations in some tissues and no expression in others, may reflect differences in the conformation of tumor-produced testosterone molecules.

(O-05) ESTRADIOL LEVELS IN MEXICAN MEN WITH ERECTILE DYSFUNCTION

Abstract Introduction and Objective Erectile dysfunction is associated with various psychological and physiological causes, including hormone levels such as testosterone. The role of estradiol in male sexual function is controversial, and studies reporting its impact on erectile function have been inconsistent. The aim of this study was to describe the levels of testosterone and estradiol in Mexican men with erectile dysfunction, based on the severity of dysfunction. Materials and Methods Hormonal levels of TSH, T3, T4, LH, FSH, total and free testosterone, and estradiol were measured in men over 18 years of age with erectile dysfunction, attending a clinic in Mexico. Clinical variables were analyzed, estimating measures of central tendency and dispersion for numerical variables, and absolute and relative frequencies for categorical variables. The proportion of men with abnormal levels of estradiol and testosterone was calculated based on the severity of erectile dysfunction. Results A total of 70 participants were included. The average age was 53.9 years old (+/- 11.8); 18.5% had severe dysfunction, 65.7% had moderate dysfunction, 14.2% had mild to moderate dysfunction, and 1.4% had mild dysfunction. 35.7% were diabetic, and 34.2% were hypertensive. 62.8% had abnormal levels in at least one of the evaluated hormones: 5.7% had low TSH levels; 2.8% had low T3 levels; 1.4% had low T4 levels; 5.7% had low and 7.1% had high total testosterone levels; 12.8% had low and 2.8% had high free testosterone levels; 17.1% had high prolactin levels; 1.4% had low and 10% had high LH levels; 5.7% had high FSH levels. Estradiol level was high in 6 men (8.5%), 1 had mild-moderate and 5 moderate dysfunction; 8 men had low estradiol levels (11.42%), 1 had mild-moderate, 4 moderate and 3 severe dysfunction. Conclusions Alteration on the levels of Estradiol was common in the analyzed group of patients with erectile dysfunction, especially in men with moderate dysfunction, observed in 12.8% of them. Financing Boston Medical Group.

Effectiveness of Sea Cucumber Viscera Waste to Improve Reproductive Performance of Male Tiger Shrimp (Penaeus monodon)

Tiger shrimp has received attention because of the high prices. However, sustainable cultivation of tiger shrimp is still hampered by the low quality of spermatozoa in male broodstock. Sea cucumbers are a type of invertebrate that is very useful because they have many viscera with almost the same nutritional content as fresh food. However, it has other advantages compared to other fresh feeds, namely it has a very high testosterone content so that it can be used to improve the quality and quantity of spermatozoa of male tiger prawns. The study aims to compare the influence between sea cucumber viscera and fresh squid as well as the combination of sea cucumber and squid viscera against the density of tiger shrimp spermatozoa (Penaeus monodon). Test animals used were 18 male tiger shrimp with an average weight of 80.93 g. Shrimp are kept in tanks with a volume of 1 ton, with a density of 3 broodstock/tank and 3 replications. Feeding was carried out with a frequency of 3 times a day and at a dose of 20% of biomass for 30 days. The test feed used consisted of 100% fresh squid feed as a control, a combination of 50% squid and 50% of sea cucumber viscera, and 100% of sea cucumber viscera. The administration of sea cucumber visceral waste in tiger shrimp tend to increase the quantity of spermatozoa tiger shrimp.

