Syndrome In Elderly Men Research Articles

Serum testosterone level and related metabolic factors in men over 70 years old

Sex hormone decline remarkably decreases metabolic function in elderly men. Many degenerative diseases may relate to testosterone deficiency. To evaluate the serum testosterone concentration in elderly men, its related metabolic and inflammatory factors, and the relationship of metabolic syndrome to testosterone levels. 381 elderly men (78.8+/-4.1 yr old) residing in a veterans' nursing home were enrolled. We measured body height and weight, waist and hip circumferences, body fat, blood pressure, blood glucose and insulin, glycosylated hemoglobin (HbA1c), lipid profile, complete blood count, high sensitivity C-reactive protein (hsCRP), total testosterone, and SHBG. Free testosterone was calculated by Nanjee-Wheeler's method. Serum total testosterone levels were 0.20-15.74 ng/ml (free testosterone 11.78-478.31 pmol/l). Total testosterone correlated negatively with body mass index (BMI), waist-hip ratio, body fat, blood glucose, blood insulin, HbA1c, serum triglyceride, white blood cell (WBC) count and hsCRP; but positively with HDL-cholesterol (HDL-C) and hemoglobin. Multiple regression stepwise forward analysis revealed that BMI values, fasting blood glucose, WBC count, fasting hsCRP and hemoglobin were independent factors related to total testosterone. Furthermore, total testosterone is lower in elderly men with metabolic syndrome, according to National Cholesterol Education Program criteria with a modification of waist circumference. However, free testosterone plays a small role in association with metabolic factors in this elderly men's population. Total testosterone level is significantly related to metabolic and inflammatory factors in elderly men. Low total testosterone may be a significant indicator for development of metabolic syndrome in elderly men.

Modifiable Lifestyle Factors and the Metabolic Syndrome in Older Men: Effects of Lifestyle Changes

To examine the influence of lifestyle factors and changes in these factors on risk of the metabolic syndrome in elderly men. Cross-sectional and longitudinal analyses of cohort study. General practices in 24 British towns. Three thousand fifty-one men aged 60 to 79 with no diabetes mellitus or diagnosis of coronary heart disease. Lifestyle factors (smoking, physical activity, alcohol intake, body weight, dietary fat and carbohydrate intake) including recent changes in the previous 3 years (physical activity and body weight); metabolic syndrome. After adjustment for each of the other modifiable lifestyle factors, overweight/obesity and physical inactivity were associated with a significantly higher risk of the metabolic syndrome, as were cigarette smoking and a high-carbohydrate diet (>57% of energy). Alcohol intake and dietary fat intake were not related to the metabolic syndrome. Long-term ex-smokers showed similar risk to never smokers. Taking up physical activity and losing weight in the previous 3 years were associated with a reduction in risk of the metabolic syndrome. Overweight/obesity, physical inactivity, a high-carbohydrate diet, and cigarette smoking are associated with higher risk of the metabolic syndrome in elderly men. Modification of lifestyle factors, even later in life, has considerable potential for primary prevention of the metabolic syndrome.

Erectile Dysfunction as a Predictor of the Metabolic Syndrome in Aging Men: Results From the Massachusetts Male Aging Study

The metabolic syndrome, characterized by central obesity, insulin dysregulation, abnormal lipids and borderline hypertension, is a precursor state for cardiovascular disease. We determined whether erectile dysfunction is predictive of the metabolic syndrome. Data were obtained from the Massachusetts Male Aging Study, a population based prospective cohort observed at 3 points during approximately 15 years (T(1)-1987 to 1989, T(2)-1995 to 1997, T(3)-2002 to 2004). The metabolic syndrome was defined by using a modification of the Adult Treatment Panel III guidelines. The association between erectile dysfunction and the metabolic syndrome was assessed using relative risks and 95% confidence intervals estimated using Poisson regression models. Analysis was conducted of 928 men without the metabolic syndrome at T(1). There were 293 men with incident metabolic syndrome, of which 56 had erectile dysfunction at baseline. Body mass index and the presence of 1 or 2 conditions constituting the metabolic syndrome definition were the strongest predictors of the metabolic syndrome. The association of erectile dysfunction with the metabolic syndrome (unadjusted RR 1.35, 95% CI 1.01-1.81) was modified by body mass index, with a stronger effect of erectile dysfunction in men with body mass index less than 25 (adjusted RR 2.09, 95% CI 1.09-4.02), and no erectile dysfunction and metabolic syndrome association in men with body mass index 25 or greater (adjusted RR 1.06, 95% CI 0.76-1.50). Erectile dysfunction was predictive of the metabolic syndrome only in men with body mass index less than 25. This finding suggests that erectile dysfunction may provide a warning sign and an opportunity for early intervention in men otherwise considered at lower risk for the metabolic syndrome and subsequent cardiovascular disease.

