scholarly journals Features of hyperandrogenism in men

2021 ◽  
Vol 67 (2) ◽  
pp. 111-115
Author(s):  
V. A. Filatova ◽  
R. V. Rozhivanov
Keyword(s):  
Young Patients ◽  
Clinical Manifestations ◽  
Free Testosterone ◽  
Sex Hormone Binding Globulin ◽  
P Value ◽  
Total Testosterone ◽  
Androgenic Alopecia ◽  
Testosterone Levels ◽  
Group 3 ◽  
Group 2

BACKGROUND: Today the problem of hyperandrogenism in women is a widely studied and discussed while same issue in relation to men is barely raised. In clinical practice, hyperandrogenism can be the cause of a number of diseases.AIM: Provide characterization the variations of physiological hyperandrogenism in men.MATERIALS AND METHODS: Сontinuous cross-sectional study of 100 men with hyperandrogenism. The study assessed the volume and structure of the prostate, the volume of the testicles; the levels of luteinizing hormone (LH), total testosterone, sex hormone binding globulin (SHBG) were determined with further calculation of the level of free testosterone according to Vermeullen, and dihydrotestosterone (DHT). Based on the results of the analysis of the hormonal status of patients with hyperandrogenism, 4 groups of patients were formed: 1-patients with increased total testosterone and SHBG levels; 2-patients with elevated total testosterone levels and normal SHBG levels; 3-patients with an increased level of total testosterone, DHT with a normal level of SHBG; 4-patients with an increased level of DHT with normal levels of total testosterone and SHBG. The difference between groups of patients was determined, a p-value <0.05 was considered statistically significant.RESULTS: The age and volume of the prostate in group 1 patients were statistically significantly higher than in the other groups. This group, despite the high level of total testosterone, was not characterized by complaints of acne. Group 2 patients complained of acne more often, but the prevalence of this symptom even in this group was statistically significantly lower than in group 3 patients. At the same time, the frequency of occurrence of alopecia was statistically significantly lower in group 2 than in patients of both groups 3 and 4. Patients of group 3 had the most striking clinical manifestations of hyperandrogenism. Group 4 was characterized by alopecia.CONCLUSION: An increase of androgen levels can be detected at any age. At the same time, in men of the older age group, an increase in the level of total testosterone may be due to an increase in the secretion of SHBG and not be accompanied by an increase in the level of free testosterone. In young patients, the clinical manifestations of hyperandrogenism may differ: patients with elevated DHT levels are characterized by androgenic alopecia; acne is common in men with elevated total and free testosterone levels, and increased DHT exacerbates the problem.

scholarly journals SAT-LB5 Prevalence of Hypogonadism in Young Obese Males

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Anup Halappanavar ◽  
Rajiv Pakhetra
Keyword(s):  
Hypogonadotropic Hypogonadism ◽  
Armed Forces ◽  
Free Testosterone ◽  
Sex Hormone Binding Globulin ◽  
P Value ◽  
Total Testosterone ◽  
Reference Ranges ◽  
Cross Sectional ◽  
Testosterone Levels ◽  
The Impact

Abstract Ageing, obesity, and chronic illness are major factors affecting serum testosterone (T) levels in men.The magnitude of the impact of ageing on serum T levels is well established, for obesity this is less clear. Severe obesity may lead to isolated hypogonadotropic hypogonadism (IHH). Several explanations have been offered to clarify the presence of reduced T levels in obese men. One relates to the technique that is generally employed to measure serum androgen levels, i.e. measurement of total testosterone (TT) instead of free testosterone (FT). TT represents the sum of FT and T bound to albumin and sex hormone binding globulin (SHBG). A profound reduction in SHBG level is commonly found in obese men, and this is a major factor causing a decrease in TT.Measurement of free testosterone levels may provide a more accurate assessment of androgen status than the (usually preferred) measurement of total testosterone in situations where SHBG levels are outside the reference range. However, reference ranges for free testosterone levels are not well established, especially in older men, and some have argued that the measurement of free testosterone levels merely reintroduces age in a covert form. This is a cross sectional study to estimate prevalence of hypogonadism in young obese males. In this study 147 young obese men participated, of which we confirmed low total testosterone (TT) levels in 35.37% of subjects with a p value of 0.06. Since only Total Testosterone was measured for categorizing subjects with or without hypogonadism, Free Testosterone measurement would be a better indicator for the diagnosis of hypogonadism as in cases where the total testosterone is borderline-low or when SHBG concentrations are abnormal. As such, the study is valuable in the context of the ongoing controversy as to whether testosterone treatment should be limited to men with classical hypogonadism, or be considered for appropriately selected men with functional hypogonadism as well. The principal findings are in general agreement with existing literature reporting correlation between levels of testosterone, body mass index and constitutional symptoms. However, this has never been shown before in context of Indian population. The present study was carried out at Armed Forces Medical College and Command Hospital, Pune between October 2017 to August 2019.We studied to see if there is association between testosterone levels and BMI. In our study we found no statistical association as the p value was 0.26 (&gt;0.05)

