United States Men Research Articles

An investigation of racial and ethnic disparities in donor sperm availability in the United States

To determine whether the racial and ethnic distribution of sperm donors contributing to US sperm banks differs from the demographics of the US population and those of US donor sperm recipients undergoing treatment with invitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Cross-sectional study. United States donor sperm banks, US Census, and fertility clinics reporting to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System. Sperm donors from 18 banks, men aged 18-39 years on the basis of the 2021 Census Current Population Survey, and recipients of donor sperm for IVF and ICSI treatments in clinics reporting to the Assisted Reproductive Technology Clinic Outcome Reporting System from January 1, 2018, to December 31, 2020. None. Proportions of sperm donors and donor sperm recipients undergoing IVF and ICSI treatments identifying as each racial and ethnic group. Eighteen donor sperm banks were identified, encompassing 1,503 donors. Of these donors, 60.9% identified as White compared with 55.1% of the US male population and 67.7% of donor sperm recipients. Proportions of donors identifying as Asian or 2 or more races were larger than those of US men and donor sperm recipients (Asian: 18.6% vs. 6.5%, and 18.6% vs. 10.2%; 2 or more races: 11.6% vs. 2.2%, and 11.6% vs. 1.7%). In contrast, Black donors were underrepresented when compared with the US population of men and donor sperm recipients (2.8% vs. 12.9% and 2.8% vs. 13.0%). Hispanic donors were underrepresented when compared with the US population of men (6.0% vs. 22.2%). The percentages of Hispanic sperm donors and donor sperm recipients were similar (6.0% vs. 7.0%). The racial and ethnic distribution of sperm donors differs significantly from the demographics of the US male population and donor sperm recipients undergoing IVF and ICSI treatments. These findings suggest a need for targeted recruitment efforts for Black sperm donors.

Prostate Specific Antigen Screening on a Nationwide Level: Featuring the Contribution of Race and Life Expectancy in Decision Making

BackgroundEstimation of life expectancy (LE) is important for the relative benefit of prostate specific antigen (PSA) screening. Limited data exists regarding screening for Black men with extended LE. The aim of the current study was to assess temporal trends in screening in United States (US) Black men with limited vs. extended LE, using a nationally representative dataset. Materials and MethodsUsing the National Health Institution Survey (NHIS) 2000 to 2018, men aged ≥40 without prior history of prostate cancer (PCa) who underwent PSA screening in the last 12 months were stratified into limited LE (ie, LE <15 years) and extended LE (ie, LE≥15 years) using the validated Schonberg index. LE-stratified temporal trends in PSA screening were analyzed for all men, and then in Black men. Weighted multivariable analyses and dominance analyses identified the predictors of PSA screening. ResultsPSA screening declined over the study period both for all eligible men with limited and extended LE, particularly between NHIS 2008 and 2013 (27.9%-20.7% in the extended). Screening increased significantly in Black men with extended LE (17.6% in 2010-25.7% in 2018). However, LE was not an independent predictor of screening in the Black cohort. Prior recipient of colonoscopy (55%-57%) and visit to health care provider (24%-32%) were the most important determinants for screening. ConclusionFor US men with extended LE, only 1 in 4 receive PSA screening, with a decline over the study-period. Screening rates increased for Black men. However, these changes were not driven by LE consideration itself, but participation in other screenings and access to a provider.

Dietary Glutamine and Glutamate in Relation to Cardiovascular Disease Incidence and Mortality in the United States Men and Women with Diabetes Mellitus

