Total Testosterone Levels In Patients Research Articles

(123) Postoperative Changes of Serum Total Testosterone Levels in Patients with Prostate Cancer After Robot-Assisted Radical Prostatectomy

Abstract Introduction Although a relationship between prostate cancer and serum total testosterone (TT) has been studied, previous evidences were contradictory. Although a relationship between prostate cancer and serum total testosterone (TT) in terms of cancer biology as well as sexual function has been studied, previous evidences were contradictory and not organized very well. Objective We investigated the changes in TT levels after robot-assisted radical prostatectomy (RARP) for prostate cancer as a prospective surveillance. Methods From July 2015 to January 2022, 290 patients out of 1,343 prostate biopsies performed in our hospital underwent RARP with a diagnosis of localized prostate cancer. TT measurements were performed at 6:00 early morning on admission to all patients for biopsy. Of these, we studied 76 patients whose TT values have been measured during postoperative follow-up. TT values were measured 1 month after RARP, every 3 months until 36 months thereafter, and every 6 to 12 months thereafter for up to 72 months postoperatively. Results The median and quartile of age, serum PSA and TT (pre-TT) values at biopsy of the 76 patients were 69 years (64–72 years), 7.47 ng/mL (5.65–12.74 ng/mL) and 4.03 ng/mL (2.96–4.83 ng/mL), respectively. There was no significant correlation between age and pre-TT values (p = 0.21). RARP was performed an average of 2.9 months after biopsy. The median follow-up period was 43 months (31–60 months). PSA recurrence was observed in 18 patients (23.7%), with 3- and 5-year PSA non-recurrence rates of 77.4% and 74.9%, respectively. There was no significant difference in pre-TT values between patients with or without PSA recurrence (p = 0.107). Analysis of TT values at each observation period after RARP showed relative increase by an average of 23.4% (after 1 month) to 41.6% (after 36 months) when compared with pre-TT values. Further analysis of dividing 76 patients into 2 groups by a pre-TT value of 3.00 ng/mL showed that only in the low pre-TT group (pre-TT < 3.00 ng/mL: 21 cases, 27.6%), the rate of increase in TT values over pre-TT was significantly higher than that in the normal pre-TT group (pre-TT ≥ 3.00 ng/mL: 55 cases, 72.4%) at each observation period up to 72 months after RARP except 33 and 54 months Conclusions The transition of postoperative TT values in the patients who underwent RARP continued to show a significant increase at each observation period only in the group with low TT values preoperatively, suggesting that biochemical hypogonadism may have been presumably caused by prostate cancer-bearing conditions preoperatively in these patients with low TT values. Disclosure No.

Increased oxidative stress is associated with hyperandrogenemia in polycystic ovary syndrome evidenced by oxidized lipoproteins stimulating rat ovarian androgen synthesis in vitro.

To determine the relationship between serum total testosterone (TT) levels and oxidative stress indices in patients with polycystic ovary syndrome (PCOS), and to investigate the effect of oxidative stress on androgen synthesis and its mechanism in rat ovarian theca-interstitial (T-I) cells. Clinical, hormonal, metabolic, and oxidative stress parameters were analyzed in a cross-sectional case-control study including 626 patients with PCOS and 296 controls. The effects of oxidized low-density lipoprotein (ox-LDL) and oxidized high-density lipoprotein (ox-HDL) on cell proliferation, TT secretion, and expression of key enzymes involved in testosterone synthesis were evaluated in T-I cells. Serum TT levels were elevated with an increase in ox-LDL levels, whereas glutathione concentrations were lower in the high-TT subgroup than in the low-TT subgroup. The average ovarian volume and ox-LDL and malondialdehyde levels were significant predictors of TT levels in the multivariate regression models. In a rat ovarian T-I cell model, lipoprotein and oxidized lipoprotein treatments stimulated proliferation and promoted testosterone secretion. The mRNA and protein levels of 17α-hydroxylase were significantly higher in oxidized lipoprotein-treated cells than those in lipoprotein-treated cells. The mRNA levels of cholesterol side chain cleavage enzyme and steroidogenic acute regulatory protein were also significantly higher in ox-HDL-treated cells than in HDL-treated cells. Oxidative stress can promote androgen production by up-regulating the expression of testosterone synthesis-related enzymes in vitro and may be an essential factor in elevating serum TT levels in patients with PCOS.