The Majority of Myeloma Patients Are Hypogonadal but This Is Not Associated with High Risk Cytogenetics

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5329-5329
Author(s):  
Beau Snoad ◽  
Samantha Hudzik ◽  
Douglas W Sborov ◽  
Nita Williams ◽  
Desiree Jones ◽  
...  
Keyword(s):  
Overall Survival ◽  
High Risk ◽  
Conflicts Of Interest ◽  
Serum Testosterone ◽  
Clinic Visit ◽  
Total Testosterone ◽  
Testosterone Levels ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Introduction: Hypogonadism, i.e. low total testosterone, is present in approximately a quarter of men older than 70 years (Harman SM et al, J. Clin Endo & Met, 2001, PMID 11158037 and Wu FCW et al, J Clin Endo & M et, 2008, PMID 18270261). Myeloma patients are known to suffer from fatigue and decreased functional performance, mood disturbances, and anemia; similar trends have been found in people with hypogonadism. Cytogenetically high risk myeloma characterized by the amplification of 1q21 is associated with increased serum levels of soluble IL-6 receptor (sIL-6r) (Stephens OW, Blood, 2012, PMID 22072558). We hypothesized that total testosterone levels will be associated with overall survival from the time of diagnosis, presence of 1q21 amplification by CD138-selected FISH, anemia, and anti-depressant use. Methods: The Buckeye Myeloma Registry (OSU 10115) opened in 2011 to enroll any patient with a plasma cell dyscrasia. Serum total testosterone was measured at the time of the initial clinic visit to the myeloma group at Ohio State. Less than 325 ng/dL was defined as the hypogonadal range, and testosterone was divided into <100 (group 1), 100-240 (group 2), 240-325 (group 3), and greater than 325 ng/dL (group 4), although normal testosterone decreases with age. Female patient testosterone levels were also analyzed and divided into <10 (group 1), 10-60 ng/dL (group 2), and >60 ng/dL (group 3). A retrospective chart review was initiated to review all myeloma patients with a serum testosterone drawn at the time of their initial clinic visit to OSU. Results: Among 418 male MM patients, median age was 65 y.o. (range 24-95), 86% were Caucasian and 14% African-American, and the distribution of ISS stage was 32% stage 1, 22% stage 2, and 19% stage 3 with 28% missing staging data. Cytogenetic data was missing from 28% of patients. Out of 418 male MM patients, 29 (7%) had serum testosterone <100, 202 (48%) with testosterone 100-240, 79 (19%) with testosterone 241-325, and 108 (26%) > 325 ng/dL. Out of 172 female MM patients, 44 (26%) had an undetectable serum testosterone, 120 (70%) with testosterone 10-60, and 8 (5%) with testosterone > 60. Among male MM patients, log-rank [Mantel-Cox] analysis of overall survival with serum testosterone including all 4 groups demonstrated no significant differences (p=0.917) with only 80 events. Among 275 male MM patients with cytogenetic information available, there was no correlation between presence of 1q21 trisomies or tetrasomies and overall survival (r=0.0714, p=0.238). There was a strong and expected correlation between testosterone and BMI (r=0.14, p=0.00468). Among 161 total female MM patients, log-rank analysis with serum testosterone including all 3 groups also demonstrated no differences (p=0.416) with only 29 events in total. Among 101 females with cytogenetic information, there was also no correlation with 1q21 amplification (r=0.0895, p=0.373). Conclusion: The majority of male MM patients (74%) have secondary hypogonadism and approximately half have total testosterone levels <240 ng/dL. Cox proportional hazards analyses of survival adjusted for significant univariate covariates will be presented at the meeting. Correlations with anemia and medication use (specifically opiates and anti-depressants) will also be presented at the meeting. Disclosures No relevant conflicts of interest to declare.

scholarly journals Hypoactive sexual desire in transsexual women: prevalence and association with testosterone levels

2008 ◽  
Vol 158 (3) ◽  
pp. 393-399 ◽  
Author(s):  
Els Elaut ◽  
Griet De Cuypere ◽  
Petra De Sutter ◽  
Luk Gijs ◽  
Michael Van Trotsenburg ◽  
...  
Keyword(s):  
Sexual Desire ◽  
Free Testosterone ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Sex Hormone Binding Globulin ◽  
Control Group ◽  
Total Testosterone ◽  
Cross Sectional ◽  
Oestrogen Treatment ◽  
Testosterone Levels

