Male Age Research Articles

Associations of age and sex with characteristics of extracellular vesicles and protein-enriched fractions of blood plasma.

Extracellular vesicles (EVs) are nanosized particles that are released by various cell types and play vital roles in intercellular communication. They carry biological molecules reflecting the physiological and pathological states of their source cells and tissues, showing potential as biomarkers. However, the impact of demographic factors like age and sex on the properties of blood plasma EVs remains underexplored. This study aims to fill this gap by evaluating how these factors influence the particle count and proteomic profiles of plasma EV preparations and corresponding protein fractions. Plasma samples from 120 healthy volunteers were collected and pooled into six groups: young males (age: 27.6 ± 4.0), young females (27.4 ± 3.8), middle-aged males (48.8 ± 3.8), middle-aged females (48.9 ± 3.9), old males (69.3 ± 3.9), and old females (69.4 ± 4.3). EV- and protein-enriched fractions were separated by size-exclusion chromatography (SEC). Fractions were characterized for particle number concentration and protein composition to identify characteristics affected by age and biological sex. Plasma EVs and corresponding protein fractions exhibited distinct characteristics, with differential enrichment of markers related to EVs and other blood components, including lipoproteins. Proteomic profiles of both EVs and protein fractions displayed sex- and age-dependent differences. Differentially abundant proteins displayed functions previously identified in the context of aging and sex differences, highlighting their utility as biomarkers. Age and sex significantly affect the characteristics of plasma EVs and proteins, potentially influencing their efficacy and interpretation as biomarkers in clinical applications. This study lays the groundwork for detailed mechanistic research to understand how EVs mediate age- and sex-related effects in health.

Assessment of Adverse Effects Associated with Antipsychotics in Patients with Schizophrenia

Schizophrenia causes major disruptions in a person's life, making it challenging to go to work or school, maintain a routine, interact with others, finish daily duties, or take care of oneself. This study aimed to assess adverse effects of antipsychotics in patients with schizophrenia. This study is relevant in identifying the side effects and improving the treatment options which HELPs reducing side effects and improved quality of life of patients. Antipsychotic drugs can lessen or alleviate psychotic symptoms like delusions and hallucinations. Antipsychotic medications can have side effects that range from being mildly unpleasant to extremely unpleasant. A total of 42 patients complying the inclusion criteria were included in the study among which The majority were in the age group of 35-44 and with male gender dominanc. The study observed no significant relationship between the occurrence of the side effects and age but found to have a significant relation between weight gain and male gender. The drug which was most prescribed was Risperidone, followed by Olanzapine. From this study it was evident that, side effects such as akathisia, tremors, insomnia, weight gain, dizziness, weight gain etc was due to second generation antipsychotics from usage over a longer period of time. This study observed that male age groups were more prone to get weight gain as side effect while taking second generation side effects. While no significant comparison with age was found. The study concluded that adverse effect can be attenuated by alternating the drugs instead of long term usage.

8377 Associations of Serum Testosterone and Sex Hormone-Binding Globulin with Incident Fractures in Middle-Aged to Older Men

Abstract Disclosure: L. Grahnemo: None. R.J. Marriott: None. K. Murray: None. L. Tyack: None. M. Nethander: None. A.M. Matsumoto: None. E.S. Orwoll: None. D. Vanderschueren: None. B.B. Yeap: None. C. Ohlsson: None. As men age, their circulating testosterone (T) decreases, circulating sex-hormone binding globulin (SHBG) increases, and risk of bone fracture increases. Unexpectedly, a recent large clinical trial reported that T treatment increased fracture risk in men. It is unclear if circulating T, independently of comorbidities, is associated with male fracture risk. We tested the hypothesis that serum T concentration is an independent risk predictor for incident bone fractures in men. We analyzed associations for T and SHBG with incident fractures in the large and well-characterized UK Biobank cohort (205,973 male participants median age 58 years, excluding men on androgen-related therapies). Baseline serum total T and SHBG were measured by immunoassay, and incident fractures documented over a median follow-up of 13.6 years (11,088 any fracture cases; 1,680 hip fracture cases; 1,366 forearm fracture cases). Associations of hormonal variables with fracture outcomes were modelled using Cox regression, adjusted for multiple comorbidities/covariates, with imputation for missing data, and non-linearity assessed using cubic splines. For total T, in multivariable models not including SHBG, there was a non-linear association with any fracture and hip fractures but not forearm fractures, with the lowest risk in the second quintile (Q2; hazard ratio (HR), 95% confidence intervals (CIs) Q2 vs Q5 any fracture 0.89, 0.84-0.94; hip fracture 0.76, 0.66-0.87; forearm fracture 0.97, 0.83-1.13). However, in multivariable models analyzing total T which were adjusted for SHBG, lower total T was associated with higher risk for fractures at all evaluated bone sites (HR, 95% CIs Q1 vs Q5 any fracture 1.24, 1.16-1.33; hip fracture 1.28, 1.08-1.51; forearm fracture 1.51, 1.25-1.82). Similar results were seen in multivariable models using calculated free T values. Lower SHBG concentration was associated with lower risk of any fracture, hip fractures, and forearm fractures, in multivariable models not including total T (HR, 95% CIs Q1 vs Q5, any fracture 0.71, 0.67-0.75; hip fracture 0.55, 0.47-0.65; forearm fracture 0.62, 0.52-0.74), with similar results following additional adjustment for total T. In conclusion, associations of total T concentrations with fracture risk without adjustment for SHBG are non-linear and inconsistent, whereas lower total T concentration, adjusted for SHBG, was independently associated with higher risks of any fracture, hip fractures, and forearm fractures. Lower circulating SHBG, without or with adjustment for total T, was strongly associated with lower risk of fractures at all three sites, consistent with SHBG being a major independent biomarker of fracture risk in men. When examining the relationship of endogenous T concentrations with health outcomes influenced by androgen-sensitive tissues in middle-aged to older men, both total T and SHBG concentrations should be assessed. Presentation: 6/2/2024