Effect of SARS-CoV-2 viral infection on male sexual hormones levels post COVID-19 exposure: A systematic review and meta-analysis.

The COVID-19 can affect human testicles, thus will interfere the production of important male sexual hormone such as testosterone. Our study provides scientific evidence through systematic reviews and meta-analyses that focus on the effects of SARS-CoV-2 virus infection on male sexual hormonal disorders in patients post-exposure to COVID-19. This meta-analysis was made in accordance with the PRISMA guidelines. The outcomes of this study were the level of total testosterone, free testosterone, LH and FSH. Chi-square and I2 tests were used to evaluate heterogeneity between studies. The standardized mean deviation (SMD) with 95% CI were used and analysis was performed using the Review Manager 5.4 software. The four included studies reported a total of 256 patients with COVID-19 with time of follow-up time post COVID-19 varying from one month to 7 months. The mean age distribution in the study was 34-57 years old. Total testosterone level (SMD = -158.71; 95% CI= -205.30 - -112.12; p<0.00001) was significantly higher at follow-up post COVID-19, while LH (SMD = 0.40; 95% CI = 0.15-0.65; p=0.002) was lower. The free testosterone level and FSH level showed no significant difference between baseline and after following up post COVID-19. At follow up, the total testosterone level in patients with SARS-CoV-2 infection appeared to be elevated while LH was lower compared to the baseline.

Low Total Testosterone Levels in Men with Newly Diagnosed Early-Onset Type 2 Diabetes: A Cross-Sectional Study in China.

There is a bidirectional interaction between circulating testosterone and blood glucose levels. We aim to investigate the testosterone levels in men with early-onset type 2 diabetes (T2DM). A total of 153 drug naive men with T2DM were enrolled in the study. Early- (n = 63) and late-onset (n = 90) T2DM was classified according to age 40 years old. Clinical characteristics and plasma for biochemical criterions were collected. Gonadal hormones were measured using chemiluminescent immunometric assay. The concentrations of 3β- and 17β-HSD were determined using ELISA. Compared with men with late-onset T2DM, those with early-onset T2DM had lower serum total testosterone (TT), sex hormone-binding globulin (SHBG), and FSH, but higher dehydroepiandrosterone sulfate (DHEA-S) level (p < 0.05). The mediating effect analysis showed that the decreased TT levels in patients with early-onset T2DM were associated with the higher HbA1c, BMI, and triglyceride in these patients (both p < 0.05). The early-onset of T2DM directly correlated with increased DHEA-S (both p < 0.01). The 3β-HSD concentration in the early-onset T2DM group was lower than that in the late-onset T2DM group (11.07 ± 3.05 vs. 12.40 ± 2.72 pg/mL, p = 0.048) and was positively correlated with fasting C-peptide, while negatively correlated with HbA1c and fasting glucagon (p all < 0.05). Patients with early-onset T2DM showed inhibition of conversion from DHEA to testosterone, which may attribute to the low level of 3β-HSD and high blood glucose in these patients.

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.