ObjectiveAn unknown proportion of transsexual women (defined as post-operative male-to-female transsexuals on oestrogen replacement) experience hypoactive sexual desire disorder (HSDD). It has been suggested that the absence of ovarian androgen production together with oestrogen treatment-related increase in sex hormone-binding globulin (SHBG) levels could be leading to HSDD, due to low levels of biologically available testosterone. This study wishes to document the HSDD prevalence among transsexual women and the possible association to androgen levels.DesignCross-sectional study.MethodsTranssexual women (n=62) and a control group of ovulating women (n=30) participated in this study. Questionnaires measuring sexual desire (sexual desire inventory) and relationship and sexual satisfaction (Maudsley Marital Questionnaire) were completed. Serum levels of total testosterone, LH and SHBG were measured in blood samples obtained at random in transsexual women and in the early follicular phase in ovulating women.ResultsThe transsexual group had lower levels of total and calculated free testosterone (both P<0.001) than the ovulating women. HSDD was reported in 34% of the transsexual and 23% of the ovulating women (P=0.30). Both groups reported similar levels of sexual desire (P=0.97). For transsexual women, no significant correlation was found between sexual desire and total (P=0.64) or free testosterone (P=0.82). In ovulating women, these correlations were significant (P=0.006, resp. P=0.003).ConclusionsHSDD is reported in one-third of transsexual women. This prevalence is not substantially different from controls, despite markedly lower (free) testosterone levels, which argues against a major role of testosterone in this specific group.

scholarly journals Testosterone profile in older men with Alzheimer's disease

2008 ◽  
Vol 2 (4) ◽  
pp. 289-293
Author(s):  
Cristiana Roscito Arenella Dusi ◽  
Lílian Schafirovits Morillo ◽  
Regina Miksian Magaldi ◽  
Adriana Nunes Machado ◽  
Sami Liberman ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Free Testosterone ◽  
Older Men ◽  
Sex Hormone Binding Globulin ◽  
Control Group ◽  
Total Testosterone ◽  
Chi Square ◽  
Testosterone Levels ◽  
Significant Difference

Abstract Evidence suggests low testosterone levels in Alzheimer's disease. Objectives: To compare testosterone levels between older men with and without Alzheimer's disease. Methods: Fourteen men with Alzheimer's disease were compared with twenty eight men without dementia. Demographic variables and clinical profiles were analyzed. Within fifteen days before or after the described evaluation, measures of total testosterone and Sex Hormone Binding Globulin (SHBG) were performed. Free testosterone level was calculated based on total testosterone and SHBG. Quantitative variables were analyzed using Student's t test or Kruskal-Wallis test, while qualitative variables were analyzed using chi-square or Fisher test. Results: Mean age in the Control and Alzheimer's disease groups were 72.0 (SD±4.8) years and 79.3(SD±5.9) years, respectively (p=0.001). Mean schooling between these two groups were 8.78 and (±5.86) years, respectively (p=0.022). There were no statistically significant differences between the two groups for testosterone levels, although a trend was observed for the Alzheimer's disease group to present lower levels than the control group (p=0.066). There was no direct correlation between free testosterone and age, although a trend was evident (p=0.068). Conclusions: There was no significant difference in testosterone between men with AD and those without dementia.

scholarly journals Effects of SHBG rs1799941 Polymorphism on Free Testosterone Levels and Hypogonadism Risk in Young Non-Diabetic Obese Males

2019 ◽  
Vol 8 (8) ◽  
pp. 1136
Author(s):  
Daniel Castellano-Castillo ◽  
José Luis Royo ◽  
Ana Martínez-Escribano ◽  
Lidia Sánchez-Alcoholado ◽  
María Molina-Vega ◽  
...  
Keyword(s):  
Regression Models ◽  
Biological Function ◽  
Free Testosterone ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Hormone Binding ◽  
Testosterone Levels ◽  
Increased Risk ◽  
Lineal Regression

Introduction: Obesity has been associated with increased risk of presenting hypogonadism. Free testosterone (FT) is the fraction of testosterone that carries out the biological function of testosterone, and is determined from total testosterone (TT) and sex-hormone binding globulin (SHBG) levels. We aimed to study the SHBG polymorphism rs1799941 in a cohort of young non-diabetic obese males to unravel the possible implication of this polymorphism in obesity-related hypogonadism. Methodology: 212 young (<45 years) non-diabetic obese (BMI ≥ 30 kg/m2) males participated in this study. Subjects were classified according to TT and FT levels in: Eugonadal (n = 55, TT > 3.5 ng/mL and FT ≥ 70 pg/mL; EuG), normal FT hypogonadism (n = 40, TT < 3.5 and FT ≥ 70 pg/mL; normal FT HG) and hypogonadism (n = 117, TT < 3.5 ng/mL and TL < 70 pg/mL; HG). The SHBG rs1799941 polymorphism (GG/GA/AA) was analyzed using the Taqman Open Array (Applied biosystem). Results: The rs1799941 frequencies were different among the groups. Higher proportion of the allele (A) was found in HG, compared to EuG and normal FT HG. Among the genotypes, the rare homozygous (AA) were found in the normal FT HG group and higher levels of serum SHBG and lower of FT were observed. The presence of the allele A was related (according to lineal regression models) to an increased of SHBG levels ((GA) β = 3.28; (AA) β = 12.45) and a decreased of FT levels ((GA) β = −9.19; (AA) β = −18.52). The presence of the allele (A) increased the risk of presenting HG compared to normal FT HG (OR = 2.54). Conclusions: The rs1799941 of the SHBG gene can partially determine the presence of obesity-related hypogonadism in young non-diabetic males and whether these subjects have normal FT HG.

