Serum Free Testosterone Levels Research Articles

ODP418 Late-Onset Hypogonadism Detected in Young Male Patients Suffering From Post COVID-19 Condition

Abstract At least one-third of post COVID-19 patients suffer from various chronic symptoms, defined by WHO as "post COVID-19 condition". However, the pathogenesis of post COVID-19 condition and its clinical course remain unclear. In February 2021, we set up an outpatient clinic specialized for COVID-19 after care (CAC) in Okayama University Hospital in Japan and we have investigated the clinical characteristics of patients with post COVID-19 condition. Our recent study revealed that general fatigue is the most common symptom in the post COVID-19 condition. Direct effects of viruses on each organ and conditions such as post-intensive care syndrome, post-traumatic stress disorder, and myalgic encephalomyelitis / chronic fatigue syndrome have been considered as possible etiologies. Recently, it has been suggested that endocrine disruption including the hypothalamic damage might be involved in the underlying mechanism. In the present study, we focused on male hypogonadism, called late-onset hypogonadism (LOH) syndrome. LOH syndrome causes fatigue and metabolic syndrome in middle-aged males. The aim of this study was to clarify the clinical characteristics of patients with LOH syndrome who visited our CAC outpatient clinic. We retrospectively reviewed medical records of all 39 male patients in whom serum free testosterone (FT) level was measured between February 2021 and November 2021 in our CAC outpatient clinic. As a result, 19 patients (48.7%) met the criteria for LOH syndrome (FT < 8.5 pg/mL; LOH group), and 14 (73.6%) of those patients were under the age of 50 years. A weak negative correlation was found between age and serum FT level (R=-0.301, p=0. 0624). A comparison of the LOH group with the non-LOH group showed that there were no significant differences in the patients’ background factors including age (36. 0 vs. 37.5 years), acute hospitalization (9 patients, 47.4% vs. 5 patients, 25. 0%), and number of days between COVID-19 onset and CAC outpatient clinic visitation (71 vs. 81 days). There were also no significant differences in various laboratory parameters between the two groups. However, symptoms including anxiety, cough and hair loss were more frequent in the LOH group. Compared to the incidence of LOH syndrome in the general population, the present study revealed that there is a relatively high incidence of LOH syndrome in young patients with post COVID-19 condition. Although it is known that gonadal functions are impaired in the acute phase of COVID-19, hypogonadism is also thought to be related to the chronic phase of COVID-19. Leydig cells in the testis may be susceptible to damage by SARS-CoV-2 virus because of the high level of ACE2 receptor expression; however, the underlying mechanisms of LOH syndrome due to post COVID-19 condition have yet to be elucidated. Presentation: No date and time listed

PREVALENCE OF LOW FREE TESTOSTERONE LEVEL IN MEN WITH TYPE 2 DIABETES MELLITUS

Background 
 Prevalence of low serum free testosterone levels in men with type2 diabetes mellitus has been reported worldwide.
 Objectives 
 To find the prevalence of low free testosterone levels in type2 diabetic men.
 Patients and Methods
 A cross-sectional study was carried out in (the Diabetic and Endocrine Center) in Sulaimani from the 5th of April, 2017, to the 3rd of January, 2018. Eighty-eight male patients of type two diabetes mellitus who attended the centre for regular follow-up are included. After taking consent and history from the patient, a questionnaire was taken on Sociodemographic data and diabetic characteristics (duration &type of treatment), body mass index, and statin use. In addition, blood tests, including; free testosterone, were measured from morning samples using the ELISA kit (bioactive diagnostic, free testosterone ELISA kit), blood sugar (fasting), HbA1c, serum cholesterol, and serum triglyceride were done for all patients.
 Results
 There was little relation (correlation coefficient =0.07) (p-value 0.49) between free testosterone and HbA1c% concentration, and serum HbA1c% does not seem to contribute significantly to the free testosterone level variation. Duration of diabetes does not affect free testosterone levels. 
 Conclusion
 The level of free testosterone in type2 diabetic men was average; there was no correlation between serum HbA1c concentration and serum-free testosterone.