Estrogen/androgen balance in men with hyperestrogenism normalized by using letrozole of the aromatase inhibitor drug class

Introduction. Currently, virtually no data on comparative studies of efficacy and safety of drug class aromatase inhibitors vs. standard therapies used in patients with overweight and/or obesity with an initial testosterone deficiency and excessive estradiol are available.Aim: to study and evaluate the efficacy and safety of the use of the reversible aromatase inhibitor letrozole in adult men with overdeveloped adipose tissue and/or obesity with hyperestrogenism and testosterone deficiency.Materials and Methods. A randomized, open, interventional, comparative, single-centre clinical trial was conducted by enrolling 49 obese men. The patients were divided into 2 groups: Group 1 (n = 26) – patients received standard metformin therapy (1000 mg 2 times a day), along with letrozole (at a dose of 2.5 mg 2 times a week); Group 2 (n = 23) – patients received only standard metformin therapy. Patients were monitored for 8 weeks from the date of inclusion. Anthropometric parameters were monitored: body weight, body mass index, waist as well as hip circumference. Laboratory data were also evaluated: level of sex hormone binding globulin (SHBG), total testosterone, estradiol, glucose, uric acid, insulin. All subjects filled out questionnaires twice (before the start of the study and after its completion) – the aging symptoms questionnaire for men (Aging Males Symptoms, AMS) and IIEF (International Index of Erectile Function).Results. Total testosterone level significantly and reliably increased only in Group 1 from 10.6 to 22.2 nmol/L. In Group 2 testosterone level increased insignificantly from 9.28 to 11.02 nmol/L, and did not reach the physiological normal range. Estradiol changes also differed markedly and significantly: in Group 1, estradiol decreased from 51.4 to 24.3 pg/ml, i.e., by 2.1-fold reaching physiological range, whereas in Group 2 estradiol level decreased insignificantly from 45.1 to 44.4 pg/ml, and remained above the range of normal values. Significant changes in SHBG were observed only in Group 2. Insulin level in Group 1 significantly decreased from 10.6 to 6.6 μIU/ml, i.e., by 1.6-fold. In Group 2, insulin also decreased, but less pronounced, from 15.8 to 13.7, i.e., by 1.2-fold, which turned out to be statistically insignificant and according to the НОМА-IR index (Homeostasis Model Assessment of Insulin Resistance), it remained within the insulin resistance range. Glucose level did not change significantly in both groups. Uric acid, on the contrary, significantly changed in both groups: in Group 1, from 0.41 to 0.35 mmol/L, and in Group 2, from 0.40 to 0.36 mmol/L.Conclusion. The use of letrozole significantly increases total testosterone level in patients with initial testosterone deficiency and hyperestrogenism. At the same time, patients with androgen deficiency and hyperestrogenism, in most cases, have excess body weight due to adipose tissue, metabolic syndrome in a combination of its various components, which underlie a need to use standard methods of therapy primarily modified lifestyle and metformin, which provide the maximum positive effect in the treatment of such patients.

SARS-CoV-2 Pneumonia Affects Male Reproductive Hormone Levels: A Prospective, Cohort Study