Effectiveness of the Mentha spicata leaves in reducing testosterone levels and aggressive behaviour in female Wistar albino rats treated with testosterone propionate

High testosterone hormone levels play an important role in exhibiting aggressive behaviour and several disorders in female rodents and women. The present study aimed to determine the protective role of the alcoholic extract of Mentha spicata leaves (MSL) in the reduction of the level of testosterone and aggressive behaviour of female rats that suffer from high levels of testosterone. A total of 30 female Wistar albino rats were divided into 6 Groups. Group 1: Control rats received sesame oil(0.5 ml). Group 2: Rats injected with testosterone propionate (TP) alone. Group 3: Rats received MSL alone (100 mg/kg) orally. Groups 4, 5, and 6: Rats received TP + MSL, 6mg/rat of TP followed by 200, 400, and 600 mg/rat, respectively) for 60 days. The testosterone, dopamine, and aggressive behaviour were measured using specialized ELISA test kits. The results showed that testosterone and dopamine levels in the serum had a significant decrease (P<0.05) (4.82 (ng/ml) in testosterone and 272.83 (pg/ml) in dopamine) in animals treated with MSL only compared to Group 2, which found a significant rise (p<0.05) (16.52 (ng/ml) in testosterone and 607.59 (pg/ml) in dopamine) in the levels of testosterone and dopamine. The results exhibited a significant rise (P<0.05) in the aggressive behaviour in Group 2 of rats compared to the control and other Groups. In comparison, aggressive behaviour was significantly decreased (P<0.05) (7.40 (ng/ml) in testosterone and 263.49 (ng/ml) in dopamine) in Groups 2, 4, 5, and 6. Thus, the study revealed the protective role of the alcoholic extract of MSL in reducing levels of testosterone and aggressive behaviour in female rats suffering from higher levels of testosterone.

A biological characterization of patients with postmenopausal Parkinson's disease.

Menopause increases the risk for Parkinson's disease (PD), although the underlying biological mechanisms have not been established in patients. Here, we aimed to understand the basis of menopause-related vulnerability to PD. Main motor and non-motor scores, blood levels of estradiol, testosterone, follicle-stimulating hormone, and luteinizing hormone, CSF levels of total α-synuclein, amyloid-β-42, amyloid-β-40, total tau, and phosphorylated-181-tau were examined in 45 women with postmenopausal-onset PD and 40 age-matched controls. PD patients had higher testosterone and lower estradiol levels than controls, and the residual estradiol production was associated with milder motor disturbances and lower dopaminergic requirements. In PD but not in controls, follicle-stimulating hormone levels correlated with worse cognitive scores and CSF markers of amyloidopathy and neuronal loss. In conclusion, menopause-related hormonal changes might differentially contribute to clinical-pathological trajectories of PD, accounting for the peculiar vulnerability to the disease.

Association of Testosterone and Sex Hormone-Binding Globulin With All-Cause and Cardiovascular Disease Mortality in Older Chinese Men.

The associations of high and low testosterone with all-cause and cardiovascular disease (CVD) mortality risk in men are conflicting. Our objective was to examine associations of total testosterone, free testosterone, bioavailable testosterone, and sex hormone-binding globulin (SHBG) with all-cause and CVD mortality in older Chinese men. Total testosterone and SHBG were assayed, and free testosterone and bioavailable testosterone were calculated using Vermeulen formula. Cox proportional hazards regression was used to assess the associations with risks of all-cause and CVD mortality, giving hazard ratios (HRs) and 95% confidence intervals (CIs). Of 3948 men aged 50+ years, 949 deaths (312 CVD) occurred during an average 10.5-year follow-up. After multivariable adjustments, the highest, versus the third, quartile of total testosterone and free testosterone were associated with higher all-cause mortality risk (1.17 [0.97-1.41] and 1.45 [1.20-1.74], respectively), whereas free testosterone was associated with higher CVD mortality risk (1.88 [1.33-2.66]). Similar positive associations were found for bioavailable testosterone and all-cause mortality risk (1.27 [1.05-1.54]). Lower SHBG (quartile 1 vs quartile 3) was associated with higher all-cause and CVD mortality risk (1.25 [1.04-1.52] and 1.28 [1.08-1.52], respectively). Consistent associations were observed in relatively healthy men and men excluded death during the first year. Higher total testosterone, free testosterone, and bioavailable testosterone were associated with higher all-cause mortality in older men, higher free testosterone was associated with higher CVD mortality whilst lower SHBG was associated with higher all-cause and CVD mortality. Clarification and confirmation of causality require further mechanistic studies.