Association between serum fructose level and insulin resistance in women with polycystic ovary syndrome: The effect of obesity

Background: Polycystic ovary syndrome (PCOS) women's most prevalent endocrinology condition is a mixture of environmentally and genetically adduced causing PCOS. The relationship between monosaccharide and PCOS is largely unknown. Objective: This research was designed to investigate the relationship between blood levels of fructose, insulin resistance, and androgen hormone in women with PCOS, and the effect of obesity on the obtained result, as well as to study the efficacy of serum fructose as a biomarker in the diagnosis of PCOS. Cases and methods: This case-control research study was conducted at the Gynecology Clinic and Infertility Center, in Baghdad Teaching Hospital / Medical City between November 2021 to March 2022. It involved 120 women between the ages of 18-40 year. Fifty-nine women (cases) were newly diagnosed with PCOS by a gynecologist and 61 age and BMI matched healthy women (controls). PCOS women were subdivided according to their body mass index into four groups: lean, normal weight, overweight and obese. Investigations included serum measurements of fructose, luteinizing hormone (LH), follicular stimulating hormone (FSH), free testosterone, insulin, glucose, and calculated homeostasis model assessment- insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI). Results: The mean ±SD values of serum fructose, glucose, insulin and HOMA-IR were significantly augmented in PCOS women as compared to controls (p< 0.001), while mean value of QUICKI was significantly decreased (p<0.0001). There was a significant positive correlation between BMI values and fructose levels in PCOS women. The result showed that serum fructose and free testosterone levels had the highest sensitivity and specificity in the differentiation between the PCOS group and the controls, with the area under curve values for free testosterone higher than area under curve values for fructose. Conclusions: The fructose level can be used as an alternative biomarker for women with PCOS independent of insulin resistance. The majority of PCOS women are obese and overweight, and a minority are lean who are severely complicated by insulin resistance.

The Association Between Serum Testosterone Levels and Coronary Artery Disease in Men

Background: Death due to coronary artery disease (CAD) is twice higher in men than women, and older men are more susceptible to the disease. Serum testosterone levels decrease with increasing age. Objectives: In this study, we aim to study the association between serum testosterone levels and Gensini scores in men. Methods: This cross-sectional study was conducted on 60 men above 40 years who had undergone coronary angiography. Thirty of them had normal coronary vessels, and 30 had coronary artery disease. For each group, the Gensini score was calculated. Results: Serum testosterone levels in the CAD group and the control group were 4.04 ± 2.56 and 5.59 ± 2.20 ng/mL, respectively (P < 0.05), and free testosterone levels in the CAD patients and the control groups were 7.32 ± 5.24 and 12.91 ± 3.27 pg/mL respectively (P < 0.001). Sex hormone binding globulin (SHBG) levels in the CAD and the control groups were 28.88 ± 15.30 and 38.2 ± 19.9 nmol/mL, respectively (P = 0.04). Univariate analysis showed a significant association between Gensini score and total and free testosterone levels. The receiver operating characteristic curve (ROC) showed that the cut-off point of 7.97 had a sensitivity of 73.3% and specificity of 90% in predicting a high Gensini score (AUC = 0.799, P < 0.001). Conclusions: Findings of our study demonstrated that serum free testosterone levels have a significant correlation with Gensini score and CAD severity.

Association Between the Levels of Serum Free Testosterone and Lifestylerelated Diseases in People Living with HIV.

Recently, male hypogonadism was reported to be prevalent in people living with HIV (PLWH), even in cases diagnosed based on the serum free testosterone level (fTST). However, studies on the management of PLWH showing the relationship between male hypogonadism and lifestyle-associated diseases, are sparse. This study evaluated the relationship between serum fTST levels and lifestyle-related diseases in virologically stable PLWH. This study was a retrospective cohort single-center study. The study included HIVinfected men on antiretroviral therapy, with available data on serum fTST levels at Teikyo University Hospital between June 2020 and September 2020. Clinical information was collected at the time of fTST measurement. A simple regression analysis was used to identify continuous variables significantly associated with serum fTST levels. Student's t-test and Mann-Whitney U test were also used to identify non-continuous variables that were significantly correlated with serum fTST levels. Sixty male patients were evaluated. The median age was 47 (40-62) years. Low serum fTST levels were significantly associated with old age, low hemoglobin and total cholesterol levels, and high hemoglobin A1c levels. Non-use of INSTI and comorbid hypertension were also significantly associated with low serum fTST levels. Hypertension and the serum hemoglobin A1c level as a standard parameter for diabetes was significantly associated with low serum fTST levels in Japanese male PLWH. This study suggested that sex-hormone replacement therapy could be a preferred option for PLWH with low serum fTST levels to manage their long-term complications.

Alterations of Gut Microbiome and Fecal Fatty Acids in Patients With Polycystic Ovary Syndrome in Central China.

