271.
Current status of testosterone replacement therapy
in men.
Winters SJ
Department of Medicine, University of Pittsburgh
Medical Center, Pa., USA.
winters@med1.dept-med.pitt.edu
Arch Fam Med 1999 May-Jun;8(3):257-63
Testosterone plays an essential role in the
development of the normal male and in the
maintenance of many male characteristics,
including muscle mass and strength, bone mass,
libido, potency, and spermatogenesis. Androgen
deficiency occurs with disorders that damage the
testes, including traumatic or surgical castration
(primary testicular failure) or disorders in which
the gonadotropin stimulation of the testes is
reduced (hypogonadotropic hypogonadism). The
clinical manifestations of androgen deficiency
depend on the age at onset and the severity and
duration of the deficiency. In adult
males, these manifestations may include reduced
body hair, decreased muscle mass and strength,
increased fat mass, decreased hematocrit,
decreased libido, erectile dysfunction,
infertility, osteoporosis, and depressed
mood. The forms of androgen replacement
currently available in the United States are
intramuscular depot injections of testosterone
esters, oral tablets of testosterone derivatives,
and transdermal patches. For most
patients, androgen replacement therapy with
testosterone is a safe, effective treatment for
testosterone deficiency.
272.
Direct effects of estrogens on the endocrine
function of the mammalian testis.
Moger WH
Can J Physiol Pharmacol 1980
Sep;58(9):1011-22
This article reviews literature relevant to the
view that estradiol (E2) synthesized in the testis
acts locally to modify testosterone secretion.
Despite a lack of convincing evidence from in
vitro experiments, in vivo experiments with intact
and hypophysectomized animals have demonstrated
that estrogens can inhibit testosterone secretion
by acting directly on the testis. Reduced
testosterone production in estrogen-treated
animals probably results from reduced 17
alpha-hydroxylase and (or) C17-C20 lyase activity.
Estrogen-inhibited steroidogenesis may result from
estrogen binding to high affinity--low capacity
estrogen receptors. Besides being an estrogen
target tissue, the testis produces E2; the
cellular site of testicular E2 synthesis remains
controversial. Recent studies indicate that E2 is
synthesized primarily in the Sertoli cells of
neonatal rats and in the Leydig cells of older
rats. Follicle-stimulating hormone and human
chorionic gonadotropin (hCG) increase testicular
aromatase activity and E2 concentrations in
neonatal and older rats, respectively. An increase
in testicular E2 concentrations, following hCG
administration, may be one mechanism by which
testosterone synthesis becomes desensitized to
subsequent hCG stimulation. However, whether
gonadotropin-stimulated testicular E2 synthesis is
part of a physiologically relevant "short"
feedback loop that participates in the regulation
of testosterone synthesis remains to be
determined.
273.
Direct inhibitory effect of estrogen on the human
testis in vitro.
Namiki M, Kitamura M, Nonomura N, Sugao H,
Nakamura M, Okuyama A, Utsunomiya M, Itatani H,
Matsumoto K, Sonoda T
Department of Urology, Osaka University Medical
School, Japan.
Arch Androl 1988;20(2):131-5
The direct inhibitory effects of estrogens on
human testicular functions were investigated with
a testicular organ culture technique. 125I-labeled
human chorionic gonadotropin (125I-hCG) bindings
in testes cultured in media containing
diethylstilbestrol diphosphate (DESDP) began to
dose-relatedly decrease a day after the start of
the culture, and this decrease remained relatively
constant during the 5-day culture. On the other
hand, testosterone produced by the cultured testes
time-relatedly decreased during the 5-day culture.
From the above results it may be concluded
that the direct inhibitory effect of estrogens on
human testicular androgen production consists of
not only the loss of testicular hCG receptors but
also of other mechanisms at a distal step from hCG
receptor activation.
274.
The acute effect of estrogens on testosterone
production appears not to be mediated by
testicular estrogen receptors
Damber J E; Bergh A; Daehlin L; Ekholm C;
Selstam G; Sodergard R
Department of Physiology, University of UMEA,
90187, UMEA.
Mol Cell Endocr 31 (1). 1983. 105-116.
Scatchard binding analysis was performed to
measure the cytoplasmic estrogen receptor in the
testis of rats. After treatment of rats with the
antiestrogen tamoxifen no estrogen receptor
binding was found in testicular low speed
supernatant between 12 and 96 h after treatment.
Such tamoxifen-treated rats were used to study the
acute effect of estrogens on testosterone
secretion, both in vivo and in vitro.
Injection of estradiol benzoate (50 .mu.g,
24 h prior to experiment) resulted in a
significant depression of basal and
LH[lutropin]-stimulated plasma testosterone levels
in control rats and this effect was unchanged in
tamoxifen-pretreated rats. In vitro,
estradiol-17.beta. also inhibited the LH-induced
rise in testosterone secretion by isolated
testicular interstitial cells. This inhibition
was not affected if the rats had been pretreated
with tamoxifen. The inhibitory effects
of exogenous estrogens on testicular testosterone
production are probably not mediated by the
estrogen receptor.
275.
The effect of testosterone aromatization on
high-density lipoprotein cholesterol level and
postheparin lipolytic activity.
