Mean Serum Testosterone Research Articles

Hypogonadal obese men with and without diabetes mellitus type 2 lose weight and show improvement in cardiovascular risk factors when treated with testosterone: An observational study

Treatment of obesity with diet and exercise may have short-term success but longer-term maintenance of weight loss is less successful. Obesity is associated with a reduction of serum testosterone, and, vice versa, a reduction in serum testosterone is associated with obesity and features of the metabolic syndrome. To investigate whether restoring serum testosterone to normal in hypo-gonadal obese men is beneficial with regard to weight loss and improvement of the metabolic syndrome. A prospective registry accumulated to 181 men over five years (mean serum testosterone 10.06±1.3 nmol/L (N>12.1), body mass index (BMI) ≥30 kg/m2. Of these men, 72 had diabetes mellitus type 2. All received parenteral testosterone undecanoate 1000 mg/12 weeks for up to five years. Waist circumference (cm) decreased from 111.2±7.54 to 100.46±7.1, weight (kg) from 114.71±11.59 to 93.2±8.49, BMI (kg/m2) from 36.72±3.72 to 30.2±2.59 (all variables statistically significant vs. baseline (p<0.0001) and each year compared to the previous year (p<0.0001)). In the 72 diabetic men, waist circumference (cm) decreased from 112.93±7.16 to 101.48±7.24, weight (kg) from 116.94±11.62 to 94.42±9.42, BMI (kg/m2) from 37.71±3.5 to 30.95±2.69 (all variables statistically significant vs. baseline (p<0.0001) and each year compared to the previous year (p<0.0001)). In all men serum glucose, HbA1c, lipid profiles and blood pressure improved significantly. Testosterone treatment as assessed by hemoglobin, hematocrit, serum prostate specific antigen (PSA) and occurrence of prostate cancer was acceptably safe. Normalizing serum testosterone in obese hypogonadal men, also in those with diabetes type 2, improved their metabolic state.

Serum Testosterone Levels and Clinical Outcomes in Male Hemodialysis Patients

Studies linking low serum testosterone concentration to adverse clinical outcomes in hemodialysis patients have been relatively small. We investigated the role of testosterone in adverse outcomes and quality of life in an incident cohort of male Canadian hemodialysis patients. A prospectively designed multicenter observational study using data from the Canadian Kidney Disease Cohort Study (CKDCS). Male patients initiating hemodialysis therapy since February 14, 2005, in 3 Canadian centers serving ethnically diverse populations were studied (N = 623). Serum testosterone levels using the International Society of Andrology, International Society for the Study of the Aging Male, and European Association of Urology cutoffs (low, <231 ng/dL; borderline, 231-346 ng/dL; normal, >346 ng/dL). All-cause mortality, fatal and nonfatal cardiovascular (CV) events, and Health Utility Index (HUI)-assessed health-related quality of life. Participants completed a structured interview on demographics and medical history and an HUI questionnaire (version 3). Routine laboratory test results captured into the study database, and serum testosterone measured within 3 months after initiation of the baseline hemodialysis session. During a median follow-up of 20 (range, 1-81) months, 166 (27%) died and 98 (20%) had a CV event. Mean serum testosterone level was 234.1 ± 146.1 (SD) ng/dL. Higher serum testosterone levels were associated with significantly decreased unadjusted risk of death (HR per 10-ng/dL increase, 0.58; 95% CI, 0.37-0.90). There was a statistically significant trend for higher all-cause mortality with low serum testosterone levels in adjusted analyses (P < 0.001). Higher levels of log-transformed testosterone were associated with significantly higher HUI scores (P for trend<0.001), and low levels of serum testosterone were associated significantly with lower HUI scores (P for trend<0.001). Although there was a significant trend in the unadjusted risk of CV events among participants with low serum testosterone levels (P < 0.001), the risk was no longer significant after adjustment for age. There was no significant interaction with age and serum testosterone level tested as continuous variables (P = 0.07). A short follow-up period and serum testosterone measured on a single occasion. Low serum testosterone concentration may be a modifiable risk factor for adverse outcomes and poor quality of life in male hemodialysis patients. This hypothesis should be tested in randomized controlled trials.