6681 Age and Sex Disparity in NASH and the Potential Role of Estradiol Treatment for NASH

Abstract Disclosure: M. Tripathi: None. S. Sakthivel: None. A. Suzuki: None. B.K. Singh: None. P.M. Yen: None. Introduction: NAFLD (nonalcoholic fatty liver disease) and its more severe form, NASH (nonalcoholic steatohepatitis) are sexually dimorphic conditions that exhibit higher prevalence in men than women during reproductive ages but have similar prevalence after menopause. Reproductive age women are protected from hepatic fibrosis relative to men, although they lose this protection after menopause. These sex differences in NASH have been attributed, at least partly, to different circulating estrogen levels. However, the underlying mechanism(s) is not fully understood. We thus conducted animal experiments to investigate: 1) sex differences in the histologic severity of NASH, necroinflammatory and fibrogenic activities, and other relevant pathways in young and old male and female mice and 2) the effects of estradiol administration on these parameters in old male and female mice to evaluate the therapeutic potential of estradiol in NASH. Methodology: Young/reproductive age (12-weeks old) and old/post-reproductive age female and male (48∼50-weeks weeks old) C57BL/6J mice were fed control chow diet (NCD) or high-fat methionine/choline-deficient (MCD) diet for six weeks to induce NASH. The old mice were administered 200nM 17β-estradiol (physiological) in drinking water. We analyzed serum and hepatic NASH parameters, ER stress, and lysosome-autophagy defects. Results and Conclusion: Among reproductive age mice with NASH, females developed less severe histologic inflammation and fibrosis and decreased gene expression of Il1b, Il6, Tgfb, Col1a1, Ccl2, and Ccl5, and lower hepatic collagen than males. Females with NASH also had less inhibition of hepatic autophagy and lysosomal protein expression than males with NASH. Among old mice, post-reproductive age females fed NCD or MCD exhibited more severe hepatic inflammation and fibrosis and had higher gene expression of inflammatory and fibrogenic markers with comparable autophagic inhibition and lysosomal defects as similar age males. Physiological doses of estradiol significantly reduced hepatic gene expression of inflammatory and fibrogenic markers, ER stress and lysosomal-autophagic defects in post-reproductive age females. In conclusion, similar to clinical NASH, we observed marked sex and age-related differences in the severity of NASH. Furthermore, physiological doses of estradiol treatment improved the hepatic histology, lysosome-autophagy, inflammation, and fibrosis in post-reproductive age female mice with NASH and suggests that estradiol supplementation may decrease or reverse NASH progression in post-menopausal women with NASH. Presentation: 6/2/2024

A maternal germline mutator phenotype in a family affected by heritable colorectal cancer.