Relationship between Androgens and Vascular and Placental Function during Pre-eclampsia.

Hypertensive disorders of pregnancy (HDP) represent a substantial risk to maternal and fetal health. Emerging evidence suggests an association between testosterone and pre-eclampsia (PE), potentially mediated through androgen receptors (AR). Nevertheless, the mechanism driving this association is yet to be elucidated. On the other hand, reports of transgender men's pregnancies offer a limited and insightful opportunity to understand the role of high androgen levels in the development of HDP. In this sense, a literature review was performed from a little over 2 decades (1998-2022) to address the association of testosterone levels with the development of HDP. Furthermore, this review addresses the case of transgender men for the first time. The main in vitro outcomes reveal placenta samples with greater AR mRNA expression. Moreover, ex vivo studies show that testosterone-induced vasorelaxation impairment promotes hypertension. Epidemiological data point to greater testosterone levels in blood samples during PE. Studies with transgender men allow us to infer that exogenous testosterone administration can be considered a risk factor for PE and that the administration of testosterone does not affect fetal development. Overall, all studies analyzed suggested that high testosterone levels are associated with PE.

Higher testosterone is associated with higher HDL-cholesterol and lower triglyceride concentrations in older women: an observational study

Objective This study aimed to determine whether concentrations of testosterone and its main precursor after menopause, dehydroepiandrosterone (DHEA), are associated with lipoproteins and other lipids in community-dwelling older women. Methods The Sex Hormones in Older Women (SHOW) study was an observational study of 6358 Australian women, aged at least 70 years, with no prior major adverse cardiovascular event who had sex hormones measured by liquid chromatography–tandem mass spectrometry. Associations between hormones and lipids were examined using multilinear regression adjusted for potential confounders. Results The cross-sectional analyses included 3231 participants, median age 74.0 (interquartile range 71.7–77.9) years. Compared with concentrations in the lowest quartile (Q1), testosterone concentrations in the highest quartiles (Q3 and Q4) were positively associated with high-density lipoprotein cholesterol (HDL-C) (p = 0.002 and p < 0.001, respectively) while Q4 testosterone concentrations were positively associated with total cholesterol (p = 0.038). Q2, Q3 and Q4 testosterone concentrations were significantly inversely associated with triglycerides (TG) (p = 0.024, p = 0.003 and p < 0.001, respectively). For DHEA, Q4 concentrations was positively associated with non-HDL-C (p = 0.024). Conclusions In older women, higher endogenous testosterone concentrations are significantly associated with higher HDL-C and lower TG, indicating a less atherogenic profile. These findings suggest a neutral, or potentially protective, cardiovascular disease effect of testosterone in older women.

(084) Low Serum Testosterone is Associated with an Increased Risk of First-time Nephrolithiasis in Men Without Testosterone Replacement Therapy

