scholarly journals Endogenous testosterone to prostate-specific antigen relationship in men without prostatic diseases: a 10-year retrospective study

2018 ◽  
Vol 5 (4) ◽  
pp. 1186
Author(s):  
Promise N. Wichendu ◽  
Ehimen P. Odum ◽  
Collins Amadi ◽  
Benjamin M. Aleme
Keyword(s):  
Retrospective Study ◽  
Specific Antigen ◽  
Serum Testosterone ◽  
Tertiary Hospital ◽  
Total Testosterone ◽  
Hospital Data ◽  
Testosterone Levels ◽  
Prostatic Diseases ◽  
Total Psa ◽  
Prostate Diseases

Background: The relationship between endogenous testosterone and PSA in men without prostatic diseases is controversial. Hence, this study was designed to investigate this relationship among healthy Nigerian men.Methods: A retrospective study of serum total testosterone (TT) and total PSA records of 1066 prostate disease-free men was undertaken in a Nigerian tertiary Hospital. Data on age, serum testosterone, and PSA from 1st January 2007 to December 2016 was abstracted and analysed.Results: The mean age, serum PSA, and serum total testosterone levels among study cohorts are 58.40±12.24 years, 3.0±2.24 µg/l, and 15.5±0.53 nmol/l respectively. There was an inverse relationship between serum PSA and testosterone levels with age. Subjects with high-risk PSA level (PSA>4.0 µg/l) had statistically significant higher PSA (p<0.001) and TT (p<0.001) values compared to the low-risk PSA level group. Subjects in the eugonadism group had higher PSA levels than those in the hypogonadism group (eugonadism 3.90µg/l±2.22 versus hypogonadism 2.18µg/l±2.30; p=0.012). Age correlated positively with PSA (p<0.001), but negatively with TT (p<0.001) while PSA correlated positively with TT (p<0.001).Conclusions: The findings of this study suggest an association between endogenous TT and PSA among healthy men without prostatic diseases and augment the evidence that serum TT maybe linked to prostate diseases. Clinical decisions regarding PSA should factor the levels of endogenous TT to enhance clinical judgments.

scholarly journals Effects of Aromatase Inhibition in Elderly Men with Low or Borderline-Low Serum Testosterone Levels

2004 ◽  
Vol 89 (3) ◽  
pp. 1174-1180 ◽  
Author(s):  
Benjamin Z. Leder ◽  
Jacqueline L. Rohrer ◽  
Stephen D. Rubin ◽  
Jose Gallo ◽  
Christopher Longcope
Keyword(s):  
Short Form ◽  
Specific Antigen ◽  
Serum Testosterone ◽  
Total Testosterone ◽  
Elderly Men ◽  
Symptom Index ◽  
Testosterone Levels ◽  
Group 2 ◽  
American Urological Association ◽  
Group 1

Abstract As men age, serum testosterone levels decrease, a factor that may contribute to some aspects of age-related physiological deterioration. Although androgen replacement has been shown to have beneficial effects in frankly hypogonadal men, its use in elderly men with borderline hypogonadism is controversial. Furthermore, current testosterone replacement methods have important limitations. We investigated the ability of the orally administered aromatase inhibitor, anastrozole, to increase endogenous testosterone production in 37 elderly men (aged 62–74 yr) with screening serum testosterone levels less than 350 ng/dl. Subjects were randomized in a double-blind fashion to the following 12-wk oral regimens: group 1: anastrozole 1 mg daily (n = 12); group 2: anastrozole 1 mg twice weekly (n = 11); and group 3: placebo daily (n = 14). Hormone levels, quality of life (MOS Short-Form Health Survey), sexual function (International Index of Erectile Function), benign prostate hyperplasia severity (American Urological Association Symptom Index Score), prostate-specific antigen, and measures of safety were compared among groups. Mean ± sd bioavailable testosterone increased from 99 ± 31 to 207 ± 65 ng/dl in group 1 and from 115 ± 37 to 178 ± 55 ng/dl in group 2 (P &lt; 0.001 vs. placebo for both groups and P = 0.054 group 1 vs. group 2). Total testosterone levels increased from 343 ± 61 to 572 ± 139 ng/dl in group 1 and from 397 ± 106 to 520 ± 91 ng/dl in group 2 (P &lt; 0.001 vs. placebo for both groups and P = 0.012 group 1 vs. group 2). Serum estradiol levels decreased from 26 ± 8 to 17 ± 6 pg/ml in group 1 and from 27 ± 8 to 17 ± 5 pg/ml in group 2 (P &lt; 0.001 vs. placebo for both groups and P = NS group 1 vs. group 2). Serum LH levels increased from 5.1 ± 4.8 to 7.9 ± 6.5 U/liter and from 4.1 ± 1.6 to 7.2 ± 2.8 U/liter in groups 1 and 2, respectively (P = 0.007 group 1 vs. placebo, P = 0.003 group 2 vs. placebo, and P = NS group 1 vs. group 2). Scores for hematocrit, MOS Short-Form Health Survey, International Index of Erectile Function, and American Urological Association Symptom Index Score did not change. Serum prostate-specific antigen levels increased in group 2 only (1.7 ± 1.0 to 2.2 ± 1.5 ng/ml, P = 0.031, compared with placebo). These data demonstrate that aromatase inhibition increases serum bioavailable and total testosterone levels to the youthful normal range in older men with mild hypogonadism. Serum estradiol levels decrease modestly but remain within the normal male range. The physiological consequences of these changes remain to be determined.