Variation in DNA repair genes can increase cancer risk by elevating the rate of oncogenic mutation. Defects in one such gene, MUTYH, are known to elevate the incidence of colorectal cancer in a recessive Mendelian manner. Recent evidence has also linked MUTYH to a mutator phenotype affecting normal somatic cells as well as the female germline. Here, we use whole genome sequencing to measure germline de novo mutation rates in a large extended family containing both mothers and fathers who are affected by pathogenic MUTYH variation. By developing novel methodology that uses siblings as "surrogate parents" to identify de novo mutations, we were able to include mutation data from several children whose parents were unavailable for sequencing. In the children of mothers affected by the pathogenic MUTYH genotype p.Y179C/V234M, we identify an elevation of the C>A mutation rate that is weaker than mutator effects previously reported to be caused by other pathogenic MUTYH genotypes, suggesting that mutation rates in normal tissues may be useful for classifying cancer-associated variation along a continuum of severity. Surprisingly, we detect no significant elevation of the C>A mutation rate in children born to a father with the same MUTYH genotype, and we similarly find that the mutator effect of the mouse homolog Mutyh appears to be localized to embryonic development, not the spermatocytes. Our results suggest that maternal MUTYH variants can cause germline mutations by attenuating the repair of oxidative DNA damage in the early embryo.

Global and Regional Burden of Vaccine-Associated Erythema Multiforme and their Related Vaccines, 1967-2023: An In-Depth Analysis of the World Health Organization Pharmacovigilance Database.

Vaccine-associated erythema multiforme (EM) remains under-researched, impacting global vaccine safety evaluations. This study examines the global and regional burden of EM and its association with specific vaccines to optimize vaccination strategies. We analyzed data from the WHO pharmacovigilance database on vaccine-associated EM from 1967 to 2023 (n=131,255,418 reports). Reporting frequencies, reported odds ratios (ROR), and information components (IC) were calculated for 16 vaccines across 170 countries. We identified 6,355 cases (males, n=3,182 [50.07%]) of vaccine-associated EM from a total of 46,378 reports of all-cause EM. While vaccine-associated EM has been consistently reported, there has been a notable increase in reported incidence particularly in 2010 and 2020. Measles, mumps, and rubella vaccines had the highest association with vaccine-associated EM reports (ROR, 8.75 [95% confidence interval (CI), 8.11-9.44]; IC, 3.10 [IC0.25, 2.97]), followed by hepatitis B (8.54 [7.66-9.51]; 3.06 [2.88]), hepatitis A (8.11 [7.01-9.39]; 2.98 [2.74]), typhoid (6.50 [4.75-8.90]; 2.60 [2.07]), encephalitis (5.86 [4.35-7.91]; 2.47 [1.96]), diphtheria, tetanus toxoids, pertussis, polio, and Hemophilus influenza type b (5.70 [5.42-5.99]; 2.46 [2.38]), pneumococcal (5.56 [5.11-6.06]; 2.45 [2.31]), rotavirus (4.96 [4.21-5.84]; 2.29 [2.01]), varicella-zoster (4.44 [3.99-4.95]; 2.13 [1.95]).Vaccine-associated EM reports were more strongly correlated with younger age groups and males. The overall fatality rate of vaccine-associated EM was 0.04%. The rise in vaccine-associated EM across multiple vaccines, especially in younger populations, highlights the need for closer monitoring and more informed vaccination practices to mitigate adverse reactions.

Do sperm factors influence embryonic aneuploidy? Long live the oocyte.

What is the impact of male age- and sperm-related factors on embryonic aneuploidy? Using a 3-fold analysis framework encompassing patient-level, embryo-level, and matching analysis, we found no clinically significant interactions between male age and sperm quality with embryo ploidy. While the effect of maternal age on embryo chromosomal aneuploidy is well-established, the impact of male age and sperm quality on ploidy is less well-defined. This retrospective cohort study analyzed autologous preimplantation genetic testing for aneuploidy (PGT-A) and frozen embryo transfer cycles from December 2014 to June 2021. The study involved 11087 cycles from 8484 patients, with a total of 35797 embryos. The aneuploidy rate, calculated as the ratio of aneuploid blastocysts to the total number of blastocysts biopsied in a single treatment cycle, was evaluated. In the embryo-level analysis, the main outcome measure was the ploidy state of the embryos. The study employed a multifaceted analytical approach that included a patient-level analysis using generalized linear mixed models, an embryo-level analysis focusing on chromosomal ploidy, and a propensity score matching analysis contrasting groups with distinct ploidy rates (0% and 100%). There were no interventions as this was an observational study of PGT-A cycles. No clinically relevant factors influencing ploidy rate related to male and sperm quality were revealed. In contrast, female age (coefficient = -0.053), BMI (coefficient = 0.003), prior ART cycle (coefficient = -0.066), and number of oocytes retrieved (coefficient = -0.018) were identified at the patient level. Embryo analysis identified age (coefficient = -0.1244) and ICSI usage (coefficient = -0.0129) as significant factors. Despite these, no significant interactions between male and female assessed factors on the ploidy rate emerged. Propensity score matching between maximal (100% vs 0%) euploid rates did not reveal significant differences of influence by male age and sperm quality. The focus on patients having blastocyst biopsy for PGT-A may not reflect the broader IVF population. Other semen quality parameters like DNA fragmentation were not included. Exclusion of embryo mosaicism from the analysis could affect aneuploidy rate interpretations. There may also be unmeasured influences like lifestyle or environmental factors. Male age and sperm quality parameters were consistent across both maximal and minimal ploidy rate comparisons. No significant clinical characteristics related to the factors assessed for the male-influenced blastocyst ploidy status, confirming the dominancy of the oocyte and female age. The study was not funded. There are no competing interests. N/A.