Varicocelectomy Is Associated With Increases in Serum Testosterone Independent of Clinical Grade

To determine whether the varicocele grade is related to the degree of improvement in serum testosterone levels after varicocelectomy. We performed a retrospective review of men with a total serum testosterone level<400 ng/dL who had undergone microsurgical subinguinal varicocelectomy for infertility and/or hypogonadism. All men had clinically palpable left varicoceles and preoperative and postoperative total serum testosterone levels available. For patients with bilateral varicoceles, the greatest grade on either side was used to stratify the patients. The men with an isolated, left-side, grade I varicocele were not offered varicocelectomy. The changes in the testosterone levels were evaluated, with the results expressed as the mean ± standard error. P≤.05 was considered statistically significant. A total of 59 patients had undergone bilateral varicocelectomy and 19 unilateral varicocelectomy. Overall, an increase in testosterone was seen in 65 of the 78 men (83%) in the present study. Themean follow-up was 7 months. The mean serum testosterone level increased from 308.4 to 417.5 ng/dL, with a mean increase of 109.1 ± 12.8 ng/dL (n= 78). The improvements in the serum testosterone levels were seen regardless of the clinical grade. Microsurgical varicocelectomy resulted in significant increases in the serum testosterone level, independent of the varicocele grade.

Variations in circulating sex steroid levels in metastatic prostate cancer patients with combined androgen blockade: observation and implication

Testosterone is the major precursor of estradiol (E2) in men. We hypothesized that, in metastatic prostate cancer, androgen deprivation therapy suppression of serum androgen to the castration level may also disrupt serum E2 level, and variation in serum E2 level might play a role in the development of castration-resistant prostate cancer. Our investigation was designed to observe the variation in circulating oestrogen and androgen levels in metastatic prostate cancer patients after combined androgen blockade, and to explore the possible clinical significance. We recruited 105 consecutive metastatic prostate cancer patients who were treated with combined androgen blockade from June to August 2011, and divided them into three groups according to different hormone-sensitivity status, including 58 hormone-sensitive prostate cancers, 27 after failure of first-line hormone therapy (androgen-independent prostate cancer) and 20 castration-resistant prostate cancers. Another 36 consecutive patients with treatment-naive metastatic prostate cancer during the same period were used as controls. Serum testosterone, E2 and E2/testosterone (E2/T) ratio were analysed and compared between the groups. After combined androgen blockade, testosterone was suppressed to a low level, regardless of different hormone sensitivity (p>0.05). Mean serum testosterone was 4.07, 0.15, 0.11 and 0.09ng/mL in treatment-naive, hormone-sensitive, androgen-independent and castration-resistant prostate cancer respectively. For each group, mean E2 was 33.06, 9.23, 9.13 and 15.05pg/mL respectively. Mean E2/T was 9.58, 269.29, 292.06 and 996.67 respectively. Recovery of E2 and increased E2/T ratio were more significantly associated with combined androgen blockade failure, especially in castration-resistant prostate cancer (p<0.001). This study indicated that metabolism of oestrogen might change during combined androgen blockade in metastatic prostate cancer patients, and oestrogen-related pathways might play a role in the development of castration-resistant prostate cancer.