Zmuda JM; Fahrenbach MC; Younkin BT; Bausserman
LL; Terry RB; Catlin DH; Thompson PD
Department of Medicine, Miriam Hospital,
Providence, RI.
Metabolism (United States) Apr 1993, 42 (4)
p446-50,
Stanozolol, an oral 17 alpha-alkylated
androgen, increases hepatic triglyceride lipase
activity (HTGLA) and decreases high-density
lipoprotein cholesterol (HDL-C) levels, whereas
intramuscular testosterone has comparatively
little effect. In the present study, we tested the
hypothesis that aromatization of androgen to
estrogen blunts the lipid and lipase effects of
exogenous testosterone. Fourteen male
weightlifters received testosterone enanthate (200
mg/wk intramuscularly), the aromatase inhibitor
testolactone (250 mg four times per day), or both
drugs together in a randomized cross-over design.
Serum testosterone level increased during all
three drug treatments, whereas estradiol level
increased only with testosterone alone (+47%, P
< .05), demonstrating that
testolactone effectively inhibited testosterone
aromatization. Testosterone decreased HDL-C(-16%,
P < .05), HDL2-C(-23%, NS), and apoprotein
(apo) A-I (-12%, P < .05) levels, effects that
were consistently but not significantly greater
with simultaneous testosterone and testolactone
administration (HDL-C, -20%; HDL2-C, -30%; apo
A-I, -15%; P < .05 for all). In contrast, both
testosterone regimens decreased HDL3-C levels by
13% (P < .05 for both). HTGLA increased 21%
during testosterone treatment and 38% during
combined testosterone and testolactone treatment
(P < .01 for both). Lipoprotein lipase activity
(LPLA) increased only during combined testosterone
and testolactone treatment (+31%, P < .01),
suggesting that estrogen production may
counteract the effects of testosterone on
LPLA. Testolactone alone had little
effect on any lipid, lipoprotein, apoprotein, or
lipase concentration.(ABSTRACT TRUNCATED AT 250
WORDS)
276.
Effects of estradiol administration in vivo on
testosterone production in two populations of rat
Leydig cells
Keel B.A.; Abney T.O.
Dep. Endocrinol., Med. Coll. Georgia, Augusta, GA
30912 United States
Biochemical and Biophysical Research
Communications (United States) 1982, 107/4
(1340-1348)
The effects of in vivo administration of
estradiol on isolated rat testicular Leydig cells
were investigated. Adult intact rats were injected
s.c. with 50 mug/100 g B.W. of 17beta-estradiol or
vehicle twice daily for 2 days. Twelve hours after
the last injection, collagenase dispersed
interstitial cells were obtained and Leydig cells
were subsequently isolated on metrizamide
gradients. Two distinct peaks of specific sup 1sup
2sup 5I-hCG binding corresponding to population I
and II Leydig cells were observed. The hCG binding
profile was unaltered as a result of estradiol
treatment. Although twice as much testosterone was
produced in population II, the responsiveness of
the two populations to hCG or dbcAMP in vitro was
identical (11- to 13-fold increase). Estradiol
administration in vivo resulted in a 33-48%
decrease in basal and stimulated testosterone
production in both populations. These data
indicate for the first time that both population I
and II Leydig cells are sensitive to the direct
inhibitory effects of estrogens on testosterone
production. This inhibitory effect was
not associated with an alternation in hCG binding
capacity in either population. Therefore,
we conclude that no functional difference exists
between the two populations of Leydig cells with
respect to the action of estrogens.
277.
Tetrahydroisoquinoline alkaloids mimic direct but
not receptor-mediated inhibitory effects of
estrogens and phytoestrogens on testicular
endocrine function. Possible significance for
Leydig cell insufficiency in alcohol
addiction.
Life Sci 1991;49(18):1319-29
Stammel W, Thomas H, Staib W, Kuhn-Velten WN
Abteilung Physiologische Chemie, Universitat Ulm,
F.R. Germany.
Possible effects of various
tetrahydroisoquinolines (TIQs) on rat testicular
endocrine function were tested in vitro in order
to prove whether these compounds, some of which
have been claimed to accumulate in alcoholics,
may be mediators of the development of
Leydig cell insufficiency, a well-known
side-effect of ethanol ingestion. TIQ
effects on different levels of regulation of
testis function were compared in vitro with
estrogen effects, since both classes of compounds
have structural similarities.
Gonadotropin-stimulated testosterone production by
testicular Leydig cells was inhibited by
tetrahydropapaveroline and isosalsoline, the IC50
values (30 microM) being comparable to those of
estradiol (3 microM), 2-hydroxyestradiol (10
microM), and the phytoestrogens, coumestrol (15
microM) and genistein (7 microM); salsolinol (85
microM) and salsoline (240 microM) were less
effective, and salsolidine was ineffective. None
of these TIQs interacted significantly with
testicular estrogen receptor as analyzed by
estradiol displacement. However,
tetrahydropapaveroline, isosalsoline and
salsolinol competitively inhibited (Ki 130-150
microM) substrate binding to cytochrome
P450XVII, one key enzyme of androgen biosynthesis,
with similar efficiency as the estrogens
did (Ki 50-110 microM); salsoline and
salsolidine were again much less effective. Since
the efficient TIQ concentrations in this system
are identical with those reported to generate
central-nervous effects, it is concluded that
certain TIQs may amplify peripheral inhibitory
effects of ethanol on testicular endocrine
function by their interaction with at least one
enzyme of the androgen biosynthetic pathway.