When is prostate cancer really cancer?

Prostate cancer (PC) is a major cause of cancer-related deaths worldwide, with far more diagnoses than deaths annually. Recent discussions have challenged whether Grade Group 1 (GG1) PC should be labeled "cancer" due to its indolent nature. To address this question, an international symposium convened stakeholders from various fields. We summarize key discussion points: autopsy studies reveal GG1 is so common in aging males as to be perhaps a normal aspect of aging. Pure GG1 has no capacity to metastasize. Modern diagnostic pathways focus on detecting higher-grade disease, explicitly omitting biopsy if GG 2 or higher is not suspected, so GG1 has effectively become an "incidentaloma." Recent spatial transcriptomics of prostate sections identifies a continuum of genomic changes-including alterations characteristic of malignancy in histologically normal regions, so the designation of cancer based entirely on conventional pathology findings increasingly seems arbitrary at least to an extent. Pathologists discussed heterogeneity and diagnostic challenges, suggesting "acinar neoplasm" as one possible alternative label. GG1 should not be considered "normal," and absolutely requires ongoing active surveillance; whether patients would adhere to surveillance absent a cancer diagnosis is unknown. Patient perspectives highlighted the adverse effects of overtreatment and the burden of a cancer diagnosis. The anticipated impact on screening and treatment varies across health-care systems, but many believe public health would on balance greatly improve if GG1-along with lesions in other organs with no capacity to cause symptoms or threaten life-were labeled something other than "cancer." Ultimately, our goal is to reduce PC mortality while minimizing harms associated with both overdiagnosis and overtreatment.

Concentration of kidney markers and detection of exosomes in urine samples collected in cotton wool balls in preterm and term neonates

Collecting urine samples in neonates by catheterisation or suprapubic puncture causes trauma, whereas self-adhesive collection bags can damage fragile skin. An alternative method is the collection of samples from urine-soaked cotton wool balls placed in diapers. The aim of this study was to compare the concentration of albumin, creatinine, neutrophil gelatinase-associated lipocalin (NGAL), and uromodulin between clean-catch urine and samples collected in cotton balls in neonates and assess the efficiency of exosome extraction. Standard clean-catch urine samples (SSs) were assayed for albumin, creatinine, NGAL, and uromodulin using commercial ELISA kits. Concentrations were compared to the same urine samples extracted immediately from soaked cotton wool balls (sample 2, S2) or the urine extracted from cotton wool balls placed in diaper in a warm incubator for 2 h before extraction (sample 3, S3). Exosomes were extracted from all three samples of one patient for visualisation by electron microscopy. Twenty-six infants (17 males) of median gestational age at birth of 32+1 weeks had urine collected at a median age of 29 days at 37+6 weeks corrected age. Concentrations in S2 and S3 were within 10% of the concentration of SS in 46% and 35% of specimens for albumin, 69% and 58% for creatinine, 12% and 12% for NGAL, and 27% and 15% for uromodulin, respectively, without consistent positive or negative bias. Urine albumin/creatinine ratios (UACRs) were 4.3% less in S2 and 4.5% less in S3 than in SS. Exosomes were extracted and visualised from all three sample types. Neonatal urine samples extracted from cotton wool balls can be used to screen for relevant albuminuria ​but provide imprecise estimates of NGAL and uromodulin. The proof of exosome extraction from urine collection in cotton wool balls opens the potential to examine exosomal cargo.