BackgroundSARS-CoV-2 which causes coronavirus disease 2019 (COVID-19) binds to angiotensin-converting enyzme 2 (ACE2) and enters the host cell. ACE2 protein is expressed highly in the testis. AimThe aim of this study was to compare male reproductive hormones such as total testosterone (TT), luteinizing hormone (LH), follicular stimulant hormone (FSH), and prolactin between patients with COVID-19, age-matched cases with non–COVID-19 respiratory tract infection, and age-matched controls. MethodsThis was a prospective cohort study and included 262 men aged between 20 and 65 years. The study comprised 3 groups including patients with COVID-19 (n = 89), cases with non–COVID-19 respiratory tract infection (n = 30), and age-matched controls (n = 143). All cases were evaluated using TT, LH, FSH, and prolactin. Correlations between TT and clinical parameters of patient groups were investigated using Pearson's correlation test. OutcomesThe primary outcome of the study was detection of the difference of TT, FSH, LH, and prolactin levels between the groups. Secondary outcome was to correlate TT and hospitalization time and oxygen saturation on hospital admission (SpO2) of patients. ResultsThe mean age of study groups was 49.9 ± 12.5 years, 52.7 ± 9.6 years, and 50 ± 7.8 years, respectively (P = .06). Serum TT levels was median 185.52 ng/dL in patients with COVID-19, median 288.67 ng/dL in patients with non–COVID-19 respiratory tract infection and median 332 ng/dL in control cases, (P < .0001). The proportion of patients with testosterone deficiency in group 1, group 2, and group 3 was 74.2%, 53.3%, and 37.8%, respectively (P < .0001). Serum LH levels (P = 0.0003) and serum prolactin levels (P = .0007) were higher in patients with COVID-19 and patients with non–COVID-19 respiratory tract infection than control cases. Correlation analysis revealed significant negative correlation between serum TT levels and hospitalization time of patients with COVID-19 (r = –0.45, P < .0001). In addition, a significant positive correlation was observed between SpO2 and serum TT levels in patients with COVID-19 ( r = 0.32, P = .0028). Clinical ImplicationsPhysicians may consider to evaluate male patients with COVID-19 for concomitant androgen deficiency. Strengths & LimitationsStrengths include the evidence about the alteration of male reproductive hormones under COVID-19. Limitations include the analysis limited to one general hospital, only a single measurement of TT was available, free and bioavailable testosterone levels were not evaluated. ConclusionThis study demonstrates COVID-19 is associated with decreased level of TT and increased level of LH and prolactin. More serious COVID-19 causes more reduction in TT levels and prolongs hospitalization period.Kadihasanoglu M, Aktas S, Yardimci E, et al. SARS-CoV-2 Pneumonia Affects Male Reproductive Hormone Levels: A Prospective, Cohort Study. J Sex Med 2021;18:256–264.

Prognostic value of total testosterone levels in patients with acute coronary syndromes.

Endogenous testosterone levels decrease in men with aging. Controversies persist regarding the screening and treatment of low testosterone levels in patients with acute coronary syndromes (ACS). Total serum testosterone levels were measured in 1054 men hospitalized for ACS that were part of a Swiss prospective cohort. Total testosterone levels were classified first in tertiles and using the cut-off of 300 ng/dL. Primary endpoint was all-cause mortality at one year. Cox regression models adjusting for the GRACE score (composite of age, heart rate systolic blood pressure, creatinine, cardiac arrest at admission, ST segment deviation, abnormal troponin enzyme and Killip classification), preexisting diabetes and inflammation (high-sensitivity C-reactive protein). A total of 430 men (40.8%) had total testosterone levels ≤300 ng/dL. Low total testosterone levels were correlated with lower high-density lipoprotein cholesterol and higher triglycerides, high-sensitivity C-reactive protein, high-sensitivity troponin T, N-terminal-pro B-type natriuretic peptide and glucose levels (all p < 0.01). Patients in the lowest testosterone tertile had a mortality rate at one-year of 5.4% compared with 2.9% in the highest tertile with an unadjusted hazard ratio of 1.92 (95% confidence interval 0.96-1.90, p = 0.095) and adjusted hazard ratio of 1.26 (95% confidence interval 0.57-2.78, p = 0.565). In an exploratory analysis, the highest mortality rate (10.3%) was observed in men aged >65 years old belonging to the lowest testosterone tertile. In this large population of men with ACS, we found a prevalence of low total endogenous testosterone levels of almost 40%. However, low testosterone levels were not significantly associated with mortality after adjustment for high-risk confounders.

602 Clinical outcomes of androgen replacement therapy (ART) in Japanese patients with late-onset hypogonadism(LOH) syndrome -comparison of total and free testosterone value

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 androgen replacement therapy (ART) in patients with LOH syndrome. Two hundred thirty male patients who visited our LOH syndrome out-patient department from January, 2008 to September, 2013 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. 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. Androgen replacement therapy (ART) 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 androgen replacement therapy 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 ART in 31 patients.

Which Exercise Is Better for Increasing Serum Testosterone Levels in Patients with Erectile Dysfunction?