ObjectiveThe purpose of this study was to elucidate the characteristics of the gut microbiome in patients with Polycystic ovary syndrome (PCOS) and analyze the alterations of fecal fatty acid metabolism, so as to further provide the pathogenesis of PCOS.MethodsFecal samples from the PCOS group (n = 31) and healthy control group (n = 27) were analyzed by 16S rRNA gene sequencing and untargeted metabolomics. Peripheral venous blood was collected to measure serum inflammation and intestinal permeability. Finally, the correlation analysis of intestinal flora, fecal metabolites, and laboratory indicators was carried out.ResultsSerum D-lactate content in the PCOS group was higher than that in the control group. There was no significant difference in microbial α diversity and β diversity between PCOS patients and healthy controls. Peptostreptococcaceae and Bacteroidales S24-7 group existed significant differences between PCOS patients and healthy controls. Based on linear discriminant analysis selection, 14 genera including Klebsiella, Enterobacteriaceae, and Gammaproteobacteria were dominant in patients with PCOS, while 4 genera, including rumenococcus (Ruminocaccaceae UCG 013), prewortella (Prevotellaceae UCG 001), and erysipelas (Erysipelatoclostridium), were dominant in healthy controls. Compared with PCOS with Body mass index (BMI) < 24, patients with BMI ≥ 24 have multiple dominant genera including Abiotrophia and Peptostreptococcaceae. Moreover, serum levels of free testosterone and androstenedione were positively correlated with Megamonas, while total testosterone was negatively correlated with Alistipes. Additionally, fecal contents of acetic acid and propionic acid in patients with PCOS were significantly higher than those in healthy controls. Eubacterium_coprostanoligenes_group and Alistipes were positively correlated with 6 kinds of fatty acids.ConclusionSpecific intestinal flora fecal fatty acids and serum metabolites may mediate the occurrence and development of PCOS. PCOS patients with different body sizes have specific intestinal flora.

Vitamin D receptor and estrogen receptor gene polymorphisms in men with type 2 diabetes: Effects on Bone Metabolism.

There is an increased fracture risk in type 2 diabetes mellitus [DM] patients independent of bone mineral density [BMD], both in men and women. Estrogen receptor [ER]-alpha and vitamin D receptor [VDR] gene polymorphisms may predispose patients to increased osteoporosis and fracture risk. This study aims to analyze the relationship of the ER-alpha gene and VDR gene polymorphisms with indicators of bone turnover and BMD in male type 2 diabetic patients. Type 2 diabetic men diagnosed with diabetes for at least one year and healthy controls were included in this cross-sectional study. BMD was measured by dual X ray absorptiometry. Gene polymorphisms were evaluated with polymerase chain reaction-restriction length polymorphism. Serum iPTH, calcium, beta-CrossLaps (cTx), osteocalcin, and free testosterone levels were also evaluated. Participants were 141 type 2 diabetic men [55 ± 8 years] and 100 healthy controls [53 ± 7 years]. BMD measurements were not statistically different between the groups. While iPTH [p < 0.05] and serum calcium levels [p = 0.03] were higher in men with type 2 DM; beta-CrossLaps [p = 0.0001], osteocalcin [p = 0.005], and free testosterone [p = 0.04] were lower than controls. The differences in terms of the frequencies of VDR Apa, Taq, Bsm, Fok and ER-alpha polymorphisms were not statistically significant between the groups. No relationship was observed between polymorphisms and BMD in both groups. VDR and ER-alpha gene polymorphisms seem to have no effect on BMD and bone turnover in men with DM.

Clinical outcomes of testosterone replacement therapy in Japanese patients with late onset hypogonadism (LOH) syndrome