Brain natriuretic peptide as a predictor of 30-day mortality after return of spontaneous circulation in cardiac arrest patients

PurposeTo determine the predictive value of brain natriuretic peptide (BNP) levels for 30-day mortality after return of spontaneous circulation (ROSC) in patients with cardiac arrest (CA) of presumed cardiac etiology. MethodsThis retrospective study included 260 patients with CA of presumed cardiac etiology who regained ROSC and was conducted between November 2013 and June 2022 at two tertiary comprehensive hospitals. Cox regression and nomogram models were used to demonstrate the value of BNP level in predicting 30-day mortality rates. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were used to compare the ability of the two models to predict 30-day mortality risk. ResultsBNP level was a predictive factor for 30-day mortality (hazard ratio [HR] = 1.441; 95 % confidence interval [CI] = 1.198–1.734). The area under curves (AUCs) of BNP level alone and model 2 (male sex, age, non-shockable rhythm, epinephrine, and time to ROSC >30 min) for predicting 30-day mortality were similar(0.813 versus 0.834). Model 1 that included the variables in model 2 and BNP level showed good predictive value (area under curve = 0.887; 95 % CI = 0.836–0.939). Compared to Model 2, Model 1 showed improved comprehensive differentiation and net weight classification of mortality prediction, further demonstrating the predictive value of BNP for 30-day mortality (NRI = 0.451, 95 % CI = 0.267–0.577; IDI = 0.109, 95 % CI = 0.035–0.191). ConclusionBNP level was a predictive factor for 30-day mortality after ROSC in patients with CA of presumed cardiac etiology who regained ROSC. The nomogram model included BNP may provide a reference for predicting 30-day mortality.

An evaluation of couples undergoing intrauterine insemination at the BioART Fertility Centre, Johannesburg

Objective: To describe couples who underwent intrauterine insemination (IUI) and determine predictors of successful IUI in low and middle-income countries. Background: Assisted reproductive technology is still largely unavailable or inaccessible in most low and middle-income countries. IUI, which consists of the deposition of processed sperm from the partner or donor into the cavity of the uterus around ovulation time, is one of the oldest methods used and is still widely practiced to this day. Methods: A retrospective descriptive study was done at the BioArt Fertility Centre from January 2019 to June 2021. In total, 451 IUI cycles were analyzed in 273 couples. The main outcome measure was a clinical pregnancy on transvaginal ultrasound 4 weeks post-IUI. Multivariate logistic regression was done to find predictors of successful IUI. Results: The mean male age was 37.15 years (SD ± 5.16), with most male participants having a processed total motile sperm count (PTMSC) of >39×106/mL. The mean female age was 33.51 years (SD ± 4.83). The main etiology of infertility was ovulatory dysfunction (37.7%). The clinical pregnancy rate and the live birth rate per cycle were 12.4% and 11.9%, respectively, for a cumulative pregnancy rate of 21.6% for couples that underwent 3 cycles. The PTMSC, female age, duration of infertility, and follicle size were directly correlated with an increased pregnancy rate (P < 0.05). Conclusion: IUI is an effective choice of therapy for infertility in selected couples, achieving acceptable pregnancy rates for up to 3 treatment cycles, especially in females <40 years with <5 years duration of infertility, and in males with a PTMSC of >39×106/mL.

The rate, causes and predictors of ambulance call outs to residential aged care in the Australian Capital Territory: A retrospective observational cohort study.

Older people in residential aged care are susceptible to acute illness or injury which may necessitate an ambulance call out, assessment/treatment by a paramedic and transfer to a hospital emergency department. Understanding the case mix of residential aged care ambulance attendances is important for prevention strategies and for planning services. A retrospective observational closed cohort study was designed to investigate the characteristics of emergency ambulance call outs to 15 residential aged care sites in the Australian Capital Territory over a 12-month period. Data were collected from the local ambulance service and the aged care sites. Case load data were analysed to determine rates, clinical characteristics, ambulance attendance outcomes and the temporal distribution of call outs. A Poisson regression model was developed to investigate demographic, morbidity and medication-related risk factors associated with the number of ambulance call outs per resident. Annual ambulance call out costs were estimated. There were 1,275 residents, with 396 (31.1%) requiring at least one ambulance call out over 12 months. Of 669 ambulance attendances, the majority (87.0%) were transported to emergency departments. Trauma (23.9%), pain (16.9%) and infections (9.4%) were the most common primary assessments by the ambulance attendees. Cases/day were similar throughout the year and on weekdays compared to weekends/public holidays. The main predictors of ambulance call out were multi-morbidity, taking regular anticholinergic medicines, being male and younger age. Estimated costs of ambulance call outs/year were $475/resident and $40,375/residential aged care site. The most frequent primary assessments (trauma, pain, infections) may constitute priorities for developing prevention strategies and for treatment initiatives within residential aged care. Strategies to reduce anticholinergic medication prescribing may also be a potential intervention to decrease ambulance call outs and hospital emergency department demand. The ambulance usage data from this study may be useful to compare with future datasets to measure the impact of the introduction of new services.