OP-071 THE ASSOCIATION BETWEEN CORONARY ARTERY ECTASIA AND NEUTROPHIL/LYMPHOCYTE RATIO

and severity of coronary artery disease indicated by Gensini score in middle-aged Turkish men. Methods: Between October 2011 and April 2012, 124 middle aged (40–59) male patients with known or suspected coronary artery disease were included in the study. Coronary angiography was performed in all patients and Gensini score was calculated. Total serum testosterone levels were measured. The relation between serum testosterone levels and Gensini score was studied. Results: The mean age of the patients was 51.76±5.47. The mean Gensini score of the patients was 44.11±39.08. The mean plasma T level was 3.51±1.39ng/ml. There was no correlation between T levels (r = 0.236, p > 0.05) and HDL-C levels (r = 0.081, p > 0.05) and TG levels (r = −0.044, p > 0.05). There was a correlation between serum T levels and TC levels (r = 0.236, p: 0.008), LDL-C levels (r = −0.210, p: 0.019), and body surface area (BSA) (r = −0.286, p: 0.001). When the patients with coronary artery disease (Gensini score ≥1) were compared with control group (n =29, Gensini score: 0), the mean serum testosterone levels were lower (3.37±1.34 vs. 3.97±1.46, p: 0.043). Conclusion: The mean serum testosterone levels were lower in coronary artery disease patients. We failed to document its relation with severity of disease by means of Gensini score. Testosterone administration in patients with lower testosterone levels, but within normal range may be a therapeutic option in coronary artery disease in middle aged men in near future.

Two Innovative Pharmaceutical Forms of Leuprorelin: Results from 818 Patients with Advanced Prostate Cancer

This study set out to examine the efficacy and tolerability of two innovative implant forms of leuprorelin acetate in men with advanced hormone-dependent prostate cancer in everyday clinical practice. Data were collected from 818 patients (from 273 centers across Germany) who were pretreated with slow-release luteinizing hormone-releasing hormone (LHRH) agonist formulations and who were about to be switched to the leuprorelin implants. Patients received three injections of 1- or 3-month leuprorelin implant and physicians were asked to complete a case report form specific to each of the three clinic visits. Documented parameters included laboratory measurements, such as testosterone and prostate-specific antigen (PSA) levels, adverse events, and patient- and physician-rated assessments of the therapy. Compared with baseline, a significant decrease in both testosterone and PSA levels were measured after the first and second injections of leuprorelin implant. These results were confirmed for both the 1-month and 3-month implants in separate analyses. Switching, without treatment interruption, from Trenantone® (Takeda Pharma GmBH, Aachen, Germany) to the leuprorelin implant resulted in a significant decrease in the mean serum testosterone concentrations (P < 0.05) and a nonsignificant increase in the proportion of patients reaching castrate testosterone levels, while the number of patients with PSA values ≤ 4 ng/mL significantly increased (P = 0.045). Similar results were obtained for patients previously treated with goserelin who switched to leuprorelin implant. For 94% of patients, treating physicians rated the efficacy of leuprorelin implant as "very good" or "good." Treatment with leuprorelin implant was well tolerated, with only 61 adverse events reported in 42 (5.1%) patients. Patients and physicians rated the tolerability of leuprorelin implant as "very good" or "good" in 95% and 91% of cases, respectively. These results confirm the efficacy, tolerability, and ease of use of the leuprorelin implants among a large population of men with advanced, hormone-dependent prostate cancer treated in a clinical practice setting.

Effect of noise stress on male rat fertility, and the protective effect of vitamins C and E on its potential effect

ObjectiveTo evaluate the effect of noise on the fertility of male rats, and to assess the effect of vitamins C and E on its potential effect. Materials and methodsForty adult male rats were randomly divided into five equal groups. Group 1 (control) was not exposed to noise. Groups 2–5 were exposed to noise of 90–130dB and 300–350Hz from 19.00 to 07.00h every day for 50days; group 2 received vitamin C and group 3 received vitamin E. Group 4 received vitamins C and E concomitantly and group 5 received no vitamins. After 50days, the serum levels of follicle-stimulating hormone (FSH), luteinising hormone (LH) and testosterone were measured. Each rat was then left for 1week with three female rats, for mating. Pregnant females were killed humanely after 19days of pregnancy and evaluated for the presence and number of viable, dead and absorbed fetuses. ResultsThe mean serum FSH level was statistically significantly different between the control and groups 2 (P<0.05) and 5 (P<0.001). The mean serum LH level differed significantly between the control and groups 2 (P=0.05), 3 (P<0.05) and 5 (P<0.001). The mean serum testosterone level was significantly different between the control and group 5 (P<0.001). Serum FSH, LH and testosterone levels in group 5 were significantly different from all the others (P<0.001). The pregnancy rates in females mated with groups 1 and 5 were statistically different (P<0.05). Comparing groups 1–4, there was no difference in the occurrence of abnormal pregnancy (P>0.05), but group 5 values were significantly different from the others (P<0.001). ConclusionThese data strongly suggest that noise stress has a significant effect on the fertility of male rats.