PurposeWe investigated the correlations of serum total testosterone (TT) levels with body composition and physical fitness parameters in patients with erectile dysfunction (ED) to know the best exercise for testosterone deficiency.Materials and MethodsEighty-seven ED patients underwent serum TT assessment as well as body composition and basic exercise testing. The bioelectrical impedance analysis was used to assess body composition. Seven types of basic exercise tests were used to determine physical fitness. Correlations between serum TT levels and body composition/physical function parameters were evaluated using partial correlation analyses. A serum TT cut-off value was obtained for the parameters significantly correlated with serum TT levels.ResultsThe subjects had a mean serum TT level of 342.1 ng/dL. Among the body composition parameters, body and abdominal fat percentages showed statistically significant negative correlations with serum TT levels. Among the basic exercise test parameters, only the cycle ergometer test for cardiorespiratory fitness showed a statistically significant positive correlation with serum TT levels.ConclusionsSerum TT levels in patients with ED, may be increased by reducing fat percentage and improving cardiorespiratory fitness via aerobic exercise.

Analysis of risk factors on hypogonadism in male patients with type 2 diabetes

Objective To investigate the risk factors of hypogonadism in male type 2 diabetic patients. Methods A total of 213 male patients with type 2 diabetes were enrolled and divided into low testosterone group (n=75) and normal testosterone group (n=138). Blood pressure, blood glucose, blood lipids, serum insulin and sex hormones including total testosterone (TT), sex hormone binding globulin (SHBG), progesterone, prolactin, estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), dehydroepiandrosterone (DHEA) were measured in all patients. The correlations between the metabolic index and sex hormone levels were analyzed. Results Compared with normal testosterone group, body mass index (BMI), fasting insulin (FINS), and homeostasis model assessment insulin resistance (HOMA-IR) levels were significantly increased in low testosterone group(all P<0.05)while LH, FSH, and SHBG levels were significantly decreased(all P<0.05). Pearson correlation analysis showed that TT was negatively correlated with FINS and HOMA-IR(r=-0.142, -0.154, both P<0.05)while positively correlated with LH and FSH (r=0.157, 0.138, both P<0.05). TT level in patients with metabolic syndrome(MS) was significantly decreased (P<0.05). A multiple logistic regression analysis revealed that BMI, MS, HOMA-IR, and LH were significant independent risk factors for hypogonadism. Conclusions Hypogonadism often occurs in male patients with type 2 diabetes, especially in patients with MS. BMI, HOMA-IR, LH, and MS are risk factors for hypogonadism in male type 2 diabetic patients. (Chin J Endocrinol Metab, 2017, 33: 556-561) Key words: Diabetes; Male; Hypogonadism; Testosterone; Insulin resistance; Luteinizing hormone

Is testosterone deficiency a possible risk factor for priapism associated with sickle-cell disease?

The purpose of this study was to determine the association of testosterone deficiency and priapism in adult men with sickle cell disease (SCD). A cross-sectional study of 50 adult men with SCD (hemoglobin SS) was performed. All patients had early morning blood taken for total and free testosterone, FSH, LH, prolactin, lipid levels, LDH and hematological indices. Patients completed an interviewer-administered questionnaire regarding priapism frequency, duration and treatment. Testosterone deficiency was defined as a serum total testosterone<12 nmol/L (346 ng/dL). The mean age of the study population was 34.2±8.9 years. Priapism was noted in 24 (48%) patients and was most frequently seen in men between ages 18-25 years. Testosterone deficiency was observed in 11 of the 50 (22%) patients, particularly in 6 of 24 (25%) patients with histories of priapism. There was no difference in mean total testosterone levels in patients with and without a history of priapism (16.7±4.9 nmol/L and 15.4±5.9 nmol/L, respectively) (p=0.43). Similarly, there was no difference in serum LH and FSH levels based on history of priapism. Testosterone deficiency is prevalent in patients with SCD; however, we did not identify an association based on a history of priapism. Larger, prospectively gathered data are needed to define the priapism profile of SCD patients with testosterone deficiency.

Testosterone and high-sensitive C-reactive protein in coronary artery disease patients awaiting coronary artery bypass graft.