Study of Some Hormonal and Biochemical Parameters among Patients with Chronic Liver Diseases

It has been revealed previously that chronic liver disease (CLD) may be associated to hormonal fluctuations. The current study, therefore, aimed to evaluate some hormones in CLD patients compared with non-CLD individuals. This case control study was conducted at Gastroenterology and Hepatology Teaching Hospital, Medical city, Baghdad, Iraq during December 2021 to May 2022. One hundred and twenty male patients with CLD (age:14-75 years) and 120 control males (age: 24-70 years) were involved in this study. Serum samples were taken from all individuals and were then analysed for many tests which included hormones (Cortisol, testosterone, prolactin, insulin and thyroid stimulating hormone TSH); biochemical analysis (Prothrombin time PT, international normalized ratio INR and albumin); liver enzymes (aspartate aminotransferase AST, alanine aminotransferase ALT, alkaline phosphatase ALP and gamma glutamyl transferase (GGT)) and interleukins (Interleukin 13 IL-13 and transforming growth factor TGF). Some hormones such as cortisol, prolactin and insulin significantly increased in CLD patients while other hormones (testosterone and TSH) significantly decreased in CLD patients compared with the controls. Results also showed significant increase in liver enzymes among CLD patients. These changes in the hormones and liver enzymes levels may be related with significant increase in INR and albumin which were significantly higher in CLD patients than in the control group. Finally, IL-13 increased significantly in CLD patients while no significant differences were noticed between CLD and control regarding TGF levels. It can, therefore, be concluded that hormonal imbalance can affect people with liver conditions. and that this hormonal imbalance may be associated with high levels of liver enzymes.

Suicide Mortality in the United States, 2002-2022.

This report provides final 2022 suicide numbers and age-adjusted rates, updating a provisional 2022 suicide report. Data were analyzed using National Vital Statistics System multiple cause-of-death mortality files for 2002 through 2022, with suicide deaths identified using International Classification of Diseases, 10th Revision underlying cause-of-death codes U03, X60-X84, and Y87.0. Age-adjusted death rates were calculated using the direct method and the 2000 U.S. standard population. Pairwise comparisons were conducted using the z test with an alpha level of 0.05, and trends were assessed using the Joinpoint Regression Program (5.0.2). After increasing from 2002 to 2018, the age-adjusted suicide rate declined from 2018 (14.2 deaths per 100,000 standard population) through 2020 (13.5) but then increased 5%, to 14.2 in 2022. Following a period of decline between 2018 and 2020, suicide rates generally increased between 2020 and 2022 for females ages 25 and older. For males ages 10-14 and 15-24, rates decreased between 2020 and 2022, while rates for older age groups generally increased. For females in 2022, firearm-related suicide (2.0) was the leading means of suicide, with rates generally increasing since 2007. For males in 2022, firearm-related suicide (13.5) was the leading means of suicide, with rates increasing since 2006.

Body Composition, Nutritional Status, and Socio-Demographic Factors Among University Students and Teachers in Bangladesh: A Pilot Study

BackgroundBody composition, particularly visceral fat content, is regarded as an important determinant of major metabolic disorder. People with similar BMI could have differential body fat and muscle composition with different metabolic outcome. Epidemiological research largely focuses on BMI or relative body weight across the range of height and waist hip ratio (WHR) as a index of central body shape; however, body composition has hitherto given little importance in Bangladesh. Therefore, we designed a small pilot cross sectional study to assess anthropometrics, the body composition by bioelectrical impedance and nutritional status and its differences among students and teacher of Islamic University, Bangladesh. MethodsA total of 133 participants (median age of 22.51±3.86 years), students and teachers, were recruited. In addition to BMI and waist-hip ratio (WHR), a body composition analyzer (based on bioelectrical impedance) was used to determine the body composition parameter. Descriptive statistics, chi-square, T test and Pearson correlations were done. ResultsConsiderable differences were observed among various age groups and genders. Most of the respondents had a higher metabolic age (definition) than the chronological age, and 42.86% had high fat percentage. Male had lower body fat (19.56% vs 26.29%) but more visceral fat (4.96% vs 4.32) than female. Visceral fat was significantly (p<0.001) raised in older age groups than younger ones (10.26% vs 4.33%, P<0.05). The cut-off values of BMI were normal in range for both genders, and WHR for male and female were 0.83 and 0.81 respectively. Body protein, muscle, water, moisture, and abio-salt content were higher at the age of 40 years, and female respondents had the lowest ones compared to males. ConclusionUnhealthy visceral fat was higher in male and older age group. A healthy level of all body composition parameters was observed in young age groups compared to the older ones.

