Resveratrol Modulates Bone Mineral Density and Bone Mineral Content in A Rat Model of Male Hypogonadism

Objective: To determine whether resveratrol(Res) can correct osteoporosis induced in a rat model of male hypogonadism. Methods: Thirty-two rats were randomly divided into 4 groups, 8 in each group;1) a control sham group: underwent a similar surgical procedure for induction of orchiectomy(ORCD) without ligation of any arteries or veins or removal of the testis and epididymis;2) a control + Res-treated group(Con+Res):underwent sham surgery similar to the control, but was then treated with Res, as described below;3) an ORCDinduced group: bilateral ORCD surgery as described above, and 4) a ORCD+Res-treated group: bilateral ORCD surgery followed by Res treatment. Res treatment began 4 weeks after ORCD and continued for 12 weeks. After 12 weeks, bone mineral density(BMD) and bone mineral content(BMC) were measured in the tibia and femur of each rat’s right hind leg. Blood levels of bone turnover indicators such as deoxypyridinoline(Dpd), N-telopeptide of type Ⅰ collagen(NTXⅠ), alkaline phosphatase(ALP), and osteocalcin(OC), as well as receptor activator of nuclear factor kappa B(RANK) and osteoprotegerin(OPG) were assessed. Results: ORCD significantly decreased BMD(P<0.01) and significantly increased bone resorption, manifested by increased RANK. In addition, it inhibited serum levels of OPG and OC. Res treatment after ORCD effectively increased serum levels of bone formation markers such as OPG and OC, compared with testisectomized rats(P<0.05). Conclusion:Res could ameliorate bone loss induced by male hypogonadism, possible via restoration of the normal balance between RANK and OPG.

Management of male obesity-related secondary hypogonadism:A clinical update

The global obesity pandemic has resulted in a rise in the prevalence of male obesity-related secondary hypogonadism(MOSH)with emerging evidence on the role of testosterone therapy.We aim to provide an updated and practical approach towards its management.We did a comprehensive literature search across MEDLINE(via PubMed),Scopus,and Google Scholar databases using the keywords“MOSH”OR“Obesity-related hypogonadism”OR“Testosterone replacement therapy”OR“Selective estrogen receptor modulator”OR“SERM”OR“Guidelines on male hypogonadism”as well as a manual search of references within the articles.A narrative review based on available evidence,recommendations and their practical implications was done.Although weight loss is the ideal therapeutic strategy for patients with MOSH,achievement of significant weight reduction is usually difficult with lifestyle changes alone in real-world practice.Therefore,androgen administration is often necessary in the management of hypogonadism in patients with MOSH which also improves many other comorbidities related to obesity.However,there is conflicting evidence for the appropriate use of testosterone replacement therapy(TRT),and it can also be associated with complications.This evidence-based review updates the available evidence including the very recently published results of the TRAVERSE trial and provides comprehensive clinical practice pearls for the management of patients with MOSH.Before starting testosterone replacement in functional hypogonadism of obesity,it would be desirable to initiate lifestyle modification to ensure weight reduction.TRT should be coupled with the management of other comorbidities related to obesity in MOSH patients.Balancing the risks and benefits of TRT should be considered in every patient before and during longterm management.

Testicular ultrasound inhomogeneity is an informative parameter for fertility evaluation

Testicular volume(TV)is proposed to be a positive predictor of male fertility status,because of the relation known between the TV and the seminiferous tubule content.Independently of the measurement methodology,the role of TV and testicular ultrasound(US)assessments is still debated in andrological clinical practice.In this retrospective cohort study,we evaluated TV and testis US role in the diagnostic workup of andrological patients.All consecutive outpatients undergoing single-operator testis US(Modena,Italy)from March 2012 to March 2018 were enrolled,matching sonographic,hormonal,and seminal data.A total of 302 men were referred and evaluated for gynecomastia,suspected hypogonadism,couple infertility(Cl),or sexual dysfunction.In the hypogonadal group,TV was lower compared to that in other groups(P<0.001),and a significant,direct correlation between TV and testosterone level was observed in nonandrogen-treated patients(R=0.911,P<0.001),suggesting that testicular size could be related to the testosterone-secreting compartment.In the Cl group,normozoospermic patients showed higher TV compared to men with impaired semen quality(P=0.003)and azoospermia(P=0.003).However,TV was not able to discriminate between patients presenting normal and altered semen quality.On the contrary,testis US inhomogeneity was more frequent in patients with impaired sperm quality(55.0%;P=0.007)and azoospermia(40.0%;P=0.012),compared to patients with normozoospermia(5%),identifying thereby the sonographic pattern as an informative parameter of the fertility status.Therefore,in the Cl workup,US evaluation seems to be more informative than the TV assessment alone.