Abstract Introduction Serum testosterone levels in men have declined on a population level since 1999. Although the role of testosterone in nephrolithiasis is unclear, men are twice as likely as women to develop kidney stones. Some studies posit high testosterone levels as a lithogenic factor, but a recent study showed an inverse relationship between testosterone levels and kidney stones, suggesting that low testosterone may increase the risk of kidney stones in men over 40. The relationship between low testosterone in men and kidney stone risk remains unclear. Objective To determine the association of low serum testosterone levels with the development of incident kidney stones in men without a history of testosterone therapy (TTh). Methods Using TriNetX, a tool that de-identifies and aggregates electronic health record data from tens of millions of patients, we used the TriNetX Research Network to examine men aged ≥18 with a known testosterone level. Men with a history of nephrolithiasis before testosterone measurement and a history of TTh at any point in their life were excluded as both are known to increase the risk of subsequent kidney stones. Men were divided into a low testosterone group (&amp;lt;300 ng/dL) and a normal testosterone group (300-1000 ng/dL). Demographic and clinical characteristics, including comorbidities and medications, were compared using descriptive statistics for all patients. To address potential confounders, we used propensity score matching based on demographic and clinical characteristics (Table 1). We used 1:1 greedy nearest-neighbor matching with a caliper of 0.1 pooled standard deviations of the propensity score. A standardized mean difference of less than 0.1 indicated successful matching. Our outcome of interest was all-time risk of developing an initial kidney stone in men aged ≥18 following a laboratory-confirmed low testosterone. Subgroup analyses was performed on age cohorts. Survival analysis was performed using a log-rank test and Cox proportional hazards regression. All analyses were performed on the TriNetX platform without natural language processing. Results 445,682 men ≥18 with low testosterone were included. The number of men before matching (Table 1) and in each age subgroup after matching is seen in table 2. The percentage of men that developed a diagnosis of nephrolithiasis increased with age regardless of testosterone level (Table 2). In men ≥18, low testosterone was associated with higher risk of incident nephrolithiasis (HR 1.14, 1.11-1.17). Men with low testosterone aged 34-44 (HR 1.28, 1.18-1.40) had the highest risk of nephrolithiasis. Low testosterone was not associated with an increased risk of nephrolithiasis in men aged 18-24 (Figure 1). Conclusions In investigating the association of low testosterone with kidney stones in men without a history of kidney stones or TTh, we found that low serum testosterone is associated with a higher risk of a first-time encounter diagnosis of nephrolithiasis in men greater than 25 years of age compared to men with normal testosterone levels. Men aged 33-44 with low serum testosterone had the highest risk of nephrolithiasis. Future work will investigate the risk of kidney stone recurrence in men with low serum testosterone levels. Disclosure No.

Testosterone and soluble ST2 as mortality predictive biomarkers in male patients with sepsis-induced cardiomyopathy.

Sepsis-induced cardiomyopathy (SIC) is characterized by high mortality and poor outcomes. This study aimed to explore the relationship between testosterone and soluble ST2 (sST2) and all-cause mortality in patients with SIC. Clinical data from SIC patients at Renmin Hospital of Wuhan University from January 2021 and March 2023 were reviewed. Serum testosterone and sST2 were measured at admission. Kaplan-Meier analysis and receiver operative characteristic curve (ROC) were used to estimate the predictive values of testosterone and sST2 on 28 days and 90 days mortality of SIC. A total of 327 male subjects with SIC were enrolled in this study. During the 28 days and 90 days follow-up, 87 (26.6%) and 103 deaths (31.5%) occurred, respectively. Kaplan-Meier analysis showed significantly higher 28 days and 90 days survival in patients with higher testosterone and decreased sST2 levels (p < 0.001). Testosterone, sST2, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were significantly associated with 28 days and 90 days mortality (p < 0.05). Partial correlation analysis showed strong positive correlation between testosterone and left ventricular ejection fraction (LVEF) (p < 0.001), and negative correlation between testosterone and sST2 (p < 0.001), high-sensitivity troponin I (hs-TnI) levels (p < 0.001) and smoke history (p < 0.01). The concentrations of sST2 were positively related with E/e' ratio (p < 0.001), and negatively correlated with TAPSE (p < 0.001). The combination of testosterone and sST2 enhanced the prediction of both 28 days [area under the ROC curve (AUC), 0.805] and 90 days mortality (AUC, 0.833). Early serum testosterone and sST2 levels could predict mortality of SIC independently and jointly. Further research is needed to determine the utility of biochemical markers in identifying high-risk patients with SIC.

Correlation between chronic low-grade inflammation and glucose and lipid metabolism indicators in polycystic ovary syndrome