Natural androgens inhibit atherosclerosis in men. This study aimed to examine whether testosterone and high-sensitive C-reactive protein differ between patients with coronary artery disease and those without coronary artery disease and to determine the association with the severity of coronary artery disease. Two hundred and six male subjects were recruited. Serum total testosterone and high-sensitive C-reactive protein were estimated. Severity of coronary artery disease was assessed by angiographic scores. Total testosterone level in patients was significantly different from controls (11.4±2.7 vs. 18.1±7.2nmP=0.001) and high-sensitive protein level in cases was significantly higher compared to controls (3.37±1.62mgl(-1) vs. 1.71±0.60mgl(-1) , P=0.001). Testosterone levels were not significantly different with vessel (P=0.592), Leaman (P=0.694) and Gensini (P=0.329) score groups, but high-sensitive C-reactive protein showed significant positive correlation among the respective groups (P=0.005, P=0.028, P=0.015). Testosterone was lower, while high-sensitive C-reactive protein was higher in patients compared to controls. Testosterone showed no correlation with the severity of atherosclerosis, but high-sensitive C-reactive protein showed significant positive correlation.

The impact of metabolic syndrome on serum total testosterone level in patients with erectile dysfunction

Objectives: To determine the association between metabolic syndrome (MetS) and serum testosterone levels (TT) in patients with erectile dysfunction (ED).Methods: This study included 280 ED patients above 40-years-of-age. Participants were divided into two groups according to 2005 criteria of International Diabetes Federation. The severity of ED was determined according to the International Index of Erectile Function-EF (IIEF-EF score; 0–10 severe ED, 11–25 mild to moderate ED). The severity of ED, serum TT levels and other MetS components were compared between the groups.Results: The mean age of the patients was 55.7 ± 8.2 years. One hundred eighteen patients (%42.1) had MetS. Sixty-eight patients with MetS (57.6%) and 71 patients without MetS (43.8%) had severe ED (p = 0.031). A total of 46 (16.4%) patients had hypogonadism. Hypogonadism was seen more prevalent in patients with MetS (22.9% vs. 11.7%, p = 0.013). Logistic regression analyses for ED risk factors demonstrated that abnormal FBG increased the relative risk of severe ED up to 10.7-fold (p < 0.001) but not presence of hypogonadism (p = 0.706).Conclusion: Metabolic syndrome was seen in almost half of the patients with ED. ED was more severe among MetS patients. Hypogonadism alone is a not risk factor for severe ED.

Androgen receptor GGC polymorphism and testosterone levels associated with high risk of prostate cancer and benign prostatic hyperplasia

Polymorphic GGC repeats in the androgen receptor (AR) gene can alter transactivation of androgen-responsive genes and increase the risk of benign prostatic hyperplasia (BPH) and prostate cancer (PCa). We investigated the association between GGC repeat length, testosterone levels and the risk of developing PCa and BPH in a population from southern Brazil. A sample comprising 130 PCa, 126 BPH and 88 control patients was evaluated. DNA was extracted from leukocytes and the AR gene was analyzed by fragment analysis. The hazard ratio (HR) was estimated. GGC mean length was not different between the three study groups. The risk of developing PCa in individuals with GGC > 19 was 3.300 (95 %CI 1.385-7.874) higher when compared to the GGC ≤ 19 group (p = 0.007). The risk of developing PCa and BPH in individuals with total testosterone levels <4 ng/mL was 2.799 (95 % CI 1.362-5.754). (p = 0.005) and 2.786 (95 % CI 1.470-5.280) (p = 0.002), respectively. Total testosterone levels in patients with GGC > 19 were significantly lower when compared to patients in the GGC ≤ 19 group. Our data suggest that the presence of a high number of polymorphic GGC repeats in the AR gene is associated with an increased risk of developing PCa and BPH, and that lower testosterone levels also increase the risk of developing these diseases.