ABSTRACT Objectives The Japanese late-onset hypogonadism (LOH) guideline is using serum free testosterone (FT) level for diagnosis of LOH syndrome. On the other hand, the European and American guidelines are using total testosterone level (TT) for diagnosis of LOH syndrome. Serum total testosterone levels below 8 nmol/L (231 ng/dL) require substitution of testosterone in the E.A.U. recommendations. In this study, we compared serum free testosterone level and total testosterone level in patients who visited our LOH syndrome out-patient department. We also investigate clinical outcomes of testosterone replacement therapy (TRT) in patients with LOH syndrome. Material and Methods Two hundred thirty male patients who visited our LOH syndrome out-patient department from January, 2008 to September, 2017 were targeted at this study. The patient's average age was 55.1 years old. Average of AMS score in patients was 51.7 points. Results Only 20 patients (8.7%) were low value (less than 2.31ng/ml) and 86 (37.4%) patients were low and borderline value (less than 3.46ng/ml) in serum total testosterone (TT) level. On the other hand, 99 patients (43.1%) were low values (less than 8.5pg/ml), and also 175 examples (76.1%) were low and borderline value (less than 11.8pg/ml) in serum free testosterone (FT) level. Testosterone replacement therapy (TRT) was carried out for 3 months in 84 patients with patient with LOH syndrome. Sixty nine patients (82.1%) were effective for ART. Only four patients dropped out TRT because of dysuria and plethora. Fifty four patients (83%) with patients who were low value (l less than 8.5pg/ml) in serum free testosterone (FT) were effective for ART in 53 patients. Also 25 patients (80.6༅) who was borderline value (less than 11.8pg/ml) in serum free testosterone (FT) level were effective for TRT in 31 patients. Conclusions Including borderline case, high frequency patient is suited at the diagnostic criteria of LOH syndrome using serum FT value compared to TT value. It might be necessary to also consider measurement of the auxiliary total testosterone, and compensation of the isolation testosterone by age. Testosterone replacement therapy (TRT) was also effective in patients with LOH syndrome not only low value but also borderline value in serum free testosterone (FT). Disclosure Work supported by industry: no.

Relationship between sexual function improvement and treatment satisfaction by TRT in LOH patients

ABSTRACT Introduction In the treatment of LOH (late-onset hypogonadism) syndrome, TRT (testosterone replacement therapy) is effective for various LOH related symptoms including sexual function. However, among Japanese population, sexual desire is not always strong in elderly men. Even if the patients do not have opportunities of sexual intercourse, TRT may still be beneficial for other symptoms derived from LOH syndrome. Objectives To examine patients’ satisfaction by TRT, we examined the relationship between TRT effect on sexual function and whole treatment satisfaction in our patient cohort. Methods Patients who have LOH symptoms and low serum free-testosterone (FT) levels were diagnosed as LOH syndrome. FT was diagnosed as “low” when &amp;lt;8.5pg/ml, while diagnosed as “borderline” when 8.5-11.8pg/ml. For TRT, testosterone enanthate 250mg/2-4weeks was given for more than 6 months. SHIM (Sexual Health Inventory for Men) score and our original questionnaire asking whether they are satisfied with the treatment were examined. Results Median patients’ age was 54 years (n=95). Before treatment, total testosterone was 4.5±1.8ng/ml and free testosterone was 6.2±2.3pg/ml. The majority of chief complaint before treatment were psychological or somatic symptoms. After treatment, SHIM score showed significant improvement in all questions of 1 to 5, and total SHIM score increased from 6.4 to 9.4. The number of patients who have few opportunities for sexual intercourse (0 point for SHIM Q3.4.5) decreased from 66% to 48% after treatment. Using the questionnaire for patients’ satisfaction, 71% were classified into the effective group. The number of patients who still had few opportunities of sexual intercourse after treatment was 39% in the effective group and 71% in the ineffective group. Conclusions From the point of patient satisfaction, TRT for LOH syndrome was effective in 71% of patients. Almost 40 percent of the patients who were satisfied with the treatment answered that there were few opportunities of sexual intercourse even after treatment. The improvement in sexual function may not be always required in a cohort of our patient population. Disclosure Work supported by industry: no.

What is a predictive factor of the efficacy of testosterone replacement for late-onset hypogonadism?

ABSTRACT Introduction Testosterone replacement therapy (TRT) is a worldwide first-choice method of treatment for late-onset hypogonadism (LOH). In the diagnosis of LOH in Japan, we use 8.5 pg/mL of serum free-testosterone (FT) level measured by RIA as a lower limit. Objective The objective of this study is to determine the predictors of the TRT efficacy for LOH. Methods A total of 56 patients who attended our men's health clinic between August 2002 and June 2021 with the data available before and after TRT were enrolled into this study. These patients were divided into responders to TRT (Group 1, n=45, 80%) and non-responders to TRT (Group 2, n=11, 20%) according to clinical response including patient's satisfaction. Evaluated parameters obtained before TRT were following: age, BMI, aging males symptoms scale (AMS), sexual health inventory for men (SHIM), serum luteinizing hormone (LH), follicular stimulating hormone (FSH), testosterone (T), FT, prolactin (PRL), estradiol (E2) and T/E ratio. For statistical analysis, we used a multivariable logistic regression model. Results Univariate analysis revealed PRL (OR 0.96; 95% CI 0.93-0.99, P&amp;lt;0.03), E2 (OR 0.87; 95% CI 0.77-0.98, P&amp;lt;0.02), T/E (OR 1.13; 95% CI 1.01-1.27, P&amp;lt;0.04) as predictive factors. Then we carried out multivariate analyses of these factors and determined T/E ratio as an independent predictive factor (OR 1.16; 95% CI 1.04-1.29, P&amp;lt;0.01). Conclusion This study suggested that low value of T/E ratio might predict the low response to TRT. Although further study with a larger number of patients is necessary, we propose the measurement of serum E2 level as well as testosterone level before TRT. Disclosure Work supported by industry: no.