When do patients with retinitis pigmentosa present to ophthalmologists? A multi-centre retrospective study.

Planned gene therapies for retinitis pigmentosa (RP) depend on viable photoreceptors for efficacy. Understanding disease severity at presentation, and drivers that influence time to presentation is important when planning interventions. We examined features that influence RP severity at initial presentation. Multi-centre retrospective cohort study of RP patients at initial presentation. Disease severity was scored using ellipsoid zone (EZ) width on SD-OCT and logistic regression used to determine risk factors for advanced disease at presentation. A total of 146 unrelated RP patients were included. Median age at onset and presentation was 40.5 (range 1-74) and 50.1 (range 3.9-81.8), respectively. Severe disease (<5° of remaining EZ width) was present in 28.1% of cases at presentation. Patients with family history of RP had greater odds of severe disease (OR 3.29, 95% CI 1.56, 6.95; p = 0.002), while male gender, race, age, syndromic features, and socioeconomic status did not. Patients with affected siblings (median EZ width 6.2°; p = 0.01), but not affected parents (median EZ width 9.4°; p = 0.99), presented with severe EZ loss compared to patients without family history (median EZ width 13.1°). Patients with affected siblings had delayed presentation (≥5 years; OR 5.76, 95% CI 1.817, 18.262; p = 0.003) compared to patients without family history. Family history influences the stage of disease at which RP patients initially seek ophthalmology review. This has implications for patient counselling and the number of patients who may benefit from future therapies.

Sex-Dependent Effects of Cardiometabolic Health and APOE4 on Brain Age: A Longitudinal Cohort Study.

The aging population is growing faster than all other demographic strata. With older age comes a greater risk of health conditions such as obesity and high blood pressure (BP). These cardiometabolic risk factors (CMRs) exhibit prominent sex differences in midlife and aging, yet their influence on brain health in females vs males is largely unexplored. In this study, we investigated sex differences in relationships between BP, body mass index (BMI), and brain age over time and tested for interactions with APOE ε4 genotype (APOE4), a known genetic risk factor of Alzheimer disease. The sample included participants from 2 United Kingdom-based longitudinal birth cohorts, the Lothian Birth Cohort (1936) and Insight 46 (1946). Participants with MRI data from at least 1 time point were included to evaluate sex differences in associations between CMRs and brain age. The open-access software package brainageR 2.1 was used to estimate brain age for each participant. Linear mixed-effects models were used to assess the relationships between brain age, BMI, BP, and APOE4 status (i.e., carrier vs noncarrier) in males and females over time. The combined sample comprised 1,120 participants (48% female) with a mean age (SD) of 73 (0.72) years in the Lothian Birth Cohort and 71 (0.68) years in Insight 46 at the time point 1 assessment. Approximately 30% of participants were APOE4 carriers. Higher systolic and diastolic BP was significantly associated with older brain age in females only (β = 0.43-0.56, p < 0.05). Among males, higher BMI was associated with older brain age across time points and APOE4 groups (β = 0.72-0.77, p < 0.05). In females, higher BMI was linked to older brain age among APOE4 noncarriers (β = 0.68-0.99, p < 0.05), whereas higher BMI was linked to younger brain age among carriers, particularly at the last time point (β = -1.75, p < 0.05). This study indicates sex-dependent and time-dependent relationships between CMRs, APOE4 status, and brain age. Our findings highlight the necessity of sex-stratified analyses to elucidate the role of CMRs in individual aging trajectories, providing a basis for developing personalized preventive interventions.

2D Shear Wave Elastography of Normal Thyroid Gland in Nepalese Population

Ultrasonography (USG) is modality of choice for normal, diffuse or nodular thyroid diseases. Two dimensional shear wave elastography (2D-SWE) is the latest innovation in USG techniques that allows real-time quantitative assessment of tissue stiffness using acoustic radiation force impulse (ARFI) induced by ultrafast focused US beam sequence (up to 20,000Hz) to record the propagation of the shear waves in real time and displays a map that represents the local elasticity values of tissues in real-time and in a quantitative manner without any compression of the organ. At times, there are difficulties in differentiating normal thyroid gland from diffuse thyroid disease based solely on gray scale USG for which 2D-SWE can be an adjunct. This study aims to establish 2D-SWE parameters for normal thyroid gland in Nepalese population. A cross sectional descriptive study was carried out with 2D SWE on all euthyroid patients with normal thyroid gland on B-mode USG at Department of Radiology, Nepal Medical College Teaching Hospital between December 2021 and November 2022. Tissue stiffness of normal thyroid gland was recorded and tabulated in terms of SMV units (m/s) according age and gender. Out of 100 subjects ( 52 females and 48 males) the youngest was 16 year female and oldest was 68 year female with mean age of 37.07 year (S.D = 11.58). Minimum mean velocity of 1.78 m/s was seen in 36 year old male and maximum of 3.40 m/s in 26 year old female. Mean of mean velocity was 2.36 m/s with (S.D= 0.34). Linear positive correlation was seen between shear wave velocities and age with no statistically significant difference between genders. This study had the most number of normal subjects (100) with almost equal gender distribution (52 females and 48 males) compared to previous studies in known literature. This study also analyzed correlation of shear wave velocity with age unlike other studies. Statistically significant correlation was seen between age and velocities in males only and also in mean velocities between age group 21-40 and 41-60 years (p-value= 0.037).