Why Do We Need New Markers for Male Hypogonadism and How Seminal Proteomics Might Solve the Problem?

2020 ◽  
Vol 27 (12) ◽  
pp. 1186-1191
Author(s):  
Giuseppe Grande ◽  
Domenico Milardi ◽  
Silvia Baroni ◽  
Andrea Urbani ◽  
Alfredo Pontecorvi
Keyword(s):  
Serum Testosterone ◽  
Clinical Syndrome ◽  
Testosterone Replacement ◽  
Total Testosterone ◽  
Male Hypogonadism ◽  
Grey Zone ◽  
Testosterone Levels ◽  
Normal Number ◽  
Replacement Treatment

Male hypogonadism is “a clinical syndrome that results from failure of the testis to produce physiological concentrations of testosterone and/or a normal number of spermatozoa due to pathology at one or more levels of the hypothalamic– pituitary–testicular axis”. The diagnostic protocol of male hypogonadism includes accurate medical history, physical exam, as well as hormone assays and instrumental evaluation. Basal hormonal evaluation of serum testosterone, LH, and FSH is important in the evaluation of diseases of the hypothalamus-pituitary-testis axis. Total testosterone levels < 8 nmol/l profoundly suggest the diagnosis of hypogonadism. An inadequate androgen status is moreover possible if the total testosterone levels are 8-12 nmol/L. In this “grey zone” the diagnosis of hypogonadism is debated and the appropriateness for treating these patients with testosterone should be fostered by symptoms, although often non-specific. Up to now, no markers of androgen tissue action can be used in clinical practice. The identification of markers of androgens action might be useful in supporting diagnosis, Testosterone Replacement Treatment (TRT) and clinical follow-up. The aim of this review is to analyze the main findings of recent studies in the field of discovering putative diagnostic markers of male hypogonadism in seminal plasma by proteomic techniques. The identified proteins might represent a “molecular androtest” useful as a seminal fingerprint of male hypogonadism, for the diagnosis of patients with moderate grades of testosterone reduction and in the follow-up of testosterone replacement treatment.

Decrease in serum testosterone levels after short-term occupational exposure to diisononyl phthalate in male workers

2020 ◽  
Vol 77 (4) ◽  
pp. 214-222 ◽  
Author(s):  
Jean-Bernard Henrotin ◽  
Eva Feigerlova ◽  
Alain Robert ◽  
Mathieu Dziurla ◽  
Manuela Burgart ◽  
...  
Keyword(s):  
Occupational Exposure ◽  
Serum Testosterone ◽  
Total Serum ◽  
Total Testosterone ◽  
Type I ◽  
Short Term ◽  
Testosterone Levels ◽  
Short Term Exposure ◽  
Diisononyl Phthalate ◽  
Male Workers

ObjectiveThe objective of the study was to examine the effects of occupational exposure to diisononyl phthalate (DINP) on serum testosterone levels in male workers.MethodsFrom 2015 to 2018, 97 male workers were recruited from six French factories in the plastics industry. In a short longitudinal study, changes over 3 days in the level of total or free serum testosterone and DINP exposure were measured. DINP exposure was measured by urinary biomonitoring: mono-4-methyl-7-oxo-octyl phthalate (OXO-MINP), mono-4-methyl-7-hydroxy-octyl phthalate (OH-MINP) and mono-4-methyl-7-carboxyheptylphthalate (CX-MINP). We further analysed changes in follicle-stimulating hormone, luteinising hormone, total testosterone to oestradiol ratio and two bone turnover markers (procollagen-type-I-N propeptide, C terminal cross-linking telopeptide of type I collagen), and erectile dysfunction via standardised questionnaires (International Index of Erectile Function, Androgen Deficiency in Aging Males). Linear mixed models were used with the variables ‘age’ and ‘abdominal diameter’ included as confounder.ResultsIncreased urinary OXO-MINP was associated with a significant decrease in total serum testosterone concentrations, but only for workers who exhibited the smallest variations and lowest exposures (p=0.002). The same pattern was observed for CX-MINP but was not significant; no association with OH-MINP was detectable. More self-reported erectile problems were found in workers exposed directly to DINP at the workstation (p=0.01). No changes were observed for the other biological parameters.ConclusionsShort-term exposure to DINP is associated with a decrease in total serum testosterone levels in male workers. Our results suggest that DINP could present weak antiandrogenic properties in humans, but these need to be confirmed by other studies.

