Testosterone level and mortality in elderly men wit systolic chronic heart failure

Previous studies on the prognostic significance of serum levels of androgens in patients with chronic heart failure （CHF） have yielded conflicting results. The aim of this study was to examine the relationship between serum concentration of testosterone and mortality in men with systolic CHF. A total of 175 elderly men （age ≥60 years） with CHF were recruited. Total testosterone （TI＇） and sex hormone-binding globulin （SHBG） were measured, and estimated free testosterone （eFT） was calculated. The median follow-up time was 3.46 years. Of these patients, 17 had a TT level below 8 nmol I^-1 （230 ng dI^-1）, 27 had an eFT level below 0.225 nmol I^-1 （65 pg ml^-1） and 12 had both. Using the age-specific tenth percentiles of TT and eFT in healthy men in our laboratory as cutoff points, the prevalences of TT and eFT deficiency was 21.7% （38/175） and 27.4% （48/175）, respectively. Both TT and eFT were inversely associated with left ventricular ejection fraction （LVEF） and N-terminal pro-brain natriuretic peptide （NT-pro-BNP） （all P〈0.01）. Kaplan-Meier curves for patients in low, medium and high tertiles according to TT and eFT level showed significantly different cumulative survival rate （both P〈0.01 by log-rank test）. However, after adjustment for clinical variables, there were no significant associations of either TT or eFT levels with survival time （0R=0.97, 95% CI： 0.84-1.12, P=0.28 and 0R=0.92, 95% CI： 0.82-1.06, P=0.14, respectively）. Our study showed that levels of TT and eFT are commonly decreased in elderly patients with systolic CHF and related to disease severity, but they are not independent predictors for mortality.

Two New Species of Freshwater Shrimps from Hunan Province,China (Decapoda:Atyidae:Caridina)

Two new freshwater atyid shrimps, Caridina angustipes sp nov.and C clavipes sp nov.from Hunan Province,China are described. C angustipes sp nov.is similar to C baojingensis Guo,He et Bai,1992,but with longer rostrum,15-27 dorsal teeth,3-6 ventral teeth,and straighter inner margin of endopods in male 1st pleopods. C clavipes sp nov.is similar to C angustipes ,but with narrower distal and fewer spines on inner margin of endopds in male 1st pleopods,and shorter and thinner appendix masculina in male 2nd pleopods with only 1 spine on inner lateral margin and 4 spines in apex.The holotypes are deposited in Shanghai Fisheries University.Some representative paratypes are deposited in Foshan Science and Technology College.

Androgen deficiency in elderly men with systolic chronic heart failure

Objective Several previous studies have shown androgens deficiency in men with CHF, and 2 studies on the prognostic significance of serum levels of androgens in CHF patients have yielded conflicting results. The aim of this study was to examine the relationship between serum concentration of testosterone and mortality in men with systolic CHE Methods A total of 175 elderly （age ≥ 60 years） men with CHF were recruited. Total testosterone fiT） and sex hormone binding globulin （SHBG） were measured, and free serum testosterone （eFT） was calculated. The median follow-up time was 1262 days. Results During follow-up 54 （30.9%） patients died. TT and eFF deficiency was found in 21.7% （38/175） and 27.4% （48/175） patients, respectively. Both TT and eFT were inversely associated with LVEF and NT-proBNP （all P〈0.01）. Kaplan-Meier curves for patients in low, medium and high tertiles according to TF and eFT level showed significantly different cumulative survival rate （both P〈0.01 by log-rank test）. However, after adjustment for clinical variables, there were no significant associations between either Tr or eFT levels or survival time （OR=0.97, 95% CI, 0.84-1.12, P--0.28; and OR=0.92, 95% CI, 0.82-1.06,/＇=0.14, respectively）. Conclusion Our study showed that although levels of TT and eFT are commonly decreased in elderly patients with systolic CHF and related to disease severity, they are not independent predictors for mortality