scholarly journals Association of Serum Testosterone and Luteinizing Hormone With Blood Pressure and Risk of Cardiovascular Disease in Middle‐Aged and Elderly Men

2021 ◽  
Author(s):  
Mengyuan Qu ◽  
Chenzhao Feng ◽  
Xiaotong Wang ◽  
Yiqun Gu ◽  
Xuejun Shang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Diseases ◽  
Luteinizing Hormone ◽  
Free Testosterone ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Risk Marker ◽  
Hormone Binding ◽  
Testosterone Levels

Background The age‐related decline in testosterone levels is thought to be of great importance for male aging and cardiovascular diseases. However, data are controversial on whether abnormal sex hormones are linked to the presence of cardiovascular diseases and it is also uncertain how blood pressure modifies the association between testosterone levels and major cardiovascular diseases. Methods and Results This is a multicenter, population‐based, cross‐sectional study of 6296 men conducted between 2013 and 2016. Basic information and clinical symptoms were obtained by questionnaires. Blood pressure and plasma levels of total testosterone, sex hormone–binding globulin, luteinizing hormone, and free testosterone were determined in men in a multistage random, cluster sampling in 6 provinces of China. There were 5786 Chinese men (mean [SD] age 55.0 [10.1] years) included after exclusion criteria were applied; 37.2% (2150) of them were diagnosed with hypertension. Total testosterone, free testosterone, and sex hormone–binding globulin were inversely associated with the prevalence of hypertension. Age >65 years or body mass index ≥24 negatively impacted the inverse correlation between testosterone levels and hypertension, whereas smoking and family history of hypertension strengthened the correlation. In participants with grade 2 hypertension, total testosterone was positively associated with the presence of stroke, and luteinizing hormone was also positively correlated with cardiovascular and cerebrovascular diseases. Conclusions Lower total testosterone could be a promising risk marker for prevalent hypertension. Both low and high levels of testosterone are associated with greater cardiovascular risk. Primary hypogonadism may be a risk marker for major cardiovascular diseases in men with severe hypertension.

scholarly journals Validity of free testosterone calculation in pregnant women

2019 ◽  
Vol 8 (6) ◽  
pp. 672-679
Author(s):  
M P Schuijt ◽  
C G J Sweep ◽  
R van der Steen ◽  
A J Olthaar ◽  
N M M L Stikkelbroeck ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Equilibrium Dialysis ◽  
Free Testosterone ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Testosterone Concentration ◽  
Testosterone Levels ◽  
Liquid Chromatography Tandem Mass ◽  
Highly Correlated ◽  
Design And Methods

Objective Increased maternal testosterone concentration during pregnancy may affect the fetus. Therefore it is clinically relevant to have a quick and reliable method to determine free testosterone levels. Current calculators for free testosterone are suspected to perform poorly during pregnancy due to suggested competition between high levels of estradiol and free (bio-active) testosterone for sex hormone-binding globulin (SHBG) binding. Therefore, it is claimed that reliable calculation of free testosterone concentration is not possible. However, recent evidence on SHBG-binding sites questions the estradiol effect on the testosterone-SHBG binding during pregnancy. In this study, we investigated whether the free testosterone concentration can be calculated in pregnant women. Design and methods Free testosterone was measured with a specially developed equilibrium dialysis method combined with liquid chromatography tandem mass spectrometry (LC-MS/MS). Free testosterone was also calculated with the formulas of Vermeulen et al. and Ross et al. Results Total and free testosterone measured in healthy men and women were in good agreement with earlier reports. In pregnant women, total testosterone values were higher than in non-pregnant women, whereas free testosterone values were comparable. Calculated free testosterone levels in pregnant women were highly correlated, but marginally higher, compared to measured free testosterone levels. Conclusions We developed an equilibrium dialysis–LC-MS/MS method for the measurement of free testosterone in the low range of pregnant and non-pregnant women. Although during pregnancy total testosterone is increased, this is not the case for free testosterone. The free testosterone formulas perform well in pregnant women.

scholarly journals Hypogonadism and liver fibrosis in HIV-infected patients

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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