809 TESTOSTERONE DEFICIENCY IS A POSSIBLE RISK FACTOR FOR PRIAPISM ASSOCIATED WITH SICKLE CELL DISEASE

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Basic Research I1 Apr 2012809 TESTOSTERONE DEFICIENCY IS A POSSIBLE RISK FACTOR FOR PRIAPISM ASSOCIATED WITH SICKLE CELL DISEASE Belinda Morrison, Marvin Reid, Wendy Madden, Zhaoyong Feng, and Arthur Burnett Belinda MorrisonBelinda Morrison Kingston 7, Jamaica More articles by this author , Marvin ReidMarvin Reid Kingston 7, Jamaica More articles by this author , Wendy MaddenWendy Madden Kingston, Jamaica More articles by this author , Zhaoyong FengZhaoyong Feng Baltimore, MD More articles by this author , and Arthur BurnettArthur Burnett Baltimore, MD More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.898AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Priapism has a high incidence in sickle cell disease (SCD). Testosterone deficiency has been recognized in adolescent and adult males with SCD. We sought to determine the association of testosterone deficiency and priapism in adult men with SCD. METHODS A cross-sectional study of 50 adult men with homozygous S SCD was performed. All patients had early morning blood taken for total and free testosterone, FSH, LH, prolactin, lipid levels, LDH and hematological indices. Patients completed an interviewer administered questionnaire regarding priapism frequency, duration and treatment. Hypogonadism was defined as serum total testosterone < 12 nmol/L. The association of testosterone deficiency and priapism was determined. RESULTS Priapism was noted in 24 (48%) patients and was most frequently seen in men between ages 18-25 years. Mean age of the study population was 34.2 ± 8.9 years, and there was no difference in age based on history of priapism. Hypogonadism was assessed in 6 of 24 (25%) patients with priapism. There was no difference in mean total testosterone levels in patients with and without a history of priapism (16.7± 4.9 nmol/L and 15.4±5.9 nmol/L, respectively). Similarly, there was no difference in serum LH and FSH levels based on history of priapism. Of the patients who reported a history of priapism, there was no difference in frequency, number and duration of priapism episodes relative to total or free testosterone levels. There was a trend towards an association of free testosterone levels (p = 0.09) and duration of priapism episodes >30 min (p=0.09). CONCLUSIONS Hypogonadism is prevalent in patients with SCD. There is a 25% risk association of hypogonadism and priapism. Prospectively gathered data is needed to define the priapism profile of SCD patients with hypogonadism. Table 1. Responses to priapism questionnaire in study patients Frequency (%) History of priapism 48 Age of onset of priapism (yrs) 13-17 36 18–25 59 >25 5 Precipitating activity Sleep 95 Intercourse 5 Frequency of priapism episodes Daily 9 Alternate days 14 Once weekly 18 Once monthly 14 Other 45 Duration of priapism episodes <30 min 41 1 hour 32 2 hours 9 2–5 hours 9 >5 hours 9 Table 2. Laboratory values of patients with priapism Variable (Normal range) Mean values in patients with priapism Mean values in patients without priapism Age (yrs) 32.6±1.7 35.8±1.7 Haemoglobin (Hb) (14.0-18.0 g/dl) 7.8±1.8 7.9±1.8 LH (0-25 IU/L) 7.4±2.3 8.1±2.4 FSH (0-20 IU/L) 7.2±4.6 7.2±4.8 Total Testosterone (12.5-38.1 nMol/L) 16.7±4.9 15.4±5.9 Free Testosterone (194.4-936.1 pMol/L) 327.0±135.3 287.8±108.0 © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e330-e331 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Belinda Morrison Kingston 7, Jamaica More articles by this author Marvin Reid Kingston 7, Jamaica More articles by this author Wendy Madden Kingston, Jamaica More articles by this author Zhaoyong Feng Baltimore, MD More articles by this author Arthur Burnett Baltimore, MD More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Androgen Decline in Patients with Nonobstructive Azoospemia After Microdissection Testicular Sperm Extraction