Effect of mild moxibustion on vascular aging in senescence rats based on local MCP-1/MMP-2/TGF-β1 pro-inflammatory signal loop

To observe the effect of mild moxibustion on monocyte chemotaxis protein 1 (MCP-1)/matrix metalloproteinase 2 (MMP-2)/transforming growth factor β1 (TGF-β1) pro-inflammatory signal loop in senile rats, so as to explore its mechanisms underlying improving vascular aging (VA). Twenty-four male VA SD rats were randomized into senium (VA) control, medication and moxibustion groups, and other 8 young SD rats (aged 2 months) were used as the young control group. The VA model was established by intraperitoneal injection of D-galactose (300 mg·kg-1·d-1) once daily for 4 weeks, and verified by serum total testosterone (TT) and free testosterone (FT) levels. For rats of the moxibustion group, mild moxibustion was applied to bilateral "Shenshu"(BL23) and "Guanyuan"(CV4) for 20 min, once a day, 5 days a week for 8 weeks. Rats of the medication group were treated by intraperitoneal injection of testosterone propionate (7 mg·kg-1·[3 d]-1) once daily for 8 weeks except weekends, and rats of the senium control and young control groups treated by intraperitoneal injection of the same dose of normal saline, once daily for 8 weeks except weekends. The duration of exhausted swimming (DES) before and after the treatment was recorded. H.E. staining and Masson staining were used to observe histopathological changes and collagen fiber content of the thoracic aortic tissue, respectively. The contents of serum TT, FT and angiotensin 2 (Ang Ⅱ) were determined by ELISA. The immunoactivity of aortic MCP-1 was detected by immunohistochemistry, and the expression levels of aortic MCP-1, MMP-2 and TGF-β1 were detected by Western blot. Compared with the young control group, the levels of DES, serum TT and FT contents were significantly decreased (P<0.01), while those of serum AngⅡ and collagen fiber contents, aortic MCP-1 immunoactivity and MMP-2, TGF-β1 and MCP-1 protein expression considerably increased in the senium control group (P<0.01). After the interventions, the decreased levels of DES, serum TT and FT contents and the increased levels of serum AngⅡ, collagen fiber contents, aortic MCP-1 immunoactivity and MMP-2, TGF-β1 and MCP-1 protein expression were reversed in both medication and moxibustion groups (P<0.01, P<0.05). The therapeutic effect of mild moxibustion was significantly superior to that of medication in down-regulating the aortic collagen fiber, serum AngⅡ contents and MCP-1 immunoactivity and protein expression (P<0.05). H.E. staining showed thickened endometrium and disordered arrangement of vascular smooth muscles of the aorta in the senium group, and thinner endometrium and regular and ordered arrangement of aortic vascular smooth muscles in both moxibustion and medication groups. Mild moxibustion may improve vascular aging in senescence rats, which is possibly by suppressing vascular MCP-1/MMP-2/TGF-β1 pro-inflammatory signal loop.

Late-Onset Hypogonadism in a Male Patient with Long COVID Diagnosed by Exclusion of ME/CFS