Evaluation of an Aqueous-Ethanolic Extract from Rosmarinus officinalis (Rosemary) for its Activity on the Hormonal and Cellular Function of Testes in Adult Male Rat.

Rosmarinus officinalis has been used in traditional medicine extensively. This study evaluated the hormonal and cellular effects of Rosmarinus officinalis extract on testes of adult rats. Thirty male Wistar rats (in three groups) received 50 or 100 mg/Kg b.w of Rosmarinus officinalis extract (made from the plant's leaves, flower and stem) (treatment groups) and 10 mL/Kg b.w normal saline (control group) respectively, on a daily bases by gavage route for 60 days. Then, spermatological properties, histometric parameters and sperm dynamics, testis and body weight, testicular cell population and serum testosterone level were analyzed by an acceptable method. Results showed that the mean serum testosterone level was decreased significantly in both treatment groups (50 and 100 mg/Kg b.w) during the experiment time, compared with control group (p < 0.05). However, Rosmarinus officinalis did not change the total count, motility and viability of sperm. In addition, Rosmarinus officinalis at both doses did not change body and testes weight and their ratio. Furthermore, Rosmarinus officinalis increased the number of Spermatogonia at both doses, Spermatocyte at doses of 50 mg/Kg b.w, Leydig cell and Spermatid at dose of 100 mg/Kg b.w significantly (p < 0.05). Rosmarinus officinalis did not significantly affect the number of Spermatozoid and Sertoli cells. In conclusion, it seems that Rosmarinus officinalis may have some hormonal and cellular effects on the testes which can contribute the spermatogenesis process in rat. Rosmarinus officinalis may have antiandrogenic effect potentially indicating the possibility of developing herbal male contraceptive.

Serum total testosterone level and identification of late-onset hypogonadism: a community-based study.

PurposeLate-onset hypogonadism (LOH) in aging males is a clinical and biochemical syndrome characterized by a decline in serum testosterone levels. LOH results in various physical and mental disabilities. We evaluated the relationship between serum testosterone levels and symptoms of LOH.Materials and MethodsDuring an andropause screening program, we examined responses to the Saint Louis university androgen deficiency in aging males (ADAM) questionnaire and results on the International Index of Erectile Function (IIEF-5) in terms of clinical symptoms and evaluated serum total testosterone levels for a biochemical diagnosis of LOH in healthy community-living volunteers aged over 40 years.ResultsThe mean age of the 534 men was 59.1 years (range, 40 to 79 years), and their mean serum testosterone level was 464.1±171.9 ng/dL. The serum testosterone level decreased significantly with age. There was a 92.5% positive response rate to the ADAM questionnaire. The percentage of patients whose serum testosterone level was <350 ng/dL among those with a positive response to the ADAM questionnaire was 25.6% (137 patients). The mean serum testosterone level among patients with a positive or negative ADAM questionnaire was 472.4±198.5 ng/dL and 487.3±165.7 ng/dL, respectively (p>0.05). There was no significant correlation between IIEF-5 scores and serum testosterone levels.ConclusionsAmong men over 40 years of age, 25.6% met the clinical and biochemical diagnostic criteria for LOH. There was no relationship between serum testosterone levels and symptoms of LOH.

Can Subepididymal Orchiectomy Re-emerge as the Treatment of Choice in Patients with Advanced Prostatic Carcinoma?