Study of androgen and atherosclerosis in old-age male

Objective： To observe the difference of androgen and inflammatory cytokines level in atherosclerosis and analyse their relations. Method： Both carotid arteries and arteries of lower extremity were subjected to ultrasonic examination by Doppier＇s method. Those with much atheromatous plaque formation were ranged into case group, and those with normal result formed control group. Total, free testosterone and estradiol were assayed by radioimmunoassay. C reactive protein （CRP） was assayed by nepheloturbidity. Tumor necrosis factor-α（TNF-α）, lnterleukin-6 （IL-6）, lnterleukin-8 （IL-8）, lnterleukin-10 （IL-10）, Interleukin-18 （IL-18）, soluble intercellular adhesion molecule-1 （sICAM-1） and soluble vascular cell adhesion molecule-1 （sVCAM-1） were assayed by ELISA. The mean difference between two groups and the correlation between free testosterone and cytokines were analysed. Results： Free testosterone was （6.337±3.371） pg/L in case group and （11.375±4.733）pg/L in control group, P〈0.01. No differences were found in total testosterone and estradiol. CRP was （27.294±10.238）mg/L in case group and （12.843±6.318） mg/L in control group, P〈0.01. IL-6 was （41.700±31.385）pg/L in case group and （25.396±20.772）pg/L in control group, P〈0.05. IL-8 was （89.249±58.357）pg/L in case group and （67.873±31.227）pg/L in control group, P〈0.05. sICAM-1 was （470.491±134.078）pg/L in case group and （368.487±97.183）pg/L in control group, P〈0.01. sVCAM-1 was （537.808±213.172）pg/L in case group and （457.275±157.273）pg/L in control group, P〈0.05. There were no differences in TNF-α, IL-10 and IL-18. Correlation analysis showed that FT （free testosterone） had negative correlation with CRP, IL-6 and sICAM-1. Among them FT had well correlation with CRP, correlation index was -0.678. Conclusion： Free testosterone was in negative correlation with atherosclerosis in old-age male. Free testosterone may have the role of anti-atherosclerosis, and this effect was not achieved by its transformation to estradiol. Low tree testosterone level was followed by increased level of inflammatory cytokines. Low free testosterones coexist with inflammation and they both affect the process of atherosclerosis in old-age male.

Prevalence of late-onset hypogonadism among middle-aged and elderly males in China:results from a national survey

This study aimed to propose an operational definition of late-onset hypogonadism(LOH)that incorporates both clinical symptoms and serum testosterone measurements to evaluate the prevalence of LOH in aging males in China.A population-based sample of 6296 men aged 40 years-79 years old was enrolled from six representative provinces in China.Serum total testosterone(TT),sex hormone-binding globulin(SHBG),and luteinizing hormone(LH)were measured and free testosterone(cFT)was calculated.The Aging Males’Symptoms(AMS)scale was used to evaluate the LOH symptoms.Finally,5078 men were included in this analysis.The TT levels did not decrease with age(P=0.59),and had no relationship with AMS symptoms(P=0.87 for AMS total score,P=0.74 for≥3 sexual symptoms).The cFT levels decreased significantly with age(P<0.01)and showed a negative association with the presence of≥3 sexual symptoms(P=0.03).The overall estimated prevalence of LOH was 7.8%(395/5078)if a cFT level<210 pmol l−1 combined with the presence of≥3 sexual symptoms was used as the criterion of LOH.Among them,26.1%(103/395)and 73.9%(292/395)had primary and secondary hypogonadism,respectively.After adjustment for confounding factors,primary and secondary hypogonadism was positively related to age and comorbidities.Body mass index was an independent risk factor for secondary hypogonadism.The results suggest that the AMS total score is not an appropriate indicator for decreased testosterone,and that the cFT level is more reliable than TT for LOH diagnosis.Secondary hypogonadism is the most common form of LOH.

How do we define “castration” in men on androgen deprivation therapy?

Androgen deprivation therapy(ADT)is the mainstay for the treatment of advanced prostate cancer.Since the clinical evolution from surgical orchiectomy,we have typically used ADT and orchiectomy to be synonymous terms for castration.The goal of this study is to determine if,in contemporary medical practice,surgical and chemical castration provide for similar levels of diminishment of total and free testosterone.Further,what approaches should be used to most accurately measure testosterone levels in men with advanced prostate cancer and what cutoff values,for example for total testosterone 50 ng dl-1 or 20 ng dl-1,should be utilized.Studies available in the literature have been analyzed and compiled to address these questions.Finally,evidence is provided that free testosterone,the biologically active component,should be utilized to provide clinically relevant state of castration.