Primary and Secondary Hypogonadism in Male Persons with Diabetes Mellitus

Aims. To characterize hypogonadism in male persons with diabetes mellitus. Patients and Methods. 184 consecutive male persons with diabetes were studied. Besides the usual care, total testosterone (TT), estradiol (E2), FSH, and LH were measured in the last appointment and in 40 patients, also in the next two appointments. Statistical analysis compared groups and explored factors for TT and LH levels. Results. TT levels were stable and highly correlated (r > 0.750, p < 0.001 ) over a 6–12-month period. 20% of the patients presented secondary hypogonadism (SH) and 18% presented primary hypogonadism (PH). SH was inversely related to HbA1 (partial r (rp) = 0.229, p < 0.005 ), while PH was directly related to age (r = 0.356, p < 0.001 ). TT levels were reduced independently by metformin (364 ± 160 vs. 431 ± 242 ng/dL, t = 2.241, p < 0.05 ) and statins (359 ± 156 vs. 424 ± 230 ng/dl, t = 2.224, p < 0.05 ). TT levels were inversely related to microvascular disease (rp = −0.169, p < 0.05 ). Discussion. TT levels were stable over time and hypogonadism was common. SH, generally clinically, is related to the diabetic state, while PH, generally subclinically, is an age-dependent process unrelated to diabetes. Low TT levels were related to older age, poor metabolic control, metformin and statins use, and microvascular disease.

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Videocapillaroscopy in diabetes mellitus: Metabolic control and microvascular disease

Diabetes Research and Clinical Practice ◽

10.1016/s0168-8227(00)81891-4 ◽

2000 ◽

Vol 50 ◽

pp. 128

Author(s):

V.L.R.C. Halfoun ◽

T.J. Fernandes ◽

F.C. Victer ◽

R. Tavares

Keyword(s):

Diabetes Mellitus ◽

Metabolic Control ◽

Microvascular Disease

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Influence of Metabolic Control on Thromboxane Biosynthesis and Plasma Plasminogen Activator Inhibitor Type-1 in Non-insulin-dependent Diabetes mellitus

Thrombosis and Haemostasis ◽

10.1055/s-0038-1650518 ◽

1996 ◽

Vol 76 (01) ◽

pp. 034-037 ◽

Cited By ~ 12

Author(s):

Giovanni Davì ◽

Mario Belvedere ◽

Sergio Vingneri ◽

Isabella Catalano ◽

Carlo Giammarresi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Metabolic Control ◽

Platelet Activation ◽

Macrovascular Disease ◽

Dependent Diabetes Mellitus ◽

Secondary Failure ◽

Diet And Exercise ◽

Strict Diet ◽

Niddm Patients ◽

Pai 1

SummaryWe have previously shown that tight metabolic control by insulin therapy reduced thromboxane-dependent platelet activation in noninsulin-dependent diabetes mellitus (NIDDM) patients. The present study was undertaken to determine whether a similar effect could be obtained without switching diabetics in secondary failure to insulin treatment. For this purpose, we gave strict diet and exercise advise program and adjusted on a weekly basis the oral antidiabetic therapy (glipizide) that 26 patients with NIDDM had been given over the previous months.Basal measurements of urinary ll-dehydro-TXB2 and PAI-1 confirmed previous findings of enhanced levels of these parameters in NIDDM patients with macrovascular disease in comparison to age-and sex-matched controls. After 2-6 weeks, 16 patients achieved tight metabolic control associated with significant reduction of both thromboxane biosynthesis and PAI-1 levels; 10 patients remained in poor control and no significant decrease of both parameters was observed.We conclude that reduction of in-vivo platelet activation and PAI-1 antigen levels after metabolic improvement obtained by frequent reassessment of sulphonylurea therapy together with strict diet and exercise programs may have beneficial effects on the progression of diabetic micro- and macrovascular disease.

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Detection of Circulating Tissue Factor and Factor VII in a Normal Population

Thrombosis and Haemostasis ◽

10.1055/s-0038-1650365 ◽

1996 ◽

Vol 75 (05) ◽

pp. 772-777 ◽

Cited By ~ 30

Author(s):

Sybille Albrecht ◽

Matthias Kotzsch ◽

Gabriele Siegert ◽

Thomas Luther ◽

Heinz Großmann ◽

...