To study the effectiveness of bilateral subepididymal orchiectomy compared to bilateral simple and subcapsular orchiectomy in terms of androgen ablation, control of disease progression and esthetic superiority. 114 patients of advanced prostatic carcinoma (T3, T4, M1) were randomized to 3 groups- Group A: bilateral simple orchiectomy (38 patients), Group B: bilateral subcapsular orchiectomy (38 patients), & Group C: bilateral subepididymal orchiectomy (38 patients). Serum PSA and serum testosterone values were checked pre-operatively and at 3months follow-up. Patients' esthetic satisfaction was scored on a quality of life scale of 1-5. In Groups A, B and C, at 3months the post-operative mean serum testosterone values were 34.7, 38.1 and 36.7ng/dl (p = 0.0524); and mean serum PSA values were 4.2, 3.9 and 3.4ng/ml (p = 0.09) respectively, the differences not being statistically significant. On esthetic satisfaction scale the average scores were 1.8, 2.7 and 4.0 respectively, the difference being highly significant (p < 0.0001). Subepididymal orchiectomy maintains esthetic appearance of scrotum and provides superior patient satisfaction as compared to standard total and subcapsular orchiectomy, while achieving equal efficacy. Bilateral sub-epididymal orchiectomy may thus be considered procedure of choice to achieve androgen ablation in advanced prostatic carcinoma.

The impact of serum FSH and estradiol on postmenopausal osteoporosis related to time since menopause

Aim: To determine the impact on osteopenia/osteoporosis of serum follicle-stimulating hormone (FSH), estradiol levels and time since menopause in a group of Turkish postmenopausal women. Methods: Four hundred and thirty-three healthy postmenopausal women seen at the Marmara University Menopause Outpatient Clinic were enrolled for this prospective cohort study. The women were allocated to one of three groups according to the bone mineral density (BMD) of the lumbar vertebrae and total hip, as measured by dual energy X-ray absorptiometry (DEXA). Serum FSH, estradiol levels, age and time since menopause were compared between the groups. Results: The mean serum FSH, LH, estradiol and testosterone levels for women with normal, osteopenic and osteoporotic BMD at lumbar vertrebra L1-L4 and total hip were comparable. Time since menopause had a stronger predictive value for low BMD (osteopenia or osteoporosis) in the lumbar and hip areas than did serum FSH or estradiol levels. Conclusions: Our study showed that neither FSH nor E2 has a strong impact on postmenopausal BMD. However it appears that time since menopause has a weak non-significant association with postmenopausal osteopenia and osteoporosis.

Evaluation of ovarian reserve after laparoscopic surgery in patients with polycystic ovary syndrome.

Ovarian reserve depends on the size and quality of oocytes stored in ovary. Aging and some diseases reduce ovarian reserve, leading to decreased reproductive performance. Laparoscopic surgery is used to treat infertility in women with PCOS. The purpose of this study was measurement of ovarian reserve in patients with PCOS before and after laparoscopic surgery. In this study thirty infertile patients with PCOS that had not responded to initial treatment with drug were selected. We assessed the serum levels of anti-mullerian hormone, testosterone, luteinizing hormone (LH), and the number of antral follicles before laparoscopic surgery and 1 week, 3 and 6 months after the surgery. The average amount of anti-mullerian hormone serum levels was 8.4±4.7 before laparoscopic surgery and 7.5±4.5, 7±4.5, and 7.7±4.4 ng/ml one week, 3 and 6 months after surgery, respectively. Serum levels of LH was 13.6±6.7 and 12.7±11.1 IU /ml (P=0.87) before surgery and 6 months after laparoscopy, respectively. Mean serum testosterone levels were 0.9±0.8, 0.8±0.9 ng/ml (P=0.86) before and after surgery. Annual reproductive rate was 26.7 percent in this population. Laparoscopic ovarian puncture didn't change anti-mullerian hormone serum, testosterone and LH in women with PCOS and hence has no adverse effects on the ovarian reserve.