Objective The purpose of this study was to explore the correlation between inflammatory indicators and blood lipids and to further provide a theoretical basis for the diagnosis and treatment of clinical polycystic ovary syndrome (PCOS). Methods Whole-blood cell counts and hormone and blood lipid levels were measured in 110 patients with PCOS and 126 healthy women. The differences in the above levels and the correlation between inflammation and blood lipid levels in the two groups were determined, and classified according to BMI. Differences in inflammatory indices were also analyzed. The independent risk factors for PCOS were analyzed by binary logistic regression. Results The PCOS group had greater BMI and greater body weight than the control group. The inflammatory indicators WBC, neutrophil, lymphocyte, monocyte counts and the NLR were significantly higher than those of the control group. It had higher testosterone (TSTO), triglyceride (TG) and total cholesterol (TC) levels. Correlation analysis showed that leukocyte and neutrophil counts were positively correlated with TSTO and TG levels and negatively correlated with HDL. In the BMI ≥ 24 and BMI < 24 groups, WBC was higher in PCOS patients than in healthy controls. Logistic regression showed that TSTO, TG and FSH were independent risk factors for PCOS. Conclusion Inflammatory markers are correlated with blood lipids in PCOS. During the treatment of PCOS, blood lipids and serum inflammatory factors should be monitored.

The association between serum testosterone level and congestive heart failure in US male adults: data from National Health and Nutrition Examination Survey (NHANES) 2011-2016.

This study aimed to investigate the relationship between serum testosterone levels and the risk of congestive heart failure (CHF) in adult males. Previous research has suggested a potential link between serum testosterone and cardiovascular health, but the findings have been inconclusive. This study was cross-sectional, and the data were obtained from the 2011-2016 cycle of the National Health and Nutrition Examination Survey (NHANES), which included a sample of 6,841 male participants. Serum testosterone levels were measured using a standardized assay, and CHF status was assessed through self-reporting. Covariates such as age, ethnicity, lifestyle factors, and health conditions were considered in the analysis. Among the participants, 242 individuals had a documented history of CHF. We observed a linear correlation between serum testosterone levels and CHF occurrence, with higher serum testosterone levels associated with a decreased risk of CHF (Q4 vs. Q1, OR = 0.29, 95% CI: 0.19-0.47, P < 0.001). After adjusting for confounding variables, multivariate analysis revealed that high serum testosterone levels remained significantly associated with a lower risk of CHF (OR: 0.47, 95% CI: 0.27-0.80, P = 0.01). Subgroup analysis indicated a significant association between high serum testosterone levels and reduced CHF risk in individuals over 50 years old. Our findings suggest that the serum testosterone level was positively associated with CHF in adult males. This study highlights the potential role of serum testosterone in cardiovascular health, particularly in older individuals. Further research is needed to elucidate the underlying mechanisms and explore the clinical implications of these findings.

Low libido despite high normal testosterone levels in a male with an FSH-secreting pituitary macroadenoma.

Functioning gonadotroph adenomas with clinical manifestations are extremely rare and the majority of these are FSH-secreting macroadenomas. Clinical symptoms are due to excess gonadotrophins and sex hormones, and these may be present for a long time before the diagnosis of pituitary adenoma is made. We present the case of a 37-year-old Caucasian male with clinical manifestations of an FSH-secreting pituitary macroadenoma. He had sexual dysfunction for a year followed by bilateral testicular pain and enlargement which was initially treated as suspected recurrent epididymitis, but his symptoms did not resolve. He presented a year later with headaches and bilateral superior temporal visual field defects. Brain imaging confirmed a pituitary macroadenoma with optic chiasm compression. Pituitary profile demonstrated an unusually high FSH with high normal LH and normal testosterone level. The patient successfully underwent transsphenoidal hypophysectomy and histology confirmed gonadotroph differentiation and immunoreactivity predominantly with FSH. Gonadotrophin levels and testosterone dropped significantly after surgery, and he was started on testosterone replacement. MR imaging, 2 years post surgery, showed no recurrence of pituitary adenoma. In conclusion, testicular enlargement and hypogonadal symptoms associated with low testosterone levels are recognised features in FSH-secreting pituitary adenomas. Our patient had hypogonadal symptoms but consistently high normal testosterone levels prior to surgery. The reason for low libido despite high testosterone is unclear. Our case highlights the need to suspect such rare underlying pituitary pathology when dealing with unusual combinations of hypogonadal symptoms, testicular enlargement with low or normal testosterone levels. Functioning pituitary adenomas that secrete excess follicle-stimulating hormone (FSH) are very rare and often present with symptoms related to pituitary mass effect. Testicular enlargement alongside sexual dysfunction are commonly reported symptoms amongst male patients. Pituitary profile results demonstrate a raised FSH level with either a low, normal, or even high testosterone level which may not always correlate to clinical symptoms. Pituitary pathology should be considered in males presenting with unusual combinations of testicular enlargement and hypogonadal symptoms even with normal testosterone levels.