BackgroundEvidence regarding the potential health effects of dietary amino acids glutamine and glutamate among individuals with type 2 diabetes (T2D) is limited. ObjectivesThe aim was to examine dietary glutamine and glutamate in relation to subsequent risk of cardiovascular disease (CVD) and mortality among individuals with T2D. MethodsWe prospectively followed 15,040 men and women with T2D at baseline or diagnosed during follow-up (Nurses' Health Study: 1980–2014 and Health Professionals Follow-Up Study: 1986–2018). Diet was repeatedly assessed using validated food frequency questionnaires every 2–4 y. Associations of energy-adjusted glutamine and glutamate intake, as well as their ratio, with CVD risk and mortality, were assessed using Cox proportional-hazards models with adjustments for demographics, dietary and lifestyle factors, and medical history. ResultsDuring 196,955 and 225,371 person-years of follow-up in participants with T2D, there were 2927 incident CVD cases and 4898 deaths, respectively. Higher intake of glutamine was associated with lower risk of CVD incidence, CVD mortality, and total mortality: comparing extreme quintiles, the hazard ratios (HRs) (95% confidence intervals [CIs]) were 0.88 (0.77, 0.99), 0.78 (0.65, 0.92), and 0.84 (0.76, 0.92), respectively (all P-trend < 0.05). In contrast, higher intake of glutamate was associated with a higher risk of CVD incidence, CVD mortality, and total mortality; the HRs were 1.30 (1.15, 1.46), 1.46 (1.24, 1.72), and 1.20 (1.09, 1.32), respectively (all P-trend < 0.05). Furthermore, comparing extreme quintiles, a higher dietary glutamine-to-glutamate ratio was associated with a lower risk of CVD incidence (0.84 [0.75, 0.95]), CVD mortality (0.66 [0.57, 0.77]), and total mortality (0.82 [0.75, 0.90]). In addition, compared with participants with stable or decreased consumption of glutamine-to-glutamate ratio from prediabetes to postdiabetes diagnosis, those who increased the ratio had a 17% (5%, 27%) lower CVD mortality. ConclusionsIn adults with T2D, dietary glutamine was associated with a lower risk of CVD incidence and mortality, whereas the opposite was observed for glutamate intake.

Abstract IA007: Science of prostate cancer care and survivorship in black men: Structural, social and biological determinants

Abstract Black men are disproportionately affected by prostate cancer (CaP), with limited progress in closing the CaP care and survivorship gaps experienced by Black men compared to other racial/ethnic groups. Unfortunately, there is an uptick in CaP incidence rate in the United States (US) since 2014. As reported by the American Cancer Society, the rising CaP incidence rate indicates a shift towards higher grade and stage during diagnosis. The prostate cancer (CaP) disparities experienced by Black men in the US is a microcosm of the global burden of CaP seen in men of African ancestry. For example, the top ten countries leading CaP mortality in the world are all Black nations in Africa and the Caribbean. The complexity of CaP disparities and the need for a unique approach to better understand and address a complex chronic disease, such as CaP, underscores the need for consortium research that is multilevel, collaborative, translational, and global. Through the Department of Defense funding, we formed an inclusive Cancer Care Research Equity (iCCaRE) for Black Men Consortium to advance health equity and reduce disparities in CaP. Comprising CaP survivors, advocates, scientists, and clinicians, the iCCaRE for Black Men Consortium addresses structural, social and biological determinants of CaP among ethnically diverse Black men globally, including US Black men, West African immigrant men in the US and indigenous West African men. The overall goal of the iCCaRE consortium is to optimize CaP diagnosis experiences, treatment and survivorship based on the Science of Survivorship (SOS). Our central hypothesis is that improving social-determinants of health (SDOH) factors, CaP care and survivorship (CaPCaS)-related factors and mediating biological factors will lead to an improvement in patient-reported outcomes (PROs). This presentation will highlight the structural inequities, societal injustices and biological determinants found to be associated with CaP care and survivorship among Black men. Additionally, we will present the use of Community Living Lab (CoLLab) Health System approach to address inequity in minoritized and marginalized communities. Citation Format: Folakemi Odedina, Roxana Dronca, Kimlin Ashing, Ernest Kaninjing, Solomon Rotimi, Che Ngufor, Arnold Merriweather, iCCaRE Consortium. Science of prostate cancer care and survivorship in black men: Structural, social and biological determinants [abstract]. In: Proceedings of the AACR Special Conference: Advances in Prostate Cancer Research; 2023 Mar 15-18; Denver, Colorado. Philadelphia (PA): AACR; Cancer Res 2023;83(11 Suppl):Abstract nr IA007.