The long‐term efficacy and safety of a testosterone mucoadhesive buccal tablet in testosterone‐deficient men

What's known on the subject? and What does the study add? Striant® SR is the only available buccal delivery system for testosterone replacement therapy. Previous pharmacokinetic studies have shown that Striant SR effectively produces physiological serum testosterone levels in hypogonadal men. Efficacy and safety data from previously unpublished studies over 2 years of continuous use indicate that Striant SR is effective long term in maintaining serum testosterone within a physiological range, is well tolerated and has a high level of patient acceptance. Striant® sustained-release (SR) is a mucoadhesive buccal tablet (30 mg testosterone, The Urology Company) that adheres to the gum surface in the mouth providing controlled- and sustained-release of testosterone over a 12-h dosing period, offering a unique and rational method of testosterone delivery. Striant SR is indicated for testosterone-replacement therapy (TRT) for male hypogonadism when testosterone deficiency has been confirmed by clinical features and biochemical tests. Pharmacokinetic studies have shown that testosterone is released from Striant SR in a manner similar to the normal daily rhythm of endogenous testosterone secretion, with serum levels rising rapidly after insertion and peak levels reached by the second 12-hourly dose with no accumulation over time. In clinical trials involving hypogonadal men receiving Striant SR for up to 2 years, mean serum testosterone levels have always remained within the normal range. Striant SR is well tolerated, with gum-related disorders (such as irritation, inflammation and gingivitis) and taste perversion being the most commonly reported adverse events, reported by 5.6-16.3% and 3.0-4.1% of patients, respectively. Once patients have become accustomed to it, Striant SR has a high level of patient acceptance. In a long-term study, 90% of patients rated the twice-daily dosing as acceptable, just under half preferred it to other forms of TRT that they have used and 96% found it to be cosmetically acceptable. There is no clinically significant risk of testosterone transfer from Striant SR, as any testosterone that may be present in the saliva when swallowed is subject to extensive first-pass hepatic metabolism. It is pertinent to note that the saliva of eugonadal men contains similar levels of endogenous testosterone. Buccal delivery is particularly suitable where easy and rapid reversal of treatment might be required (such as in late-onset hypogonadism) and where there is a need to avoid the potential for transfer of testosterone to women and young children.

Effects of quetiapine on body mass index and reproductive hormonal levels in male schizophrenic patients

Objective: To asses the effects of quetiapine therapy on body mass index (BMI) and serum level of testosterone, prolactin, follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) in newly diagnosed male schizophrenic patients in comparison to healthy controls. Patients and methods: Thirty male patients with schizophrenia were included in this study. The diagnosis of schizophrenia was made according to DSM-IV criteria of the American Psychiatric Association (APA). Another thirty apparently healthy male individuals were included in the study as a control group. Blood samples were taken initially from patients and controls and assay of serum testosterone, prolactin, FSH, LH, and E2 were done using enzyme –linked fluorescent immunoassay (ELFA) technique by vidas instrument. Later, after 6 months of quetiapine therapy, other blood samples were taken and assay of the same parameters were done. Calculation of BMI was done for the patients and controls using special equation. Results: There was an insignificant difference in the mean BMI, serum testosterone, prolactin, FSH, LH, and E2 levels between patients in the pre-therapy stage group and in both the post-therapy stage group and controls. Conclusion: Chronic quetiapine therapy might be regarded as a safe drug with regard to effects on BMI and serum levels of reproductive hormones in newly diagnosed male schizophrenic patients. Keywords: Schizophrenia, quetiapine, BMI, testosterone, prolactin, FSH, LH, E2.

Seasonal variation in serum testosterone, testicular volume and semen characteristics in coatis (Nasua nasua)

The objective was to characterize seasonal changes in serum testosterone concentration, testicular volume and sperm quantity and quality in captive coatis (Nasua nasua) from Pantanal, MT, Brazil. Sampling was done once monthly for 1 y. Mean (± SEM) serum testosterone concentrations (767.37 ± 216.2 ng/ml) and total and progressive sperm motility (79.6 ± 3.9%; 3.8 ± 0.3, on a scale of 0 to 5) peaked in July. The highest combined testis volume (10.3 ± 0.4 cm3) and sperm concentration (403 million ± 102 sperm/ml) occurred in August, at the peak of the winter breeding season. No seasonal effects on percentages of morphologically normal sperm, acrosome integrity, or live sperm were detected; however, the percentage of secondary sperm defects was higher in the winter. In conclusion, intricate relationships between testosterone concentration, testis volume, semen concentration and total and progressive sperm motility with high levels of breeding activity were observed during the dry season in the winter (June, July, August), followed by a subsequent decline in these activities during the wet season (i.e., summer: December, January, February). There was no seasonal pattern for production of functionally intact and morphologically normal sperm.