Microdissection testicular sperm extraction (TESE) is the ideal procedure for obtaining a high sperm retrieval rate. However, few studies of the postoperative endocrinologic course have been reported. We evaluated the endocrinologic course for 1 year after microdissection TESE and compared the results with the testicular histologic findings. A total of 69 patients with nonobstructive azoospermia who had undergone microdissection TESE were included. The overall sperm retrieval rate was 50.7%. The endocrinologic data were evaluated before and 3, 6, and 12 months after surgery. The mean serum total testosterone level in patients with hypospermatogenesis decreased postoperatively and had recovered by 12 months (102%). The mean serum total testosterone level in patients with Klinefelter syndrome also decreased postoperatively but had recovered to only 50% of the baseline value at 12 months after microdissection TESE. At 12 months, the mean serum total testosterone level in patients with maturation arrest was 93.1% of the preoperative level and that in patients with Sertoli cell-only syndrome was 80.6% of the preoperative level. The preoperative serum luteinizing hormone and follicle-stimulating hormone in patients with Klinefelter syndrome was high and remained high after microdissection TESE. The mean serum luteinizing hormone and follicle-stimulating hormone levels in patients with hypospermatogenesis did not change, and those in patients with maturation arrest increased continuously after microdissection TESE. Finally, those in patients with Sertoli cell-only syndrome increased up to 6 months after surgery and decreased after that. The results of our study indicate that long-term endocrinologic follow-up is necessary after microdissection TESE, particularly for patients with Klinefelter syndrome to detect hypogonadism.

1620: Pretreatment Total Testosterone Levels in Patients with Prostate Cancer in the Past Two Decades in Japan

You have accessJournal of UrologyModerated Poster 50, Tuesday, May 22, 2007, 3:30 - 5:30 pm1 Apr 20071620: Pretreatment Total Testosterone Levels in Patients with Prostate Cancer in the Past Two Decades in Japan Yoshitaka Sekine, Kazuto Ito, Takumi Yamamoto, Haruki Nakazato, Yasuhiro Shibata, Motoaki Hatori, and Kazuhiro Suzuki Yoshitaka SekineYoshitaka Sekine More articles by this author , Kazuto ItoKazuto Ito More articles by this author , Takumi YamamotoTakumi Yamamoto More articles by this author , Haruki NakazatoHaruki Nakazato More articles by this author , Yasuhiro ShibataYasuhiro Shibata More articles by this author , Motoaki HatoriMotoaki Hatori More articles by this author , and Kazuhiro SuzukiKazuhiro Suzuki More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)31808-1AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "1620: Pretreatment Total Testosterone Levels in Patients with Prostate Cancer in the Past Two Decades in Japan." The Journal of Urology, 177(4S), pp. 536–537 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 177Issue 4SApril 2007Page: 536-537 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Yoshitaka Sekine More articles by this author Kazuto Ito More articles by this author Takumi Yamamoto More articles by this author Haruki Nakazato More articles by this author Yasuhiro Shibata More articles by this author Motoaki Hatori More articles by this author Kazuhiro Suzuki More articles by this author Expand All Advertisement Loading ...

Pretreatment total testosterone levels in patients with prostate cancer in the past two decades in Japan

Background: Many studies have shown the relationship between pretreatment serum testosterone levels and the clinical stage or histological grade, but the clinical significance of pretreatment testosterone levels is controversial. We studied the association of pretreatment total testosterone levels with the clinical stage and histological grade of prostate cancer. Methods: We evaluated 2914 patients whose pretreatment testosterone levels were recorded from 1982 to 2002. Serum testosterone levels were measured by radioimmunoassay. Results: There was a trend toward decreasing testosterone values with worsening clinical staging. There was a trend toward decreasing testosterone values with worsening histological grading, too. Patients with poorly differentiated adenocarcinoma had significantly lower testosterone levels than those with the others (versus well; p < 0.01, moderately; p < 0.01). Conclusions: Newly diagnosed patients with poorly differentiated adenocarcinoma of prostate have lower testosterone levels than the others.