Geographical Differences in Male Infertility between the United States and Canada: Insights from the Andrology Research Consortium

We sought to compare the demographics and fertility characteristics of men presenting to reproductive urologists (RU) for evaluation in the United States (US) and Canada using data from the Andrology Research Consortium. A standardized patient questionnaire was used to prospectively evaluate men across fifteen North American male infertility practices between 2015 and 2018. Patient demographics, fertility histories, including female partner infertility testing and treatment, and referral data were assessed. Univariate analysis was used to determine geographical differences between the various patient characteristics and the geographical region. We sampled 6,462 men with a mean age of 36.6 ± 7.5 years. The average duration of infertility was significantly higher in US men ( 4.5 ± 7.2 years) compared to Canadian men ( 3.6 ± 4 years) ( p = 0.007 ). Significantly more men in the US were obese (63% vs. 26%, p &lt; 0.001 ) compared to Canada. Intrauterine insemination use among female partners was more common in Canada (13% vs. 7%, p &lt; 0.001 ) while in vitro fertilization was less common (6% vs. 9%, p = 0.01 ) when compared to the US. Finasteride (3% vs. 0%) and testosterone usage (4% vs. 1) were more common among US men versus Canadians, respectively. In conclusion, geographical differences exist between North American males undergoing fertility evaluation. American men are older and more obese and have a longer average duration of infertility. Potentially reversible factors contributing to male infertility are more prevalent in the US.

The Effects of Childhood Sexual Abuse, Mental Health, and Motives for Sex on Sexual Risk-Taking Among United States Men Who Have Sex with Women

ABSTRACT This study assessed the role of mental health symptoms and motives for sex in the association between childhood sexual abuse (CSA) and sexual risk-taking among men who have sex with women (MSW). The sample consisted of young adult (ages 21 to 30), non-monogamous MSW (N = 532) who reported having condomless sex at least once in the past year. Due to alcohol-related aims from two larger studies from which the data were analyzed, participation was excluded to men who regularly consumed alcohol (3 to 35 weekly drinks) and reported no symptoms of alcohol use disorder. Participants answered background questionnaires in lab and then completed a six-week, follow-up survey assessing the number of sex partners and condom use during the prior six weeks. CSA survivors reported greater mental health symptoms and sex motives related to coping, self-affirmation, and partner approval relative to non-survivors. CSA, sex for partner approval, and sex to enhance motives were positively associated with the number of sex partners. Participants endorsing self-affirmation sex motives reported higher condom use than those who did not. CSA contributes to long-term mental and sexual health outcomes among MSW. Identifying and treating depressive and anxiety symptoms and motives for sex may improve sexual health among CSA survivors.

PD38-01 VALIDITY OF PSA SCREENING TRIALS IN A 'REAL WORLD' SETTING: A NATIONWIDE SURVEY ANALYSIS

You have accessJournal of UrologyProstate Cancer: Detection & Screening III (PD38)1 Apr 2020PD38-01 VALIDITY OF PSA SCREENING TRIALS IN A 'REAL WORLD' SETTING: A NATIONWIDE SURVEY ANALYSIS Deepansh Dalela*, Akshay Sood, Jacob Keeley, Sohrab Arora, Marcus Jamil, Chandler Bronkema, Nikola Rakic, James Peabody, Craig Rogers, Quoc-Dien Trinh, Mani Menon, and Firas Abdollah Deepansh Dalela*Deepansh Dalela* More articles by this author , Akshay SoodAkshay Sood More articles by this author , Jacob KeeleyJacob Keeley More articles by this author , Sohrab AroraSohrab Arora More articles by this author , Marcus JamilMarcus Jamil More articles by this author , Chandler BronkemaChandler Bronkema More articles by this author , Nikola RakicNikola Rakic More articles by this author , James PeabodyJames Peabody More articles by this author , Craig RogersCraig Rogers More articles by this author , Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author , Mani MenonMani Menon More articles by this author , and Firas AbdollahFiras Abdollah More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000917.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The efficacy of prostate specific antigen (PSA) screening is predicated on, amongst other factors, age and ethnicity of recipients. The goal of the current study was to compare the age and ethnicity of men undergoing PSA screening the United States (US) to those represented in the Prostate, Lung, Colorectal and Ovarian cancer (PLCO) and the European Randomized Study of Screening for Prostate Cancer (ERSPC) trials. Such a comparison is a key to assess the external validity of these trials in the “real world” setting. METHODS: We used publicly-available data from National Health Institution Survey (NHIS) 2000-2018, the world’s oldest continuously administered survey of non-institutionalized US population. Men aged 50-74 without prior history of prostate cancer (PCa) who underwent PSA testing in the last 12 months as a part of routine test were considered to have undergone PSA screening. Age at PSA screening and self-reported ethnicity were compared with results reported in the PLCO (Andriole, NEJM 2009) and ERSPC (Schroeder, NEJM 2009) trials, using Rao-Scott Chi-Square tests. RESULTS: Overall, 10,854 (weighted n=11,257,531) men underwent annual PSA screening within the available years. The median (IQR) age for PSA screening recipients was 60.9 (55.3-66.4) years (compared to 61.7 years in ERSPC). While PLCO did not report the median age of their cohort, they reported the percentages in each age category. Interestingly, 59.2% of men were aged 60-74 in our cohort vs 68% in PLCO cohort (p<0.001). In terms of ethnicity, 1276 (weighted n=976,126; 8.7%) men in our dataset were African-American, compared to 4.4% in PLCO (p<0.001). CONCLUSIONS: Our analyses shows that compared to PLCO, US men undergoing PSA screening over the last two decades were younger and twice as likely to be African-American. Interestingly, the age distribution in NHIS was similar to men in the ERSPC study (that showed mortality benefit with PSA screening). As such, results of PLCO study may not be extrapolatable to US men, and our findings should be kept in mind when counseling men about the potential risks vs benefits of PSA screening. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e801-e801 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Deepansh Dalela* More articles by this author Akshay Sood More articles by this author Jacob Keeley More articles by this author Sohrab Arora More articles by this author Marcus Jamil More articles by this author Chandler Bronkema More articles by this author Nikola Rakic More articles by this author James Peabody More articles by this author Craig Rogers More articles by this author Quoc-Dien Trinh More articles by this author Mani Menon More articles by this author Firas Abdollah More articles by this author Expand All Advertisement PDF downloadLoading ...