Higher serum testosterone is associated with increased risk of advanced hepatitis C–related liver disease in males

Males have strikingly increased risk of advanced liver disease. However, the association between testosterone and risk of hepatitis C virus (HCV)-related advanced liver disease is unknown. We performed a cross-sectional study in male veterans with chronic HCV. Blood samples were obtained to measure total serum testosterone and perform the FibroSURE-ActiTest. Other risk-factor data were obtained through systematic questionnaires (e.g., alcohol), physical measurements (e.g., body mass index), and serological tests (e.g., viral load). The association between total testosterone and risk of advanced hepatic fibrosis (F3 and F3/F4) and inflammatory activity (A3 and A2/3) measured by the FibroSURE-ActiTest was evaluated with logistic regression. A total of 308 eligible study participants were prospectively recruited (mean age: 57; 52% African-American). There were 105 cases with advanced fibrosis and 203 mild fibrosis controls as well as 88 cases with advanced inflammatory activity and 220 mild activity controls. Mean total serum testosterone was significantly higher in advanced fibrosis cases as well as advanced inflammatory activity cases, compared to mild disease controls (6.0 versus 5.3 ng/mL and 5.9 versus 5.4 ng/mL, respectively). We observed a significant 25% increase in advanced fibrosis risk and 15% increase in advanced inflammatory activity risk for each 1-ng/mL increase in total serum testosterone. Total testosterone in the upper tertile was associated with an even greater excess risk of advanced fibrosis than advanced inflammatory activity (odds ratio [OR](adjusted advanced fibrosis) = 3.74; 95% CI: 1.86-6.54 versus OR(adjusted advanced inflammatory activity) = 2.23; 95% CI: 1.07-4.93, respectively). Total serum testosterone is associated with an increased risk of both advanced hepatic fibrosis and advanced hepatic inflammatory activity in HCV-infected men. Testosterone may be important in the pathogenesis of HCV-related advanced liver disease in males.

Effect of surgical repair on testosterone production in infertile men with varicocele: A meta‐analysis

To determine the effect of surgical varicocele repair in improving testicular Leydig cell function as shown by increased testosterone production. Eligible studies were searched in Medline and the Pubmed database, and cross-referenced as of 31 May 2011 using the terms "varicocele,""testosterone" and "surgery." The database search, quality assessment and data extraction were independently carried out by two reviewers. Only studies including patients with testosterone evaluation before and after surgery were considered for the analysis. A systematic review and meta-analysis was carried out for continues variables using random effect models. Out of 125 studies, a total of nine were selected, including 814 patients. The combined analysis showed that mean serum testosterone levels after surgical treatment increased by 97.48 ng/dL (95% confidence interval 43.73-151.22, P=0.0004) compared with preoperative levels. Surgical treatment of varicocele significantly increases testosterone production and improves testicular Leydig cell function.

Serum testosterone levels of HbSS (sickle cell disease) male subjects in Lagos, Nigeria.

BackgroundInfertility is a major problem in sickle cell disease patients, especially in males. In addition to low serum testosterone, other abnormalities involving the accessory sex organs, such as the seminal vesicles and the prostate gland, as well as marked decrease in ejaculate volume may be observed in male HbSS patients. Hence, the need to study the role of sex hormones as a cause of infertility in male HbSS patients.MethodsAn unmatched case-control study was performed using seventy-five consenting subjects from Lagos University Teaching Hospital. These included 47 patients with haemoglobin phenotype SS from the Sickle cell clinic and 28 volunteered medical students and members of staff with haemoglobin phenotype AA. Demographic data were obtained using a self-administered questionnaire. A total of 5 mls of blood was collected from each subject between 9.00 am & 11.am, and assayed for serum testosterone concentration.ResultsThe concentrations of serum testosterone in HbSS patients ranged from 0.2 to 4.3 ng/ml with a mean of 1.28 ± 0.72 ng/ml whilst the values in HbAA controls ranged from 1.2 to 6.9 ng/ml with a mean of 2.63 ± 1.04 ng/ml. Seven (25.0%) of the 28 controls had serum testosterone concentration lower than the quoted reference (normal) range whereas 44 (93.6%) of the 47 HbSS subjects had serum testosterone concentration lower than the reference range.ConclusionOverall, subjects with HbSS have significantly lower mean serum testosterone than HbAA controls.