scholarly journals Relation of Age and Serum Prostatic-Specific Antigen level with Histopathological diagnosis in Transurethral Resection of Prostate specimen, an Experience from Eastern Tertiary Hospital

2019 ◽  
Vol 17 (2) ◽  
pp. 62-65
Author(s):  
Ram Sagar Shah ◽  
Dipesh Raj Pandey
Keyword(s):  
Transurethral Resection ◽  
Specific Antigen ◽  
Tertiary Hospital ◽  
Interquartile Range ◽  
Transurethral Resection Of Prostate ◽  
Histopathological Diagnosis ◽  
Prostatic Specific Antigen ◽  
Carcinoma Prostate ◽  
Common Diagnosis ◽  
Prostate Diseases

Background: Prostatic Specific Antigen (PSA) is a protease secreted by epithelial cells of prostate. Serum PSA level is increased when the normal structure of gland is destroyed by benign or malignant tumor or inflammation. Though there is established relation between PSA plasma level and age among the two most common prostate diseases (Benign prostatic hyperplasia and Carcinoma Prostate) in the literature, relation has not been explored in our part of the world, therefore, this study was done to see the relation between age and PSA amount with Prostate diseases. Material and Methods: This was a Cross-sectional study conducted in a tertiary hospital, Nobel Medical College Teaching Hospital from January 2017 to December 2018. Ethical clearance was obtained from Institutional Review Committee (IRC). All the cases of prostate diseases presenting to urology department undergoing transurethral resection of the prostate (TURP) were included. Histopathology report of TURP specimen were collected from department of pathology and the relationship between diagnosis, PSA level and age were established. Results: BPH was the most common diagnosis (72.41%). Age of BPH patients ranged from 48-78 years and mean age with SD was 60.56±7.32. Median age with interquartile range was 61.00. Similarly, in the BPH group, PSA value ranged between 0.80-15.40 ng/ml with mean PSA value along with SD being 5.64±4.16 ng/ml. Similarly, Median PSA value with interquartile range was 4.20ng/ml. Carcinoma Prostate (27.59%) was the second most common diagnosis. Histological type of all cases diagnosed as cancer was adenocarcinoma. Their age ranged between 54-83. Their mean age with SD was 67.67±7.68. Similarly, Median age with interquartile range was 68.00. PSA value in this group ranged between 8.50-147.30 ng/ml. Again, the mean PSA value with SD is 55.72±33.40 ng/ml. Similarly, Median PSA value with interquartile range is 54.30 ng/ml. Conclusion: PSA level in the blood of men over 40years is highly correlated with a Age, irrespective of diagnosis. In above 40 age group, with advancing age, Carcinoma Prostate becomes more and more common diagnosis than BPH. Similarly, average PSA level is higher in Carcinoma Prostate than BPH.

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 Age-specific serum prostate-specific antigen references range among healthy men in Port Harcourt, Nigeria: a retrospective hospital-based study

2018 ◽  
Vol 6 (2) ◽  
pp. 417
Author(s):  
Collins Amadi ◽  
Ehimen P. Odum
Keyword(s):  
Prostate Specific Antigen ◽  
Reference Range ◽  
Specific Antigen ◽  
Age Groups ◽  
Specific Reference ◽  
P Value ◽  
Healthy Men ◽  
Port Harcourt ◽  
Prostatic Diseases ◽  
Total Psa

Background: Total prostate-specific antigen (PSA) levels increase with advancing age. Its age-specific ranges are being advocated to increase its sensitivity and specificity. This study was aimed to examine the relationship between total PSA levels and age, and to determine the age-specific ranges among healthy men without prostatic diseases in our environment.Methods: In this retrospective hospital-based study, records of men without prostatic diseases who had visited University of Port Harcourt Teaching Hospital for routine screening for prostate cancer using serum total PSA between 1st January 2012 and 31st December 2016 were retrieved and analyzed using descriptive statistics and Spearman’s correlation test. A p-value < 0.05 was considered significant.Results: Records of 476 men aged 38 to 86 years were recruited for the study. The age-specific total PSA reference range using the 95th percentile total PSA concentration values in each 10year groups were 0-1.60, 0-4.93, 0-6.93, 0-7.80, 0-9.65, and 0-13.30 for the age groups 30-39, 40-49, 50-59, 60-69, 70-79 and >80years respectively. There was a positive correlation between serum PSA concentration and age (rs = 0.395; p<0.001).Conclusions: Total PSA increases with advancing age and its age-specific reference range in this study are similar to findings in our environment but higher than the values found in other parts of the world. We suggest serum PSA normal reference values should be characterized by age and race in our environment.