Endogenous Sex Hormones and Metabolic Syndrome in Aging Men

Endogenous Sex Hormones and Metabolic Syndrome in Aging Men

Endogenous Sex Hormones and Metabolic Syndrome in Aging Men

Endogenous Sex Hormones and Metabolic Syndrome in Aging Men

Authors’ Response: Sex Hormones and Metabolic Syndrome in Aging Men

Authors’ Response: Sex Hormones and Metabolic Syndrome in Aging Men

Letter re: Sex Hormones and Metabolic Syndrome in Aging Men

Letter re: Sex Hormones and Metabolic Syndrome in Aging Men

Letter re: Endogenous Sex Hormones and Metabolic Syndrome in Aging Men

Letter re: Endogenous Sex Hormones and Metabolic Syndrome in Aging Men

Authors’ Response: Endogenous Sex Hormones and Metabolic Syndrome in Aging Men

Authors’ Response: Endogenous Sex Hormones and Metabolic Syndrome in Aging Men

1236: Does Erectile Dysfunction Predict Risk of Metabolic Syndrome in Aging Men? Results from the Massachusetts Male Aging Study

You have accessJournal of UrologyDiscussed Poster, Tuesday, May 24, 2005, 1:00 - 5:00 pm1 Apr 20051236: Does Erectile Dysfunction Predict Risk of Metabolic Syndrome in Aging Men? Results from the Massachusetts Male Aging Study Ridwan Shabsigh, Andre B. Araujo, Amy B. O'Donnell, and John B. McKinlay Ridwan ShabsighRidwan Shabsigh More articles by this author , Andre B. AraujoAndre B. Araujo More articles by this author , Amy B. O'DonnellAmy B. O'Donnell More articles by this author , and John B. McKinlayJohn B. McKinlay More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)35381-3AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "1236: Does Erectile Dysfunction Predict Risk of Metabolic Syndrome in Aging Men? Results from the Massachusetts Male Aging Study." The Journal of Urology, 173(4S), p. 335 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 173Issue 4SApril 2005Page: 335 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Ridwan Shabsigh More articles by this author Andre B. Araujo More articles by this author Amy B. O'Donnell More articles by this author John B. McKinlay More articles by this author Expand All Advertisement PDF downloadLoading ...

Endogenous Sex Hormones and Metabolic Syndrome in Aging Men

Sex hormone levels in men change during aging. These changes may be associated with insulin sensitivity and the metabolic syndrome. We studied the association between endogenous sex hormones and characteristics of the metabolic syndrome in 400 independently living men between 40 and 80 yr of age in a cross-sectional study. Serum concentrations of lipids, glucose, insulin, total testosterone (TT), SHBG, estradiol (E2), and dehydroepiandrosterone sulfate (DHEA-S) were measured. Bioavailable testosterone (BT) was calculated using TT and SHBG. Body height, weight, waist-hip circumference, blood pressure, and physical activity were assessed. Smoking and alcohol consumption was estimated from self-report. The metabolic syndrome was defined according to the National Cholesterol Education Program definition, and insulin sensitivity was calculated by use of the quantitative insulin sensitivity check index. Multiple logistic regression analyses showed an inverse relationship according to 1 sd increase for circulating TT [odds ratio (OR) = 0.43; 95% confidence interval (CI), 0.32-0.59], BT (OR = 0.62; 95% CI, 0.46-0.83), SHBG (OR = 0.46; 95% CI, 0.33-0.64), and DHEA-S (OR = 0.76; 95% CI, 0.56-1.02) with the metabolic syndrome. Each sd increase in E2 levels was not significantly associated with the metabolic syndrome (OR = 1.16; 95% CI, 0.92-1.45). Linear regression analyses showed that higher TT, BT, and SHBG levels were related to higher insulin sensitivity; beta-coefficients (95% CI) were 0.011 (0.008-0.015), 0.005 (0.001-0.009), and 0.013 (0.010-0.017), respectively, whereas no effects were found for DHEA-S and E2. Estimates were adjusted for age, smoking, alcohol consumption, and physical activity score. Further adjustment for insulin levels and body composition measurements attenuated the estimates, and the associations were similar in the group free of cardiovascular disease and diabetes. Higher testosterone and SHBG levels in aging males are independently associated with a higher insulin sensitivity and a reduced risk of the metabolic syndrome, independent of insulin levels and body composition measurements, suggesting that these hormones may protect against the development of metabolic syndrome.