Keyword(s):

Tissue Factor ◽

Normal Population ◽

Mean Value ◽

Factor Vii ◽

Significant Difference ◽

Age Dependent ◽

The Mean ◽

Highly Correlated ◽

And Gender

SummaryThe plasma tissue factor (TF) concentration was correlated to factor VII concentration (FVIIag) and factor VII activity (FVIIc) in 498 healthy volunteers ranging in age from 17 to 64 years. Immunoassays using monoclonal antibodies (mAbs) were developed for the determination of TF and FVIIag in plasma. The mAbs and the test systems were characterized. The mean value of the TF concentration was 172 ± 135 pg/ml. TF showed no age- and gender-related differences. For the total population, FVIIc, determined by a clotting test, was 110 ± 15% and the factor VIlag was 0.77 ± 0.19 μg/ml. FVII activity was significantly increased with age, whereas the concentration demonstrated no correlation to age in this population. FVII concentration is highly correlated with the activity as measured by clotting assay using rabbit thromboplastin. The ratio between FVIIc and FVIIag was not age-dependent, but demonstrated a significant difference between men and women. Between TF and FVII we could not detect a correlation.

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Kajian Interaksi Obat Metformin pada Pasien Diabetes Mellitus

Jurnal Farmasetis ◽

10.32583/farmasetis.v8i2.592 ◽

2019 ◽

Vol 8 (2) ◽

pp. 55-58

Author(s):

Havizur Rahman ◽

Teresia Anggi Octavia

Keyword(s):

Diabetes Mellitus ◽

Drug Interaction ◽

Data Collection ◽

Drug Interactions ◽

Degenerative Disease ◽

Moderate Severity ◽

Purposive Sampling ◽

Chronic Degenerative Disease ◽

Over Time ◽

Diabetes Melitus

Diabetes melitus merupakan penyakit degeneratif kronis yang apabila tidak ditangani dengan tepat, lama kelamaan bisa timbul berbagai komplikasi, ini cenderung menyebabkan pasien mendapatkan banyak obat dalam satu resep yang dapat menimbulkan interaksi antar obat. Tujuan dari penelitian ini adalah mengetahui persentase terjadinya interaksi obat metformin secara teori serta mengkaji efek yang mungkin timbul dan solusinya. Teknik pengambilan data dengan purpossive sampling, yaitu resep pasien rujuk balik yang menderita diabetes mellitus yang menggunakan metformin. Data yang diperoleh ditemukan bahwa obat yang berinteraksi dengan metformin dengan tingkat keparahan minor ialah sebesar 60%. Kemudian untuk tingkat keparahan moderat ialah sebesar 20%. Sedangkan untuk tingkat keparahan mayor tidak ditemukan. Dari tabel diatas juga dapat diketahui bahwa terdapat 4 obat yang saling berinteraksi dengan metformin, sedangkan untuk obat yang tidak saling berinteraksi dengan metformin terdapat 9 obat. Jumlah obat yang berinteraksi secara teori sebesar 6,85% dan yang tidak berinteraksi 93,15%. Terdapat interaksi obat metformin dengan beberapa obat yaitu furosemid, lisinopril, acarbose dan ramipril. Kata kunci: interaksi obat, metformin, diabetes mellitus STUDY OF METFORMIN INTERACTION IN MELLITUS DIABETES PATIENTS ABSTRACT Mellitus is a chronic degenerative disease which if not handled properly, over time can arise various complications, this tends to cause patients to get many drugs in one recipe that can cause interactions between drugs. The purpose of this study is to determine percentage of metformin drug interactions in theory and examine the effects that may arise and solutions. Data collection techniques using purposive sampling, which is a recipe for reconciliation patients who suffer from diabetes mellitus using metformin. The data obtained it was found that drugs that interact with metformin with minor severity were 60%. Then for moderate severity is 20%. Whereas the major severity was not found. From the table above it can also be seen that there are 4 drugs that interact with metformin, while for drugs that do not interact with metformin there are 9 drugs. The number of drugs that interacted theoretically was 6.85% and 93.15% did not interact. An interaction of the drug metformin with several drugs namely furosemide, lisinopril, acarbose and ramipril. Keywords: drug interaction, metformin, diabetes mellitus

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Effects of metabolic control on cutaneous findings in diabetes mellitus

Brazilian Journal of Internal Medicine ◽

10.15743/rbmi.2014.0002 ◽

2014 ◽

Author(s):

Carlos Gustavo Wambier ◽

Maria H Takada ◽

Maria C Foss-Freitas ◽

Marco A C Frade ◽

Milton C Foss ◽

...

Keyword(s):

Diabetes Mellitus ◽

Metabolic Control

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Relationship of microvascular disease in diabetes to metabolic control

Diabetes ◽

10.2337/diabetes.26.8.760 ◽

1977 ◽

Vol 26 (8) ◽

pp. 760-769 ◽

Cited By ~ 84

Author(s):

R. Engerman ◽

J. M. Bloodworth ◽

S. Nelson

Keyword(s):

Metabolic Control ◽

Microvascular Disease ◽

Relationship Of

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Hypogonadism and liver fibrosis in HIV-infected patients

Journal of Endocrinological Investigation ◽

10.1007/s40618-021-01512-9 ◽

2021 ◽

Author(s):

E. Quiros-Roldan ◽

T. Porcelli ◽

L. C. Pezzaioli ◽

M. Degli Antoni ◽

S. Paghera ◽

...

