62 research outputs found
Effetti del polimorfismo CAG del recettore degli androgeni sui principali outcomes della terapia sostitutiva con testosterone in soggetti affetti da ipogonadismo ipogonadotropo post-chirurgico.
No full textLo scopo di questo lavoro è stato quello di valutare il ruolo indipendente del polimorfismo CAG del gene del recettore degli androgeni (AR), sugli effetti metabolici, ossei, di composizione corporea e sessuali della terapia sostitutiva con testosterone nell’ipogonadismo ipogonadotropo post-chirurgico maschile, una condizione spesso associata ad ipopituitarismo e in cui gli effetti testosterone-correlati su quegli outcomes sono combinati con quelli derivanti dalla somministrazione concomitante di terapie sostitutive della funzione ipofisaria. Sedici uomini affetti da ipogonadismo ipogonadotropo post-chirurgico sono stati valutati prima e dopo terapia con testosterone. Sono stati studiati i fattori di rischio cardiovascolare (CVRFs), i parametri di funzione sessuale e del metabolismo osseo, i parametri di composizione corporea, gli effettori periferici degli ormoni ipofisari e il polimorfismo CAG del gene AR. Il testosterone, l’insulin-like growth factor-1 (IGF-1) e l’estradiolo erano i soli ormoni che significativamente cambiavano prima e dopo la somministrazione di testosterone. Tutti i CVRFs miglioravano significativamente dopo TRT. Un’uguale tendenza si osservava per i parametri di funzione sessuale (questionario IIEF) e del metabolismo osseo (densità minerale ossea). Il grasso centrale diminuiva significativamente dopo terapia ormonale, mentre le altre misure della composizione corporea non cambiavano in modo significativo. Alla regressione lineare multipla, dopo correzione per Δ-testosterone, associazioni positive sono state riscontrate tra il numero di triplette CAG e Δ-CVRFs. Inoltre, associazioni negative sono state trovate tra la lunghezza del tratto CAG e il miglioramento dei parametri di funzione sessuale. Per quanto riguarda il metabolismo osseo, associazioni negative sono state trovate tra la lunghezza del tratto CAG e il miglioramento della densità minerale ossea a livello del femore e della colonna lombare. Infine, per quanto riguarda la composizione corporea, un’associazione positiva è stata trovata tra la lunghezza del tratto CAG e la diminuzione del grasso viscerale. In conclusione, nell’ipogonadismo ipogonadotropo post-chirurgico, la minor lunghezza del tratto CAG del gene AR sembra esercitare effetti positivi sul metabolismo, sulla funzione sessuale, ossea e sulla composizione corporea dopo terapia con testosterone, indipendentemente dagli effetti delle terapie sostitutive della funzione ipofisaria
Synergistic effect of androgen receptor (CAG repeat lenght) and endothelial mitric oxide synthase (Glu298Asp variant) gene polymorphism on seminal parameters in men with idiopathic oligoasthenozioospermia. Delli Muti N., Tirabassi G., Buldreghini E., Balercia G. 38° Congresso Nazionale SIE, Taormina, 27-30 Maggio 2015, P002
No full textInfluence of CAG repeat polymorphism on the targets of testosterone action
No full textIn the last decade, ample evidence has demonstrated the growing importance of androgen receptor (AR) CAG repeat polymorphism in andrology. This genetic parameter is able to condition the peripheral effects of testosterone and therefore to influence male sexual function and fertility, cardiovascular risk, body composition, bone metabolism, the risk of prostate and testicular cancer, the psychiatric status, and the onset of neurodegenerative disorders. In this review, we extensively discuss the literature data and identify a role for AR CAG repeat polymorphism in conditioning the systemic testosterone effects. In particular, our main purpose was to provide an updated text able to shed light on the many and often contradictory findings reporting an influence of CAG repeat polymorphism on the targets of testosterone action. © 2015 Giacomo Tirabassi et al
Dysregulation of the hypothalamic-pituitary-adrenal axis increases central body fat accumulation in males affected by diabetes mellitus and late-onset hypogonadism
No full textOBJECTIVE:
Functional hypercortisolism (FH) is a condition which occurs in some clinical states, such as major depression, eating disorders, numerous psychiatric conditions, and diabetes mellitus (DM) and which exerts several negative systemic effects. No data exist on the potentially harmful role of FH on body composition. In this retrospective study, we evaluated the influence of hypothalamic-pituitary-adrenal (HPA) axis dysregulation on body composition in men affected by DM-associated late-onset hypogonadism (LOH).