After the acute phase of COVID-19, some patients have been reported to have persistent symptoms including general fatigue. We have established a COVID-19 aftercare clinic (CAC) to provide care for an increasing number of these patients. Here, we report the case of a 36-year-old man who developed post-COVID fatigue after acute infection with SARS-CoV-2. In the acute phase of COVID-19, the patient’s fever resolved within four days; however, general fatigue persisted for three months, and he visited our CAC 99 days after the initial infection. Examination revealed a high Aging Male’s Symptoms (AMS) score of 44 and low free testosterone (FT) level of 5.5 pg/mL, which meet the Japanese criteria of late-onset hypogonadism (LOH) syndrome. Imaging studies revealed an atrophic pituitary in addition to fatty liver and low bone mineral density. Anterior pituitary function tests showed a low follicle-stimulating hormonelevel and delayed reaction of luteinizing hormone (LH) after gonadotropin-releasing hormone (GnRH) stimulation, indicating the possibility of hypothalamic hypogonadism in addition to primary hypogonadism seen in patients with post-COVID-19 conditions. After the initiation of Japanese traditional medicine (Kampo medicine: hochuekkito followed by juzentaihoto), the patient’s symptoms as well as his AMS score and serum FT level were noticeably improved. Furthermore, follow-up tests of GnRH stimulation revealed improvements in LH responsiveness. Although many patients have been reported to meet the criteria of ME/CFS such as our case, we emphasize the possibility of other underlying pathologies including LOH syndrome. In conclusion, LOH syndrome should be considered a cause of general fatigue in patients with post-COVID-19 conditions and herbal treatment might be effective for long COVID symptoms due to LOH (264 words).

The Relation between the Plasma Level of Testosterone Hormone and the Severity of COVID-19 in Iraqi Patients

Coronavirus disease 2019 discovered in December 2019, Wuhan, China. It was transmitted globally producing the present COVID-19 pandemic. Concerns have been raised about the potential impact of COVID-19 on male reproductive organs and male fertility as the number of infections in the male community has increased. The objectives of current study are studying the relationship between the plasma levels of testosterone and the markers of immune reaction with the severity and mortality in a sample of COVID-19 patients. A cross section study included NO= 103 male patients affected by SARS- CoV-2 pneumonia, diagnosed by PCR and chest CT scan, (≥ 18 years old), and recovered in the respiratory intensive care unit (RICU). Several biochemical risk factors were determined Free Testosterone, sex hormone binding globulin (SHBG) were measured by Enzyme-Linked Immunosorbent Assay(ELISA), D-dimer, Ferritin, CRP, Urea, Creatinine were measured by automated method by using Abbott Architect c4000 and Complete Blood Count(CBC). The results show that the serum free testosterone and SHBG levels a significant lower in non-survivor patients than survivor patients with COVID-19. While the other biomarkers (D-dimer, Ferritin, Urea, Creatinine) were significant higher in non-survivor patients than survivor patients. The CRP, WBC and lymphocyte showed that no significant between the both group of patients. In conclusion the study showed that lower free testosterone and SHBG levels enable significant role in increasing risk of COVID-19 mortality amongst adult male patients

Detection of Male Hypogonadism in Patients with Post COVID-19 Condition.

The pathogenesis and prognosis of post COVID-19 condition have remained unclear. We set up an outpatient clinic specializing in long COVID in February 2021 and we have been investigating post COVID-19 condition. Based on the results of our earlier study showing that “general fatigue” mimicking myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is the most common symptom in long COVID patients, a retrospective analysis was performed for 39 male patients in whom serum free testosterone (FT) levels were measured out of 61 male patients who visited our clinic. We analyzed the medical records of the patients’ backgrounds, symptoms and laboratory results. Among the 39 patients, 19 patients (48.7%) met the criteria for late-onset hypogonadism (LOH; FT < 8.5 pg/mL: LOH group) and 14 patients were under 50 years of age. A weak negative correlation was found between age and serum FT level (r = −0.301, p = 0.0624). Symptoms including general fatigue, anxiety, cough and hair loss were more frequent in the LOH group than in the non-LOH group (FT ≥ 8.5 pg/mL). Among various laboratory parameters, blood hemoglobin level was slightly, but significantly, lower in the LOH group. Serum level of FT was positively correlated with the levels of blood hemoglobin and serum total protein and albumin in the total population, whereas these interrelationships were blurred in the LOH group. Collectively, the results indicate that the incidence of LOH is relatively high in male patients, even young male patients, with post COVID-19 and that serum FT measurement is useful for revealing occult LOH status in patients with long COVID.