Blending, credit, context: Doing business, family and gender in Czech and US copreneurships

Utilising a comparative/doing gender approach and thematic narrative methodology, we examine how copreneurs – romantic business partners – construct business and caring responsibilities. We interviewed male-female partners separately from 12 couples in the Czech Republic (CR) and 13 in the United States (US), countries with diverse entrepreneurial histories, norms and family policies. We ask: (1) How do copreneurs construct/‘do’ business and family? (2) How do copreneurs credit contributions of partners? (3) How are constructions of business, caring and credit embedded in country contexts? Results show that business tasks did not align with strict gender stereotypes. Task characterisations of CR respondents shifted according to doer’s sex category. CR men claimed business leadership; US men gave women equal credit. In both countries, domestic responsibilities were attributed to women. Women’s narratives addressed blending business and care; men’s narratives concentrated on business. We document how these gendering practices referenced country employment opportunities, gender norms and family-leave policies.

Testicular cancer among US men aged 50 years and older

BackgroundThe incidence of testicular cancer in the United States (US) has substantially increased in recent decades. The majority of testicular cancers are germ cell tumors (TGCT), which are the most commonly occurring malignancies among men aged 15–44 years in the US. To date, few studies have focused on testicular cancer among men aged ≥ 50 years. Thus, we sought to examine detailed descriptive features, including incidence rates and age patterns, of tumors that arise in the testes among men aged ≥ 50 years. MethodsData from forty-one US cancer registries were included for the years 1999–2014. Incidence rates per 100,000 person-years and their 95% confidence intervals (CI) were calculated by race/ethnicity, histology, and age at diagnosis. Estimates of annual percent change (APC) were also calculated. ResultsAge-specific incidence rates of spermatocytic tumors, sex cord stromal tumors and lymphomas rose with age, while age-specific incidence rates of seminomas and nonseminomas declined. Between 1999 and 2014, the incidence of nonseminoma (APC = 3.26, 95% CI: 2.27–4.25) increased more than any other tumor type. The incidence of seminoma (APC: 1.15, 95% CI: 0.59–1.71) also increased, while rates of testicular lymphoma (APC: −0.66, 95% CI: −1.16 to −0.16), spermatocytic tumors (APC: 0.42, 95% CI: −1.42 to 2.29), and sex cord stromal tumors (APC: 0.60, 95% CI: −3.21 to 4.55) remained relatively unchanged. ConclusionGiven the distinct time-trends and age-specific patterns of testicular cancer in men aged ≥50 years, additional investigation of risk factors for these tumors is warranted.

National Trends in Sexual Behavior, Substance Use and HIV Testing Among United States Men Who have Sex with Men Recruited Online, 2013 Through 2017.

