جستجوی مقالات مرتبط با کلیدواژه « hypogonadism » در نشریات گروه « پزشکی »

Considering the impact of serum testosterone levels on metabolic diseases, this study aims to investigate testosterone levels in patients with non-alcoholic fatty liver disease (NAFLD).

A prospective cohort study was performed between two groups: Group A, 58 patients with NAFLD, and Group B, 59 patients without NAFLD. Fatty liver was diagnosed based on Abdominal ultrasound using the Hamaguchi score. Blood specimens were obtained from all patients between 8 and 10 AM and analyzed for testosterone, aspartate aminotransferase, alanine transaminase, serum lipid profile, ferritin, and fasting blood sugar levels.

The mean weight and body mass index were significantly higher in the study group (Group A) (P-value = 0.0001). The mean aspartate aminotransferase and alanine transaminase were 37.7 and 56.6 in Group A, respectively, and were significantly higher than the control group (Group B) (P-value = 0.0001). Fasting blood sugar, lipid profile, and serum ferritin differed between the two groups. The mean serum testosterone level was 3.38 ± 0.72 in Group A and 4.79 ± 0.88 ng/dL in Group B (P-value = 0.0001). The testosterone level negatively correlated with age and hepatic steatosis grade (P-value = 0.0001). However, it has a weak and positive correlation with BMI (P-value = 0.454).

This study revealed that the patients with NAFLD had a significantly lower level of testosterone compared to the other individuals. This study highlights the role of NAFLD as a potential cause of hypogonadism in men.

The male reproductive system undergoes several adverse age-related changes like decreased hormone synthesis, sperm count, and testicular alteration that can impact on fertility.

The study aims to investigate the effects of testosterone propionate (TP), and ayurvedic formulation Swarna Bhasma (SB) on D-galactose (D-gal) induced reproductive aging in male Wistar rats.

60 male Wistar rats were divided into 10 groups of 6 animals. Reproductive aging was induced by D-gal (150 mg/kg Bwt) exposure for 60 days. The rats were then treated by post and combination treatment with TP (2 mg/kg Bwt) and SB (6.75 mg/kg Bwt). Then sperm parameters, reproductive hormones, inflammatory markers, testicular antioxidant enzymes, steroidogenic enzymes, and histological manifestation of testis were evaluated.

Exposure of D-gal caused significant (p < 0.001) decrease in serum testosterone (T), testicular steroidogenic, and antioxidant enzymes. Administration of TP increased the serum T level, testicular antioxidant enzymes, and spermatogenic profile at a significant level of (p < 0.001) compared to D-gal. Further, the SB treatment significantly (p < 0.001) elevated the serum T level, sperm count, testicular antioxidant enzymes, steroidogenic enzymes, when compared to D-gal.

Both the treatment of TP and SB treatments recovered the reproductive impairments caused by D-gal. However, exogenous T supplementation via TP administration is associated with various side effects during long-term use. SB is an Ayurvedic formulation having a long history of usage in India. The current findings suggest that the SB may be used as a good alternative for potentiating reproductive function in aging males.

Idiopathic hypogonadotropic hypogonadism (IHH) is a medical condition where there is a deficiency or insensitivity of gonadotropin-releasing hormone (GnRH) without a known cause. Not only are the sexual characteristics of a person affected by this condition but also are the psychological and physical development, thus necessitating its early recognition and treatment. This research was carried out to identify the laboratory parameters and to present symptoms of the patients with complaints of IHH. This retrospective, center, single-center, cross-sectional study was carried out in Aga Khan University from December 2000 until December 2020 on the patients that presented to the clinic with IHH. The patients included in the study were those that presented with hypogonadism, a low concentration of sex steroid hormone, and an abnormal gonadotropin level without any expansive pituitary or hypothalamic lesion. Seventy nine patients presenting with IHH were included with their mean age of 24.2 ± 7.5 years. Of these, 64 (81.0%) had genital atrophy, 50 (63.6%) showed an absence of secondary sexual characteristics, 53 (67.1%) complained of infertility, 44 (55.7%) had not shown signs of puberty, 52 (65.8%) had erectile dysfunction, 46 (58.2%) had a decrease in libido, 11(13.9%) had a previous familial history, 24 (30.3%) had gynecomastia, 9 (11.4%) had non-descended testes, and 6 (7.6%) had anosmia. These patients had serum testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels of 26.3 ± 60, 1.3 ± 2.4, and 2.7 ± 5.0 (IU/L), respectively. Thus, it can be stated that small genitalia is the most common complaint among patients with IHH, followed by infertility and lack of secondary sexual characteristics. The testosterone level in serum is also found to be low among these patients.