Effects of Cannabidiol Ingestion on Thermoregulatory and Inflammatory Responses to Treadmill Exercise in the Heat in Recreationally Active Males.

Exertional heat stress can induce systemic endotoxin exposure and a pro-inflammatory cascade, likely impairing thermoregulation. Cannabidiol (CBD) is protective in pre-clinical models of tissue ischaemia and inflammation. Therefore, this study examined the effects of CBD ingestion on exercise-induced thermoregulatory and inflammatory responses. In a randomised, double-blinded study, thirteen active males (age 25 ± 5 y; peak oxygen uptake [V̇O2peak] 50.4 ± 3.2 mL/kg/min) ingested 298 mg CBD or placebo 105 minutes before 1 h treadmill exercise (60-65% V̇O2peak) in 32 °C and 50% relative humidity. Core temperature, skin temperature, heart rate, subjective outcomes and sweat loss were assessed during/after exercise. Plasma osmolality, plasma volume changes and plasma markers of intestinal damage (I-FABP), monocyte activation (CD14) and inflammatory cytokine responses (IL-6, IL-8 and TNF-α) were assessed at baseline, pre-exercise, 20- and 90-min post-exercise. Core temperature (∆ 1.69 ± 0.48 °C [CBD] and 1.79 ± 0.53 °C [Placebo]) and I-FABP increased during exercise, with no differences between conditions (p > 0.050). Mean (95% CI) CD14 was 1776 (463 to 3090) pg/mL greater 90 min post-exercise in placebo (p = 0.049). Median (interquartile range) peak IL-6 concentration was -0.8 (-1.1, -0.3) pg/mL less in CBD (p = 0.050), whilst the between-conditions difference in IL-6 area under curve was -113 (-172, 27) pg/mL·270 min (p = 0.054). CBD did not affect thermoregulation during exertional heat stress but appeared to elicit minor immunosuppressive effects, reducing CD14 and IL-6 responses, warranting investigation in humans under more severe heat strain and other pro-inflammatory scenarios.

Prevalence, Incidence, and Risk Factors of Nephropathy in Patients with Prediabetes: Family History of Diabetes Mellitus Is Not Associated with Increased Risk of Nephropathy

Background: Nephropathy, a vascular complication of hyperglycemia in patients with diabetes mellitus (DM) and prediabetes, is the leading cause of chronic kidney disease. Objectives: This study aimed to investigate the incidence and prevalence of nephropathy and its risk factors in patients with prediabetes, with a particular focus on exploring the association between a family history (FH) of DM and nephropathy. Methods: In this retrospective study, we examined the medical records of 819 patients with prediabetes referred to the Isfahan Endocrine and Metabolism Research Center in 2004. We compared the prevalence of nephropathy in 2019 to baseline levels and assessed factors such as FH of DM in first-degree relatives and other nephropathy-related factors among patients with and without nephropathy. Results: The prevalence of nephropathy increased from 39% to 60.6% over 15 years, with a cumulative incidence of 21.6% and a mean annual incidence of 2.4%. There were differences in diastolic and systolic blood pressure, lipid markers, fasting and postprandial glucose levels, and glomerular filtration rate between patients with and without nephropathy; however, these differences were not statistically significant (P-value ≥ 0.05). Male sex (Odds ratio [OR]: 1.8), age (OR: 1.02), and Body Mass Index (BMI) (OR: 1.05) were significantly associated with nephropathy (P-value &lt; 0.05). No significant association was found between a positive FH of DM and nephropathy (P-value = 0.638). Conclusions: Our findings indicate that a FH of DM is not associated with an increased risk of nephropathy in patients with prediabetes. Instead, sex, age, and BMI play a more significant role. Therefore, these factors may be more critical in guiding preventive and treatment measures.