scholarly journals Defining a new testosterone threshold for medical castration: Results from a prospective cohort series

2013 ◽  
Vol 7 (5-6) ◽  
pp. 263 ◽  
Author(s):  
Shawn Dason ◽  
Christopher B. Allard ◽  
Justin Tong ◽  
Bobby Shayegan
Keyword(s):  
Prospective Cohort ◽  
Specific Antigen ◽  
Progression Free Survival ◽  
Serum Testosterone ◽  
Serum Testosterone Level ◽  
Testosterone Levels ◽  
Tertiary Centre ◽  
Kaplan Meier ◽  
Castrate Resistant Prostate Cancer ◽  
Castrate Resistant

Background: We seek to determine if testosterone levels below the accepted castration threshold (50 ng/dL) have an impact on time to progression to castrate-resistant prostate cancer (CRPC).Methods: This is a prospective cohort series of patients undergoing androgen deprivation therapy (ADT) with luteinizing hormone-releasing hormone agonist or antagonist at a tertiary centre from 2006 to 2011. Serum testosterone level was assessed every 3 months. Patients with any testosterone >50 ng/dL were excluded. Patients were stratified into groups based on those achieving mean testosterone levels <20 ng/dL and <32 ng/dL. Progression to CRPC was assessed with the Kaplan-Meier method and compared with the log-rank test.Results: A total of 32 patients were included in this study. Mean patient follow-up was 25.7 months. Patients with a 9-month serum testosterone <32 ng/dL had a significantly increased time to CRPC compared to patients with testosterone 32 to 50 ng/dL (p = 0.001, median progression-free survival (PFS) 33.1 months [<32 ng/dL] vs. 12.5 months [>32 ng/dL]). Patients with first year mean testosterone <32 ng/dL also had a significantly increased time to CRPC compared to 32 to 50 ng/dL (p = 0.05, median PFS 33.1 months [<32 ng/dL] vs. 12.5 months [32-50 ng/dL]). A testosterone <20 ng/dL compared to 20 to 50 ng/dL did not significantly predict with time to CRPC.Conclusion: This study supports a lower testosterone threshold to define optimal medical castration (T <32 ng/dL) than the previously accepted standard of 50 ng/dL. Testosterone levels during ADT serve as an early predictor of disease progression and thus should be measured in conjunction with prostate-specific antigen.

scholarly journals The decline of serum testosterone levels in community-dwelling men over 70 years of age: descriptive data and predictors of longitudinal changes

2008 ◽  
Vol 159 (4) ◽  
pp. 459-468 ◽  
Author(s):  
B Lapauw ◽  
S Goemaere ◽  
H Zmierczak ◽  
I Van Pottelbergh ◽  
A Mahmoud ◽  
...  
Keyword(s):  
Serum Testosterone ◽  
Community Dwelling ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Elderly Men ◽  
Related Factors ◽  
Longitudinal Changes ◽  
Testosterone Levels ◽  
Testosterone Production ◽  
Healthy Elderly

ObjectiveThis study was designed to assess longitudinal changes in serum testosterone levels, explore relationships with aging, genetic-, health-, and lifestyle-related factors, and investigate predictors of changes in healthy elderly men.DesignPopulation-based, longitudinal, 4-year observational study in 221 community-dwelling men aged 71–86 years at baseline.MethodsHormone levels assessed by immunoassay, anthropometry, questionnaires on general health, and genetic polymorphisms. Predictors of changes in testosterone levels explored using linear mixed-effects modeling for longitudinal analyses.ResultsTotal testosterone (TT), free testosterone, and bioavailable testosterone (BioT) levels decreased with aging, decreases in BioT being most marked. No changes in sex hormone-binding globulin (SHBG) or estradiol (E2), while LH and FSH levels increased during follow-up. Subjects who gained weight displayed a greater decline in TT levels, mainly due to decreasing SHBG levels. However, baseline body composition was not predictive of subsequent changes in testosterone levels. Baseline E2 (P=0.023 to 0.004), LH (P=0.046 to 0.005), and FSH (P<0.002) levels were independently positively associated with a faster decline in testosterone fractions, although only FSH remained significant when adjusting for baseline testosterone (P=0.041–0.035). Carriers of a ‘TA’ haplotype of the estrogen receptor α gene (ERα) PvuII and XbaI polymorphisms displayed a slower decline of TT and BioT (P=0.041–0.007).ConclusionsIn elderly men with already low serum testosterone levels, a further decline was observed, independent of baseline age. The identification of FSH levels as a predictor of this decline appears to reflect the testicular mechanisms of aging-related changes in testosterone production, whereas associations with E2 and ERα polymorphisms are suggestive of estrogen-related processes, possibly related to changes in the neuroendocrine regulation of testosterone production.

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