 Shereshevsky-Turner Syndrome is a chromosomal condition that affects females owing to full or partial missing of X-monosomy in all or part of the body's cells. Shereshevsky-Turner Syndrome is characterized by severe hormonal disorders and defects of the cardiovascular and urinary systems. With the advent of assisted reproductive technology (ART), pregnancy has become more accessible for this group of cases, often with donor eggs. In the available literature, it was not possible to find exact information during the time of selection of progestogen support, the duration of the appointment, and the term of withdrawal.

 This is the case of a 36-yr-old primigravid woman suffering from STs, mosaic karyotype comprising of 3 clones: 45X (69), 46XX (23), 47XXX (8), and 1000 interphase nuclei. In this case, we left high-maintenance doses of progesterone due to the application of ART and concomitant extragenital pathology, leading to a decrease in all functions of the placenta, including the endocrine. The woman was monitored before, during, and after the pregnancy. She was delivered at 37 wk and 6 days of gestation.

 ART increases the possibility of having a pregnancy and gestation in cases with a wide variety of genital and extragenital pathologies.

 Clomiphene, a selective estrogen receptor modulator (SERM), is a drug which is primarily used for the treatment of anovulatory infertility in female patients. Although as an off-label use, some authorities and physicians use this drug for the treatment of idiopathic oligoasthenospermia in male patients. Clomiphene has two isomers and multiple metabolites, and its cis isomer (Zuclomiphene) can be detected in urine for as long as eight months in some cases.

 A 30-year-old male futsal player used clomiphene for infertility for two months. After 17 weeks from the last dose, his urine sample result came out as an adverse analytical finding for clomiphene. Despite the initial ruling on a four-year ban by the national anti-doping agency, the appeals committee reduced the athlete's ban to two years after receiving explanations from the athlete, his appropriate doping record, and the fact that no trace of other substances, such as anabolic androgenic steroids (AAS) was found in the player's sample.

 In this article, the authors try to show the importance of athletes' familiarity with the anti-doping code and try to emphasize the importance of the fact that athletes should receive therapeutic use exemption (TUE) if they take any drugs with doping potential.

Hereditary hemochromatosis (HH) is a rare genetic disorder, causing systemic iron overload. High amounts of iron in the bloodstream gradually oversaturate the trans- ferrin which can cause sedimentation of iron in the pancreas, liver, heart, pituitary and joints, though it can establish multiorgan involvements. We present a case of TFR2 (type 3) HH who had minor α-thalassemia and uncontrolled diabetes mellitus, and discuss the clinical presentation and patient management. A 33-year-old man with type 3 HH and alpha-thalassemia trait, presented with uncon- trolled diabetes mellitus, skin hyperpigmentation and hypogonadism. The patient had high blood glucose ,despite the administration of 80 units of Glargine and 80 units of Aspart insulins per day, but after changing them into human insulins, his diabetes mellitus was surprisingly controlled with only 32 units of NPH and 18 units of Regular insulins. Furthermore, he was treated with testosterone (due to hypogonadism) and Deferasirox (due to iron overload).

A 20-year-old woman presented with left eye ptosis without any headache and pupillary dysfunctions. After the radiological examination, the oculomotor nerve compression was detected in the interpeduncular space by the posterior communicating artery (PCoA) with normal size and shape. The patient underwent frontotemporal craniotomy, and during the surgery, the nerve was detached from the PCoA. Immediately after surgery, all symptoms disappeared. Although oculomotor nerve palsy (ONP) owing to internal carotid-PCoA aneurysm is common, vascular compression due to a non- aneurysmal PCoA is very rare. To the extent of our knowledge, this is the first case in which a slightly displaced, otherwise normal, PCoA causes ONP without any pupillary involvement. After ruling out an aneurysmal artery, this should be considered as one of the possible causes of the ONP.

Diabetic male patients are more likely to have ED and subnormal testosterone levels than non-diabetic men. We aimed to estimate the prevalence of ED and low serum testosterone level in diabetic men, and to study the patient’s age, duration of diabetes, body mass index (BMI), glycosylated hemoglobin (HbA1c) and spot urine albumin to urine creatinine ratio (uACR) as risk factors for ED, and their correlation with serum total testosterone level.

This was a cross-sectional observational study, including 103 male patients aged 30-60 years, diagnosed with type 2 diabetes mellitus (T2DM). Patients with score less than 22 on the abridged 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire were diagnosed to have ED, and patients with serum total testosterone level less than 2.3ng/ml (8nmol/L) were considered to have low serum testosterone.