METHODS:
Fourteen subjects affected by FH (FH-LOH) and 18 subjects not affected (N-LOH) were studied. Clinical, hormonal, and body composition measures were considered.
RESULTS:
The 2 groups had comparable age and weight. FH-LOH patients had lower levels of total (2 ± 0.27 ng/mL versus 2.31 ± 0.26 ng/mL; P = .003) and free (39.5 ± 6.44 pg/mL versus 46.8 ± 7.23 pg/mL; P = .005) (median, 38.7 [interquartile range, 36.1 to 41.3] pg/mL versus median, 46.1 [interquartile range, 40.4 to 52.7] pg/mL) testosterone compared to N-LOH patients. Abdominal fat amount was greater in FH-LOH than in N-LOH patients, even after adjustment for total testosterone. None of the bivariate correlations between body composition measures and hormonal variables were significant in N-LOH. Conversely, in FH-LOH, cortisol area under the curve (AUC) was found to be positively and significantly correlated with trunk (r = 0.933; P<.001) and abdominal fat (r = 0.852; P<.001) and negatively with lean leg (r = -0.607; P = .021). All of these associations were further confirmed upon linear regression analysis in FH-LOH (respectively, unstandardized β = 10.988 [P<.001]; β = 1.156 [P<.001]; β = -7.675 [P = .021]). Multivariate regression analysis confirmed AUC cortisol as a predictor of trunk and abdominal fat in FH-LOH.
CONCLUSION:
Dysregulation of the HPA axis in LOH-associated DM seems to be involved in abdominal fat accumulation
Inlluence of the hypothalamic-pituitary-adrenal axis dysregulation on the metabolic profile of patients affected by diabetes mellitus-associated late onset hypogonadism. Tirabassi G., Chelli F.M., Ciommi M., Salvio G., Lenzi A., Balercia G. 38° Congresso Nazionale SIE, Taormina, 27-30 Maggio 2015, P078
No full textDiabetes mellitus and late onset hypogonadism: the role of Glu298Asp endothelial nitric oxide synthase polymorphism.
No full textAdvances in the epidemiology, pathogenesis, and management of Cushing's syndrome complications
No full textCushing's syndrome (CS) is a clinical condition resulting from chronic exposure to glucocorticoid excess. As a consequence, hypercortisolism contributes significantly to the early development of systemic disorders by direct and/or indirect effects. Complications such as obesity, hypertension, diabetes, dyslipidemia, and hypercoagulability cause premature atherosclerosis and increase cardiovascular mortality. Impairment of the skeletal system is a relevant cause of morbidity and disability in these patients especially due to the high prevalence of vertebral fractures. In addition, muscle weakness, emotional lability, depression, and impairment of quality of life are very common. Clinical management of these patients is complex and should be particularly careful in identifying global cardiovascular risks and aim at controlling all complications. Although the primary goal in the prevention and treatment of complications is the correction of hypercortisolism, treatment does not completely eliminate these comorbidities. Given that cardiovascular risk and fracture risk can persist after cure, early detection of each morbidity could prevent the development of irreversible damage. In this review we present the various complications of CS and their pathogenetic mechanisms. We also suggest the clinical management of these patients based on our extensive clinical experience and on the available literature
Synergistic effect of androgen receptor (CAG repeat length) and endothelial nitric oxide synthase (Glu298Asp variant) gene polymorphisms on seminal parameters in men with idiopathic oligoasthenozoospermia
No full text[No abstract available
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