The American Men's Internet Survey (AMIS) is conducted annually with 10,000 men age 15 + who have sex with men (MSM). Modeling was used with 39,863 AMIS surveys from 4 cycles between December 2013 to February 2017 to identify temporal trends in sexual behavior, substance use, and testing behavior (within 12months preceding interview) stratified by participants' self-reported HIV status. HIV-negative/unknown status MSM had significant increases in condomless anal intercourse (CAI), marijuana use, use of other illicit substances, sexually transmitted infection (STI) diagnoses, and HIV or STI testing (testing only increased among MSM age 25 +). HIV-negative/unknown status MSM had significant decrease in CAI with an HIV-positive or unknown status partner. HIV-positive MSM had significant increases in CAI, methamphetamine use, and STI diagnoses/testing. Although encouraging, the few indicators of improvement in HIV/STI sexual health practices are not consistently seen across sub-groups of MSM and may be counteracted by growing proportions of MSM engaging in CAI and acquiring STIs.

Association between Dietary Zinc Intake and Hyperuricemia among Adults in the United States.

We aim to explore the associations between dietary zinc intake and hyperuricemia (HU) in United States (US) adults. 24,975 US adults aged 20 years or older from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2014 were stratified into quintiles based on zinc intake. All dietary intake measured through 24-h dietary recalls. Multivariable logistic regression analysis was performed to examine the association between zinc intake and HU after adjustment for possible confounders. For males, compared with respondents consuming less than 7.33 mg zinc daily, the adjusted odds ratios (ORs) were 0.83 (95% CI, 0.71, 0.97) among those consuming 10.26–13.54 mg zinc daily, 0.78 (95% CI, 0.63–0.96) among those consuming 18.50 mg or greater, and p for the trend was 0.0134. For females, compared with respondents consuming less than 5.38 mg zinc daily, the OR was 0.78 (95% CI, 0.63, 0.97) among those consuming 9.64–12.93 mg zinc daily, and p for the trend was 0.3024. Our findings indicated that dietary zinc intake is inversely associated with HU in US men and women, independent of some major confounding factors.

Infection-Related Hospital Admissions After Prostate Biopsy in United States Men.

Antibiotic prophylaxis during prostate biopsy is widespread; however, rates of postbiopsy infections have been rising. In an analysis of insurance claims data for 515045 prostate biopsies, 1.55% were hospitalized with infectious complications, with a mean total payment $14498.96. Infection was the second most common reason for 30-day hospital readmission.

BIRGing with the Best; CORFing for the Country: Fan Identification and Nationalism during the 2014 FIFA World Cup

ABSTRACTTo determine how consumption team performance (winning/losing) affects fan identification and subsequent nationalism traits, a national survey of 720 respondents was conducted at four different time periods throughout the 2014 FIFA World Cup. Using structural equation modelling, increased consumption significantly predicts fan identification towards the United States Men's National Team (USMNT). Consumption alone had no effect on nationalistic identity; however, fan identification towards USMNT significantly increased nationalised qualities one exhibits toward one's home country. Winning or losing had no effect on fan identity, yet losing did negatively affect fan internationalism scores and views of global citizenship. Ramifications are offered for theory as well as conclusions related to fan identity and nationalism as a byproduct from winning and losing.

Changes in Intake of Fruits and Vegetables and Weight Change in United States Men and Women Followed for Up to 24 Years: Analysis from Three Prospective Cohort Studies

BackgroundCurrent dietary guidelines recommend eating a variety of fruits and vegetables. However, based on nutrient composition, some particular fruits and vegetables may be more or less beneficial for maintaining or achieving a healthy weight. We hypothesized that greater consumption of fruits and vegetables with a higher fiber content or lower glycemic load would be more strongly associated with a healthy weight.Methods and FindingsWe examined the association between change in intake of specific fruits and vegetables and change in weight in three large, prospective cohorts of 133,468 United States men and women. From 1986 to 2010, these associations were examined within multiple 4-y time intervals, adjusting for simultaneous changes in other lifestyle factors, including other aspects of diet, smoking status, and physical activity. Results were combined using a random effects meta-analysis. Increased intake of fruits was inversely associated with 4-y weight change: total fruits -0.53 lb per daily serving (95% CI -0.61, -0.44), berries -1.11 lb (95% CI -1.45, -0.78), and apples/pears -1.24 lb (95% CI -1.62, -0.86). Increased intake of several vegetables was also inversely associated with weight change: total vegetables -0.25 lb per daily serving (95% CI -0.35, -0.14), tofu/soy -2.47 lb (95% CI, -3.09 to -1.85 lb) and cauliflower -1.37 lb (95% CI -2.27, -0.47). On the other hand, increased intake of starchy vegetables, including corn, peas, and potatoes, was associated with weight gain. Vegetables having both higher fiber and lower glycemic load were more strongly inversely associated with weight change compared with lower-fiber, higher-glycemic-load vegetables (p < 0.0001). Despite the measurement of key confounders in our analyses, the potential for residual confounding cannot be ruled out, and although our food frequency questionnaire specified portion size, the assessment of diet using any method will have measurement error.ConclusionsIncreased consumption of fruits and non-starchy vegetables is inversely associated with weight change, with important differences by type suggesting that other characteristics of these foods influence the magnitude of their association with weight change.