The prevalence of ED was 46.6%, and that of low testosterone level was 18.4%. Men with ED had significantly higher prevalence of testosterone deficiency than those without ED (31.3% vs 7.3%, P=0.004). Mean age of the patient (50.73±7.22 vs 47.51±8.67 years, P=0.045), mean duration of diabetes (10.66±5.56 vs 8.53±5.60 years, P<0.001), mean BMI (28.51±4.05 vs 24.51±3.32 kg/m2, P<0.001), and mean HbA1c (8.49±1.15 vs 7.70±1.05 %, P<0.001) were higher, while mean total testosterone level (3.18±1.65 vs 4.61±1.92 ng/ml, P<0.001) was lower in patients with ED, compared with those without ED. Total testosterone level negatively correlated with BMI (R=-0.682, P<0.001), HbA1c (R=-0.279, P=0.004), and uACR (R=-0.241, P=0.014); and positively correlated with IIEF-5 questionnaire score (R=0.519, P<0.001). BMI (P<0.001) and uACR (P=0.048) independently and negatively correlated with total testosterone level.

ED is a common complication in Indian men with T2DM. Excess weight is a risk factor for ED as well as low testosterone level. Older age, longer duration of DM and poor glycemic control are risk factors for ED, and presence of microalbuminuria is associated with low testosterone level. Serum testosterone levels should be measured in diabetic men suffering from ED.

Sperm donation and hormonal therapy with micro-Testicular Epididymal Sperm Extraction (TESE) for infertility from testicular failure might not always be available in some contexts. We report a successful embryo transfer from the patient-by ‘cumulative sperm collection’ strategy.

A 42 year-old male presented with non-obstructive azoospermia from testicular failure. Hormonal treatments were given along with the patient-initiated ‘cumulative sperm collection’ strategy, which eventually resulted in 17 sperms retrieved. Twelve mature oocytes were selected for intracytoplasmic sperm injection (ICSI) with the retrieved sperms, of which 8 oocytes were successfully fertilized but only two reached the early blastocyst stage; the first embryo transfer was not successful. Another five eggs were thawed and fertilized with the remaining 5 sperms and 3 oocytes were successfully fertilized: Seven cells were grade 3, 6 cells were grade 3, and 3 cells were grade 3. The second embryo transfer was successful, and the term female infant was successfully delivered by cesarean section.

At a center without micro-TESE availability, successful embryo transfer for testicular failure type IV could be achieved by hormonal therapy plus a ‘cumulative sperm collection’ strategy.

Xp22.3 region is characterized by low frequency of interspersed repeats and low GC content. Several clinically important genes including ANOS1 (KAL1) reside in this region. This gene was first identified due to translocation between chromosomes X and Y in a patient with Kallmann syndrome.

A 20 year old male presented with complaints of delayed secondary sexual characteristics, impaired sense of smell, and poor scholastic performance. On examination, he had short stature (151 cm; <3rd centile). His sexual maturity corresponded to Tanner stage 3. Stretched penile length was 3.6 cm (<3rd centile). Right testis was undescended with low left testicular volume (12 ml). There was mild ichthyosis over abdomen and back. He had hyposmia, hoarse voice, and synkinesia. Investigations were suggestive of hypogonadotrophic hypogonadism. Karyotype revealed an extra chromosomal material on p arm of chromosome X (46,Xp+,Y). On cytogenetic microarray, deletion of 8.3 Mb on Xp22.33 region and duplication of 12.8 Mb on Yq11.22 region were identified. The breakpoint on X chromosome resulted in deletion of exons 7-14 of ANOS1 gene and complete STS, NLGN4X, ARSL (ARSE), SHOX, and VCX genes.

Patients diagnosed with Kallmann syndrome should receive careful clinical evaluation to detect presence of a contiguous gene syndrome.

Aging in men causes a gradual decline in endogenous testosterone levels, which may have detrimental effects on their health status. Testosterone deficiency is thought to promote atherosclerosis by modulating lipid metabolism. Therefore, this study was conducted to evaluate the serum testosterone level and its correlation with lipid profile in men aged ≥60 years old.

All elderly men aged ≥60, residing in Amirkola and participating in a phase of the comprehensive project on "investigating the health status of the elderly in Amirkola" were entered into this descriptive cross-sectional study. After fasting over 12 hours, the venous blood samples were taken. Serum concentration of testosterone was determined using ELISA method. Moreover, HDL-LDL, total cholesterol, triglyceride and fasting blood glucose were measured.