Anti-apoptotic effects of curcumin on cadmium-induced apoptosis in rat testes

Cadmium (Cd) is one of the environmental pollutants affecting various tissues and organs including testis. The aim of this study was to investigate the anti-apoptotic effects of curcumin (Cur) on Cd-induced apoptosis in rat testes. The rats were randomly allotted into one of three experimental groups: control, Cd treated and Cd treated with Cur; each group contained 10 animals. The control group received 2 ml/day of dimethyl sulfoxide (DMSO). To induce toxicity, Cd (1 mg/kg body weight) was dissolved in normal saline and subcutaneously injected into rats for 4 weeks. The rats in Cur-treated group was given a daily dose of 100 mg/kg of Cur for 4 weeks. To date, no examinations of the anti-apoptotic properties of Cur on Cd-induced apoptosis in rat testes have been reported. The mean seminiferous tubule diameter, mean testicular biopsy score values and serum testosterone levels were significantly decreased in Cd-treated groups were compared to the control group. Furthermore, the Cur-treated animals showed an improved histological appearance and serum testosterone levels in Cd-treated group. Our data indicate a significant reduction in the activity of in situ identification of apoptosis using terminal dUTP nick end-labeling in testis tissues of the Cd-treated group with Cur therapy. The present study showed that Cur treatment protected testes against toxic effects of Cd. We believe that further preclinical research into the utility of Cur may indicate its usefulness as a potential treatment on the spermatogenesis after testicular injury caused by Cd-treated rats.

Penile Growth in Response to Human Chorionic Gonadotropin (hCG) Treatment in Patients with Idiopathic Hypogonadotrophic Hypogonadism

Penile growth is under androgenic control. Human chorionic gonadotropin (hCG) has a stimulatory effect on testicular steroidogenesis and penile growth. The purpose of this study was to evaluate the effect of hCG treatment on the gonadal response and penile growth in male idiopathic hypogonadotrophic hypogonadism (IHH) presenting with micropenis. A total of 20 IHH patients who met the criteria for micropenis were included in this study. hCG (1,500-2,000 IU) was administrated intramuscularly, 3 times per week, for 8 weeks. Basic laboratory and hormonal indexes (including serum testosterone and LH levels), penis length (flaccid and stretched), and testicular volume were measured before and 24 weeks after hCG treatment. The patients' mean age was 18.9 years (range, 12 to 24 years). The mean serum testosterone level was significantly increased after hCG treatment (baseline, 2, 4, 12, and 24 weeks: 0.90±1.35 ng/ml, 1.77±1.31 ng/ml, 3.74±2.24 ng/ml, 5.49±1.70 ng/ml, and 5.58±1.75 ng/ml, respectively; p<0.05). Mean penile length also increased significantly 24 weeks after treatment (flaccid length: from 3.39±1.03 cm to 5.14±1.39 cm; stretched length: from 5.41±1.43 cm to 7.45±1.70 cm; p<0.001). Mean testicular volumes increased significantly as well (left: from 5.45 cc to 6.83 cc; right: from 5.53 cc to 7.03 cc). There were no remarkable adverse effects of the hCG treatment. The hCG treatment increased the serum testosterone level, penile length, and testicular volume in IHH patients. Our results suggest that hCG treatment has a beneficial effect on gonadal function and penile growth in patients with IHH presenting with micropenis.