1029Infection-Related Hospital Readmissions Following Prostate Biopsy in United States Men

1029Infection-Related Hospital Readmissions Following Prostate Biopsy in United States Men

Recent trends in the incidence of testicular germ cell tumors in the United States.

Testicular germ cell tumors (TGCT), which comprise 98% of all testicular malignancies, are the most commonly occurring cancers among men between the ages of 15 and 44years in the United States (US). A prior report from our group found that while TGCT incidence among all US men increased between 1973 and 2003, the rate of increase among black men was more pronounced starting in 1989-1993 than was the rate of increase among other men. In addition, TGCT incidence increased among Hispanic white men between 1992 and 2003. To determine whether these patterns have continued, in the current study, we examined temporal trends in incidence through 2011. Between 1992 and 2011, 21271 TGCTs (12419 seminomas; 8715 non-seminomas; 137 spermatocytic seminomas) were diagnosed among residents of the Surveillance, Epidemiology, and End Results 13 registry areas. The incidence of TGCT was highest among non-Hispanic white men (6.97 per 100000 man-years) followed by American Indian/Alaska Native (AI/AN; 4.66), Hispanic white (4.11), Asian/Pacific Islander (A/PI; 1.95), and black (1.20) men. Non-Hispanic white men were more likely to present with smaller tumors (3.5cm) and localized disease (72.6%) than were men of other races/ethnicities. Between 1992 and 2011, TGCT incidence increased significantly among Hispanic white [annual percent change (APC)=2.94, p<0.0001], black (APC=1.67, p=0.03), non-Hispanic white (APC=1.23, p<0.0001), and A/PI (APC=1.04, p=0.05) men. Incidence rates also increased, although not significantly, among AI/AN men (APC=2.96, p=0.06). The increases were greater for non-seminoma than seminoma. In summary, while non-Hispanic white men in the US continue to have the highest incidence of TGCT, they present at more favorable stages of disease and with smaller tumors than do other men. The increasing rates among non-white men, in conjunction with the larger proportion of non-localized stage disease, suggest an area where future research is warranted.

Estradiol concentrations in young healthy US versus Chinese men

The role of estrogens among men has rarely been explicitly considered. We examined differences in total, free, and bioavailable estradiol (Bio E) between young men from the United States (US) and the most economically developed part of China, that is, Hong Kong (HK). Cross-sectional analysis was conducted based on 365 young men from the Third National Health and Nutrition Examination Survey in the US and 299 young Chinese men. All participants were aged from 18 to 29 years. Main outcome measures were total estradiol (E2) and calculated Bio E and free estradiol (FE). In both young US and Chinese men, E2 concentrations peaked at ages 25-29 years, at 43.3 pg/ml [95% confidence interval (CI) 41.9-44.8] in US men and 29.0 pg/ml (95% CI 26.2-32.0) in Chinese men. After adjustment for age and ethnicity, in all participants, US men had higher average concentrations of E2 [39.0 (95% CI 38.6-39.4) versus 28.3 (95% CI 28.3-28.4) pg/ml], FE [72.9 (95% CI 72.7-73.7) versus 56.8 (95% CI 56.6-56.9) ng/dl], and Bio E [17.9 (95% CI 17.7-18.1) versus 14.9 (95% CI 14.8-14.9) pg/ml] than HK men. Further adjustment for height or body mass index did not change the results. Estradiol, and free and Bio E concentrations are much lower in young healthy Chinese men than US men. However, these findings based on comparison between the two assays in the two different locations need further confirmation.