Correlation of ovarian volume and clinical and laboratory parameters of PCOS in Korean patients

Background: The aim of this study is to analyze the correlation of ovarian volume and clinical and laboratory parameters of polycystic ovary syndrome (PCOS) in Korean women. Methods: Two hundred and thirty-three patients aged between 20 and 40 years with PCOS diagnosis between January 2014 and June 2020 at Pusan National University Hospital, Busan, Republic of Korea, were included to this retrospective observational study using previously recorded patient medical charts. PCOS was diagnosed according to the revised 2003 Rotterdam criteria. Laboratory tests including anti-mullerian hormone (AMH), prolactin, thyroid stimulating hormone (TSH), follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, free and total testosterone, dehydroepiandrosterone-sulfate (DHEA-S), 17-alpha-hydroxyprogesterone (17-OHP), HbA1C and insulin were conducted. Results: The correlation analysis showed that free testosterone (p = 0.006, r = 0.215), total testosterone (p &lt; 0.001, r = 0.305), 17-OHP (p = 0.008, r = 0.203) and height (p = 0.008, r = 0.173) were statistically correlated with the total ovarian volume in overall PCOS patients. In these patients, serum AMH level was positively correlated with LH but negatively with body weight and body mass index (BMI). Conclusions: According to the results, the ovarian volume, quantified by ultrasonographic measurements, was significantly related to the increasing serum levels of free testosterone, total testosterone and 17-OHP in Korean PCOS patients.

Metabolic Surgery on Patients With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis.

Polycystic ovary syndrome (PCOS) is a complicated reproductive endocrine disease that is closely related to obesity. Metabolic surgery ameliorates a series of clinical manifestations and related comorbidities of PCOS. However, the overall efficacy of metabolic surgery on PCOS remains uncertain. This systematic review and meta-analysis aimed to evaluate the therapeutic effects of metabolic surgery on obese patients with PCOS. A systematic literature search for relevant studies was conducted on PubMed, Embase, Web of Science, and the Cochrane Library from inception to June 2021. Data extraction and quality evaluation were performed by three researchers, and RevMan 5.4 software was used to conduct the meta-analysis. A total of 14 studies involving 501 obese patients with PCOS were included. Incidence of PCOS in obese women ranged from 5.5% to 63.5% among the included studies. The results showed the incidence of abnormal menstruation decreased from 81% to 15% (OR=0.03, 95% confidence interval (CI): 0.01–0.08), while the incidence of hirsutism dropped from 71% to 38% (OR=0.21, 95% CI: 0.06–0.74). Serum total testosterone and free testosterone levels decreased by 25.92 ng/dL (MD = -25.92, 95% CI: -28.90– -22.93) and 2.28 ng/dL (SMD = -2.28, 95% CI: -3.67– -0.89), respectively. Sex hormone-binding globulin (SHBG) levels increased by 26.46 nmol/L (MD = 26.46, 95% CI: 12.97–39.95). Serum anti-Mullerian hormone (AMH) levels decreased by 1.29 ng/mL (MD = -1.29, 95% CI: -1.92– -0.66). Small sample size studies revealed that pregnancy rates ranged from 95.2% to 100% postoperatively. Metabolic surgery contributed to marked improvement of abnormal menstruation, hirsutism, and levels of free testosterone, total testosterone, SHBG, and AMH in patients with PCOS. Our findings indicate that patients with PCOS are expected to benefit from metabolic surgery, and could help potentially improve their reproductive outcomes. Metabolic surgery could thus be a new viable option for the clinical treatment of PCOS.Systematic Review RegistrationPROSPERO https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42021251524.

Abstract P139: Changes In Sex Hormones In Premenopausal Black And White Women Associated With Childbearing: The Cardia Women’s Study.

Introduction: Sex hormone binding globulin (SHBG) levels in blood are associated with bioavailability of sex hormones, glucose metabolism, and cardiometabolic health of premenopausal women. Low SHBG levels are associated with insulin resistance in women. Pregnancy is characterized by 6-10-fold increase in SHBG levels. This study is designed to evaluate the long-term associations among pregnancy, and SHBG, free and total testosterone levels in premenopausal women. Methods: Premenopausal women, aged 20-32 years, from the CARDIA Women’s Study cohort were tested for levels of serum SHBG, free testosterone, and total testosterone. Hormonal, anthropometric, socio-demographic, and behavioral data, along with self-reported pregnancy and birth data, were collected at baseline (1987-88 [Y0]; n=1,191) and after eight years (Y8; n=809) and 14 years (Y14; n=474) for follow-up. Participants who were pregnant, breastfeeding, had diabetes, hysterectomy, or were using oral contraceptive at any time point were excluded. Participants were divided in parity groups of 0, 1, and 2+births for analyses. Eight-year decrements of SHBG, free and total testosterone were used for primary analyses and 14-year decrements were used for secondary analyses Results: SHBG levels decreased more in parous than nulliparous women in a fully adjusted model including race, CARDIA field center, age, education, alcohol, smoking status, baseline BMI, weight gain and change in waist girth. Total testosterone decreased more in parous women between Y0-Y10 but not thereafter. No significant differences in free testosterone levels were observed among parity change groups in fully adjusted models. Hormone decrement analyses from fully adjusted model Conclusion: Childbearing is associated with a more pronounced long term decrease in SHBG but not with free testosterone levels in premenopausal women. A strong association was observed among parity and total testosterone decrements at 8-year but not 14-year follow-up.