Chronic prostatitis/chronic pelvic pain syndrome in elderly men: toward better understanding and treatment.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is the most common of the prostatitis syndromes. It is characterised by pelvic pain, with or without voiding symptoms. CP/CPPS accounts for 2 million office visits in the US alone. Recent epidemiological studies have shown that CP/CPPS can affect men at any age, including those in their 80s. The aetiology is unknown but proposals include infectious, autoimmune, neurologic and psychiatric causes. Men with CP/CPPS are much more likely to have had a past medical history of cardiovascular, neurologic, psychiatric or infectious disease (particularly sinusitis) as compared with asymptomatic individuals. Although leucocytes are commonly found in the prostatic fluid of these men, they do not correlate with the symptoms. The clinical evaluation now includes a validated, self administered symptom score, the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), which was designed as an outcome measure for treatment trials. This can aid in diagnosis and follow-up of patients' response to therapy. Treatment for CP/CPPS is empiric and limited by a lack of randomised, placebo-controlled clinical trials. Antimicrobials are commonly used to treat the symptoms of CP/CPPS. However, the finding that asymptomatic men have equal or greater numbers of bacteria which localise to the prostatic fluid, compared with men with CP/CPPS, has raised doubts about the contribution of infection to the symptoms. Other commonly used drugs include alpha-adrenoceptor antagonists, anti-inflammatory drugs, tricyclic antidepressants and anticholinergic agents. The adverse effects of these medications are a concern in older men with CP/CPPS. Other therapies available include minimally invasive procedures such as microwave thermotherapy and transurethral needle ablation, and now neuromodulation devices.Although much progress has been made, particularly in the last 7 years, considerable work still remains to be done to determine the aetiology and pathogenesis of CP/CPPS, and to develop mechanism based therapy that is shown to be effective in controlled trials.

Testosterone and andropause: the feasibility of testosterone replacement therapy in elderly men.

Andropause, a syndrome in aging men, consists of physical, sexual, and psychologic symptoms that include weakness, fatigue, reduced muscle and bone mass, impaired hematopoiesis, oligospermia, sexual dysfunction, depression, anxiety, irritability, insomnia, memory impairment, and reduced cognitive function. Free testosterone levels begin to decline at a rate of 1% per year after age 40 years. It is estimated that 20% of men aged 60-80 years have levels below the lower limit of normal. Although the causal relationship between declining testosterone levels and development of andropause symptoms is not firmly established, administration of testosterone to this population resulted in improvements in many areas. Most studies to date focused on physical benefits of testosterone replacement and failed to assess psychologic symptoms rigorously. Preliminary data suggest that therapy may benefit elderly men with new-onset depression. Testosterone administration is not without problems, the most worrisome being the potential for increased prostate cancer risk. Despite this concern, a limited number of studies administered the hormone weekly for up to 2 years, with only mild increases in prostate-specific antigen over control values. Currently, insufficient evidence, primarily regarding psychologic safety and efficacy, exists to warrant general administration of testosterone to elderly hypogonadal men. Further clinical investigations of this therapy in men with low testosterone levels and andropause symptoms are justified and necessary.

Dubin-Johnson syndrome in elderly men: Report of three cases

Dubin-Johnson syndrome in elderly men: Report of three cases