International and ethnic variability of falls in older men

Fallers and especially recurrent fallers are at high risk for injuries. The aim of this study was to evaluate fall epidemiology in older men with special attention to the influence of age, ethnicity and country of residence. 10,998 men aged 65 years or above recruited in Hong Kong, the United States (US) and Sweden were evaluated in a cross-sectional retrospective study design. Self-reported falls and fractures for the preceding 12 months were registered through questionnaires. Group comparisons were done by chi-square test or logistic regression. The proportion of fallers among the total population was 16.5% in ages 65-69, 24.8% in ages 80-84 and 43.2% in ages above 90 (P <0.001). The corresponding proportions of recurrent fallers in the same age groups were 6.3%, 10.1% and 18.2%, respectively (P <0.001), and fallers with fractures 1.0%, 2.3% and 9.1%, respectively (P <0.001). The proportion of fallers was highest in the US, intermediate in Sweden and lowest in Hong Kong (in most age groups P <0.05). The proportion of fallers among white men in the US was higher than in white men in Sweden (all comparable age groups P <0.01) but there were no differences in the proportion of fallers in US men with different ethnicity. The proportion of fallers in older men is different in different countries, and data in this study corroborate with the view that society of residence influences fall prevalence more than ethnicity.

Testosterone concentrations in young healthy us versus Chinese men

Previous small studies examining differences in testosterone concentrations by ethnicity found mixed results for Caucasians and Chinese men, which might be confounded by age differences and living standards. The aim of the present study is to examine the differences in total, free, and bioavailable testosterone concentrations between healthy young men from the United States (US) and from the most economically developed part of China, i.e., Hong Kong (HK). Cross-sectional analysis based on 365 young men from the Third National Health and Nutrition examination Survey (NHANES III) in the US and 299 Chinese men recruited from university students. All participants were aged from 18 to 29 years. Main outcome measures were total testosterone (TT) and calculated bioavailable testosterone (Bio T) and free testosterone (FT). In both US and Chinese men, TT, FT, and Bio T concentration peaked at 20-24 years of age, at 23.19, 0.49, and 12.23 nmol/l in US men, and 20.72, 0.48 and 12.59 nmol/l in Chinese men, respectively. Among those aged 18-24 years, after adjusting for age, US men had higher TT (mean, 95% confidence interval: 21.64, 21.31-21.99 versus 20.20, 20.12-20.28 nmol/l), but not FT (0.47, 0.47-0.48 versus 0.47, 0.47-0.47 nmol/l) or Bio T (11.90, 11.83-11.97 versus 12.39, 12.35-12.42 nmol/l) than Chinese men. TT, but not FT or Bio T concentrations are lower in young healthy Chinese men than US men. These differences apparent in young men may be important in understanding different patterns of diseases between Western and Asian populations.

United States Women Receive More Curative Treatment for Hepatocellular Carcinoma Than Men

Previous database studies have found gender disparities favoring men in rates of liver transplantation, which resolve in cohorts examining only patients with hepatocellular carcinoma (HCC). Our study aims to use two large, multicenter United States (US) databases to assess for gender disparity in HCC treatment regardless of transplant listing status. We performed a retrospective database analysis of inpatient admission data from the University Health Consortium (UHC) and the Nationwide Inpatient Sample (NIS), over a 9- and 10-year period, respectively. Adults with a primary discharge diagnosis of HCC, identified using the International Classification of Diseases 9th Edition (ICD-9) code, were included. Series of univariate and multivariate analyses were performed to examine gender disparities in metastasis, liver decompensation, treatment type, and inpatient mortality after controlling for other possible predictors. We included 26,054 discharges from the NIS database and 25,671 patients from the UHC database in the analysis. Women with HCC appear to present less often with decompensated liver disease (OR = 0.79, p < 0.001). Furthermore they are more likely to receive invasive HCC treatment, with significantly higher rates of resection across race and diagnoses (OR = 1.34 and 1.44, p < 0.001). Univariate analyses show that US women have lower unadjusted rates of transplant; however, the disparity resolves after controlling for other clinical and demographic factors. US women more often receive invasive treatment for HCC (especially resection) than US men with no observed disparity in transplantation rates when adjusted for pre-treatment variables.