Keyword(s):

Liver Fibrosis ◽

Univariate Analysis ◽

Free Testosterone ◽

Sex Hormone Binding Globulin ◽

Total Testosterone ◽

Cross Sectional ◽

Pituitary Dysfunction ◽

Consequent Reduction ◽

Secondary Hypogonadism ◽

The Relationship

Abstract Purpose Hypogonadism is frequent in HIV-infected men and might impact on metabolic and sexual health. Low testosterone results from either primary testicular damage, secondary hypothalamic-pituitary dysfunction, or from liver-derived sex-hormone-binding-globulin (SHBG) elevation, with consequent reduction of free testosterone. The relationship between liver fibrosis and hypogonadism in HIV-infected men is unknown. Aim of our study was to determine the prevalence and type of hypogonadism in a cohort of HIV-infected men and its relationship with liver fibrosis. Methods We performed a cross-sectional retrospective study including 107 HIV-infected men (median age 54 years) with hypogonadal symptoms. Based on total testosterone (TT), calculated free testosterone, and luteinizing hormone, five categories were identified: eugonadism, primary, secondary, normogonadotropic and compensated hypogonadism. Estimates of liver fibrosis were performed by aspartate aminotransferase (AST)-to-platelet ratio index (APRI) and Fibrosis-4 (FIB-4) scores. Results Hypogonadism was found in 32/107 patients (30.8%), with normogonadotropic (10/107, 9.3%) and compensated (17/107, 15.8%) being the most frequent forms. Patients with secondary/normogonadotropic hypogonadism had higher body mass index (BMI) (p < 0001). Patients with compensated hypogonadism had longer HIV infection duration (p = 0.031), higher APRI (p = 0.035) and FIB-4 scores (p = 0.008), and higher HCV co-infection. Univariate analysis showed a direct significant correlation between APRI and TT (p = 0.006) and SHBG (p = 0.002), and between FIB-4 and SHBG (p = 0.045). Multivariate analysis showed that SHBG was independently associated with both liver fibrosis scores. Conclusion Overt and compensated hypogonadism are frequently observed among HIV-infected men. Whereas obesity is related to secondary hypogonadism, high SHBG levels, related to liver fibrosis degree and HCV co-infection, are responsible for compensated forms.

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Sustained impact of a sleep intervention and moderators of treatment outcome for children with ADHD: a randomised controlled trial

Psychological Medicine ◽

10.1017/s0033291718004063 ◽

2019 ◽

Vol 50 (2) ◽

pp. 210-219 ◽

Cited By ~ 7

Author(s):

E. Sciberras ◽

M. Mulraney ◽

F. Mensah ◽

F. Oberklaid ◽

D. Efron ◽

...

Keyword(s):

Usual Care ◽

Sleep Problem ◽

Controlled Trial ◽

Parent Report ◽

Daily Functioning ◽

Adhd Medication ◽

Randomised Controlled ◽

Severe Sleep Problem ◽

Over Time

AbstractBackgroundWe aim to (1) determine whether a behavioural sleep intervention for children with attention-deficit/hyperactivity disorder (ADHD) leads to sustained benefits; and (2) examine the factors associated with treatment response.MethodsThis study was a randomised controlled trial of 244 children (5–13 years) with ADHD from Victoria, Australia. All participants had a moderate/severe sleep problem that met American Academy of Sleep Medicine criteria for an eligible sleep disorder by parent report. The two-session intervention covered sleep hygiene and standardised behavioural strategies. The control group received usual care. Parent- and teacher-reported outcomes at 12 months included sleep, ADHD severity, quality of life, daily functioning, behaviour, and parent mental health. Adjusted mixed effects regression analyses examined 12 month outcomes. Interaction analyses were used to determine moderators of intervention outcomes over time. The trial was registered with ISRCTN, http://www.controlled-trials.com (ISRCTN68819261).ResultsIntervention children were less likely to have a moderate/severe sleep problem by parent report at 12 months compared to usual care children (28.4% v. 46.5%, p = 0.03). Children in the intervention group fared better than the usual care group in terms of parent-reported ADHD symptoms (Cohen's d: −0.3, p < 0.001), quality of life (d: 0.4, p < 0.001), daily functioning (d: −0.5, p < 0.001), and behaviour (d: −0.3, p = 0.005) 12 months later. The benefits of the intervention over time in terms of sleep were less for children not taking ADHD medication and children with parents experiencing depression.ConclusionsA behavioural sleep intervention for ADHD is associated with small sustained improvements in child wellbeing. Children who are not taking ADHD medication or have parents with depression may require follow-up booster sleep sessions.

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