BIOMEDICINE ON HORMONE MEDIATION OF SPORTS IN ADOLESCENT HEIGHT DEVELOPMENT

ABSTRACT Introduction: Physical exercise is an important factor in regulating energy balance and body composition. Exercise itself is a kind of body stress. It involves the central nervous system, cardiovascular, respiratory, endocrine, and other systems. Sports have various effects on the hormones in adolescent height development. Objective: This article analyzes the effects of different time and load exercise training on the levels of serum testosterone, free testosterone, and cortisol in young athletes. Methods: The athletes’ blood samples were collected at the quiet time in the morning before each experiment, immediately after exercise, and at three time intervals the next morning. Then blood testosterone (T), free testosterone (FT), and corticosteroids (C) were measured. Results: One-time and one-day high-volume training can cause a decrease in serum testosterone and free testosterone levels and an increase in cortisol hormones in young athletes. The testosterone level of young athletes rises immediately after exercise. Conclusion: Hormonal changes after physical exercise provide a scientific basis for athlete exercise load prediction and exercise plan formulation. Level of evidence II; Therapeutic studies - investigation of treatment results.

A proprietary blend of standardized Punica granatum fruit rind and Theobroma cocoa seed extracts mitigates aging males' symptoms: A randomized, double-blind, placebo-controlled study.

Objective: We evaluated the safety and efficacy of a novel combination of Punica granatum fruit rind and Theobroma cocoa seed extracts (LN18178 or Tesnor®) in enhancing serum testosterone level and reducing aging males' symptoms (AMS) in a randomized, double-blind, placebo-controlled investigation (CTRI Reg. No. CTRI/2019/02/017506).Methods: One hundred twenty healthy male participants (age 36-55 years) were randomized (n=40) to placebo, 200 or 400 mg of LN18178 for a period of fifty-six consecutive days of supplementation. The primary efficacy parameter was the AMS score. The secondary parameters were serum testosterone (free and total) levels, hand-grip strength, and perceived stress scale (PSS-10) score. Measurement of other hormones included in the study was serum dihydrotestosterone (DHT), cortisol, and 17β-estradiol (E2). Total blood chemistry parameters, vital signs, and urinalysis were parts of the safety assessment.Results: Both doses of LN18178 significantly reduced the mean AMS scores after 56 days of supplementation. Furthermore, it significantly improved general, psychological, and sexual well-being. Serum levels of free testosterone and total testosterone levels were significantly increased in LN18178 supplemented (200 and 400 mg) participants compared to the baseline and placebo. Significant improvements in hand-grip strength and reduced PSS-10 scores were also observed.Conclusion: LN18178 supplementation reduced AMS scores and improved sexual performance. Also, LN18178 groups exhibited superior muscular strength and reduction in perceived stress. Total blood chemistry and urine analysis demonstrated the broad-spectrum safety.

Hyperandrogenism correlates with psychological symptoms in adolescents with polycystic ovary syndrome.

.This study aimed to analyze the depressive and anxiety states of adolescent girls with polycystic ovary syndrome (PCOS). This was a cross-sectional, multicenter, case–control study. A total of 100 participants (PCOS group, 51; control group, 49) aged 13–18 yr were included in the study. Body mass index was higher in patients with PCOS (P = 0.002). In the PCOS group, 28.5% of the patients had moderate-to-severe depressive symptoms, whereas the incidence was lower in controls (8.3%, P = 0.021). The State-Trait Anxiety Inventory (STAI)-State, STAI-Trait, and physical, psychosocial, and total Pediatric Quality of Life Inventory PedsQL scores were higher in the PCOS group, suggesting that anxiety was more common and the quality of life was worse in patients with PCOS than in healthy participants (P = 0.01, P = 0.03, P = 0.02, P = 0.046, and P = 0.047, respectively). The serum free testosterone (fT) levels were positively correlated with the depression and anxiety scores and negatively correlated with the psychosocial PedsQL scores. In conclusion, adolescent girls diagnosed with PCOS demonstrated higher depressive and anxiety symptoms and lower psychosocial quality of life scores than their healthy counterparts. A relationship was found between the fT level and all psychological measures.