Systemic Sirtuin 1 as a Potential Target to Mediate Interactions Between Body Fat and Testosterone Concentration in Master Athletes.

Evidence indicates that master athletes have higher concentration of Sirtuin 1 (Sirt1), lower body fat (BF), and greater activity of the hypothalamic-pituitary-gonadal axis in comparison to untrained peers. However, no published data have demonstrated possible mediation effect of Sirt1 in the interaction of BF and testosterone in this population. Therefore, this study compared and verified possible associations between Sirt1, BF, fat mass index (FMI), testosterone, luteinizing hormone (LH), and testosterone/luteinizing hormone (T/LH) ratio in middle-aged master athletes (n = 54; 51.22 ± 7.76years) and control middle-aged peers (n = 21; 47.76 ± 8.47years). Venous blood was collected for testosterone, LH, and Sirt1. BF was assessed through skinfold protocol. Although LH concentration did not differ between groups, master athletes presented higher concentration of Sirt1, testosterone, and T/LH ratio, and lower BF and FMI in relation to age-matched nonathletes. Moreover, Sirt1 correlated positively with testosterone and T/LH ratio, negatively with BF, and was not significantly correlated with LH (mediation analysis revealed the effect of BF on testosterone is mediated by Sirt1 and vice versa; R2 = .1776; p = .032). In conclusion, master athletes have higher testosterone, T/LH ratio, and Sirt1, and lower BF and FMI in relation to untrained peers. Furthermore, Sirt1 was negatively associated with BF and positively associated with testosterone and T/LH ratio. These findings suggest that increased circulating Sirt1, possibly due to the master athlete's training regimens and lifestyle, exhibits a potential mediation effect on the interaction between endocrine function and body composition.

Impact of testosterone levels and testosterone replacement ther-apy on men’s health

Various studies have shown that testosterone levels heavily impact many areas of a man’s health. Low serum testosterone (and, by analogy, late onset hypogonadism) may be responsible for such conditions as type 2 diabetes, obesity in abdominal area, and most of all, heightened cardiovascular risk (CV). Among other outcomes researchers have pointed out metabolic syndrome and dyslipidemia, as well as increased risk of anxiety disorders and major depressive disorder. There have also been reports of testosterone’s influence on fertility, bone mineral density and the development of polycythemia. All of these effects can be linked to the increased levels of inflammatory markers caused by low testosterone and lead to higher risk of premature death. Overly high testosterone, however, has been proven to have a notable influence on men’s personality, as well as other psychological and social traits, both in endogenously elevated testosterone level, and in patients with history of anabolic- androgenic steroid use. The last decade’s research of testosterone’s impact on the organism has brought contradictory results. Therefore, examination and understanding of the influence of its abnormal levels proves important to not only guarantee the best quality of hypogonadism treatment, but also to efficiently prevent any side effects or complications associated with testosterone use.

Rare ovarian tumor in post hysterectomized status: case report

Ovarian tumors are known for their silent nature, non-availability of definitive screening methods and varied clinico pathological variations. Conservation of normal looking ovaries macroscopically during hysterectomy is recommended to benefit the future health of the woman. Still the development of new issues related to ovaries need to be counseled to the patient and stringent vigilance by the clinician is mandatory. Steroid cell tumor is rare ovarian tumor and histopathology is the gold standard for diagnosis. Any patient with high testosterone levels should be investigated meticulously to define the origin adrenal/ovarian with an awareness about this rare entity with malignant potential. Lifetime follow up of the ovaries in women are crucial at all ages. Here we report a case of rare ovarian tumor in post hysterectomized patient.