The prevalence of hypogonadism was 91.28% among the 792 participants of this study with a cut-off point of 9.72 nmol/L (95% confidence interval, 93.25-89.31) and the prevalence of severe hypogonadism with a cut-off point of 5.2 nmol/L was reported 71.59% (95% confidence interval, 74.73-68.44%). Based on the results, there was no significant statistical correlation between the serum level of testosterone and triglyceride (r=0.03, P=0.34). Furthermore, there was a negative correlation between testosterone and HDL, which was not statistically significant(r=-0.05, P=0.13). No significant statistical correlation was found between testosterone and LDL (P=0.98). There was a negative correlation between testosterone and cholesterol, which was not statistically significant (r=-0.02, P=0.49).

According to the study results, 91% of men aged ≥60 years old had hypogonadism, no correlation was found between testosterone and lipid indices.

H syndrome is an autosomal recessive genodermatosis with reports dating back to the last decade. This syndrome is caused by mutations in the SCL29A3 gene. The clinical characteristics of this syndrome consist of dermatological manifestations, including hyperpigmented, hypertrichotic, and indurated patches and plaques. It affects various systems by causing heart anomalies, hepatosplenomegaly, hypogonadism, and low height. This is the case of a 19-year-old girl from the northwest of Iran who was born of a cousin marriage. The primary manifestations included low height, underdeveloped secondary sex characteristics, and typical dermatological manifestations. This patient was examined mostly because of digestive and endocrine problems and thus had not been subject to extensive dermatological examinations until the skin biopsies mirrored manifestations similar to histiocytoses (e.g., Rosai-Dorfman disease and granuloma annulare). The patient was eventually diagnosed with H syndrome by a dermatologist from the clinical symptoms. H syndrome is an autosomal recessive genodermatosis that affects different organs and is diagnosed by a set of typical and systemic cutaneous symptoms and biopsies. In this patient, an endoscopic examination of the upper gastrointestinal tract was carried out due to reports of anemia. A biopsy of the atrophic duodenum region revealed the existence of coeliac disease. However, the comorbidity of coeliac disease and H syndrome has not been previously reported.

Endocrine diseases, known as a curable etiology for depression, are common among men living with HIV (MLWH); while depression impedes the adherence to treatment and the perceived quality of life. We evaluated the changes in the depressive symptoms after the medical treatment of the underlying endocrine diseases among Iranian MLWH. Since April 2013 to March 2014, a convenience sample of 296 MLWH was recruited. We interviewed all the patients using the beck depression inventory (BDI- II) questionnaire. Participants with moderate to severe depression (n = 110, scores ≥ 21) were evaluated for endocrine diseases (evaluations: total testosterone, triiodothyronine, thyroxine, thyroid stimulating hormone, luteinizing hormone, follicle stimulating hormone, and serum cortisol). Eleven patients diagnosed with hypogonadism were, finally, considered for hormone replacement therapy. We re-evaluated the changes in the depressive symptoms with BDI- II. Out of 237 participants, 136 (75%) had BDI scores ≥ 21; 110 participated in the endocrine evaluations. Secondary hypogonadism was the only observed abnormality in 10% (n = 11) of the patients. Significant improvements were observed in BDI-II scores after 3 months of treatment (P = 0.027). The evaluation and the treatment of hypogonadism can help clinicians to properly address depression among people living with HIV; hence, improve the treatment compliance and the patient outcomes..

Bardet-Biedl syndrome (BBS) is one of the rare autosomal recessive disorders that affect multiple organs of the body. The signs and symptoms of this condition vary among affected individuals, even among members of the same family. We present a case of BBS with features of hypogonadism and features such as marked central obesity, retinitis pigmentosa, polydactyly, renal abnormalities and mental retardation, along with a brief review of the literature. The patient had end stage renal disease and managed with dialysis. This case also exemplifies the need for multidisciplinary approach in the management of such cases.

McCune Albright syndrome is rare with an estimated prevalence of 1 in 100,000 to 1 in 1,000,000 persons. The classical clinical triad consists of fibrous dysplasia of the bone, café-au-lait skin spots and precocious puberty. However, in rare cases, there may be primary hypogonadism and amenorrhea.
An eighteen-year-old female presented with amenorrhea. She had a short stature, round face, thick neck, and short fourth metacarpals and metatarsals. The secondary sexual characters were absent. Serum calcium, phosphorus and parathyroid concentrations were normal, but gonadotropin hormones were very low. X-ray examination revealed short fourth and fifth metacarpals, short left metatarsal, and short fibula.
These local bony abnormalities along with the biochemical findings helped us to diagnose this case as an unusual presentation of primary hypogonadism with features of McCune Albright’s syndrome where there was amenorrhea rather than preocious puberty.