278.
Fat tissue a steroid reservoir and site of steroid
metabolism
Deslypere J P; Verdonck L; Vermeulen A
Dep. of Endocrinology, Academic Hospital, Univ.
of Ghent, B-9000 Ghent, Belgium.
J Clin Endocrinol Metab 61 (3). 1985.
564-570.
Sex steroid concentrations and
17.beta.-hydroxysteroid dehydrogenase and
aromatase activities were determined in fat tissue
removed at surgery or, to allow comparisons in
different sites, postmortem. Except for
dehydroepiandrosterone (DHEA) sulfate (DHEAS),
there existed a positive tissue/plasma
gradient for all steroids studied (testosterone,
androstenedione, DHEA, androstenediol, estrone and
estradiol), suggesting androgen uptake and
estrogen synthesis in situ. Androgen
concentrations did not vary according to site of
origin of fat tissue, except that the DHEAS
concentration was significantly lower in abdominal
s.c. and omental fat than in breast, pericardial,
or sc pubic fat. Tissue androgen concentrations
were positively correlated with their plasma
concentrations, but tissue and plasma estrogen
concentrations were not correlated. All tissue
steroid concentrations, with the exception of
estradiol in men, decreased with age. Aromatase
activity [androstenedione .fwdarw. estrone; mean
maximum velocity, 7.4 .+-. 3.7 (.+-. SD) fmol
estrone/mg protein.cntdot.h] did not vary between
sexes or with site of origin of fat tissue.
17.beta.-Hydroxysteroid dehydrogenase activity
(estradiol .fwdarw. estrone, mean maximum velocity
9.8 .+-. 5.4 pmol/mg protein.cntdot.h) was higher
in fat from women than in that from men, higher in
premenopausal than in postmenopausal women, and
higher in omental than in s.c. fat. Its activity
was noncompetively inhibited in vitro by DHEA and
DHEAS in near-physiological concentrations, and
the enzyme activity was inversely correlated (P
< 0.001) with the tissue DHEA and DHEAS
concentrations. Apparently, fat tissue is
an important steroid hormone reservoir; it is the
site of active aromatase and
17.beta.-hydroxysteroid dehydrogenase; and tissue
DHEA(S) may have a modulating effect on tissue
estrogen production.
279.
Treatment of men with idiopathic oligozoospermic
infertility using the aromatase inhibitor,
testolactone. Results of a double-blinded,
randomized, placebo-controlled trial with
crossover.
Clark RV, Sherins RJ
Section of Internal Medicine, Emory University
Clinic, Atlanta, Georgia 30322.
Mt Sinai J Med 1997 Jan;64(1):20-5
The hypothesis that increased estradiol
production may be the cause of impaired
spermatogenesis in infertile men with idiopathic
oligozoospermia was tested by administering the
aromatase inhibitor, testolactone, and by
assessing its effects on sperm output and
fertility. Our study was a randomized,
placebo-controlled double-blind crossover trial.
Subjects (n = 25) with infertility due to
unexplained oligozoospermia were given
testolactone (2 g/day) or placebo for 8 months
followed by crossover to the other treatment for
an additional 8 months. Total estradiol and
testosterone levels during testolactone exposure
did not change from basal and placebo values.
However, sex hormone-binding globulin
binding capacity consistently decreased (30%, p
less than 0.01) and free testosterone levels
increased (36%, p less than 0.01). Free estradiol
values increased but not significantly.
Additionally, LH and FSH serum levels increased by
15% and 20%, respectively (p less than 0.05), and
17 alpha-hydroxyprogesterone values increased by
90% (p less than 0.05) during drug administration.
Sperm output and semen quality remained unchanged
during either testolactone or placebo treatment,
and no pregnancies occurred during the 16-month
study. These data suggest that chronic
administration of testolactone at this dose fails
to maintain aromatase inhibition despite
depression of 17,20-desmolase activity with
elevated 17 alpha-hydroxyprogesterone and
depressed SHBG binding capacity with elevation of
free testosterone. Testolactone is not
efficacious in the treatment of idiopathic
oligozoospermic infertility.
280.
Clinical utility of sex hormone-binding globulin
measurement.
Pugeat M, Crave JC, Tourniaire J, Forest MG
Hospices Civils de Lyon, Laboratoire de la
Clinique Endocrinologique, Hopital de
l'Antiquaille, France.
Horm Res 1996;45(3-5):148-55
The high-affinity binding of the sex
hormone-binding globulin (SHBG) for testosterone
and to a lesser extent for estradiol influences
the circulating levels of these sex steroid
hormones, their biodisposal to target cells as
well as their mutual balance. Although the
regulation of SHBG is still not completely
understood, in vitro studies performed with human
hepatocarcinoma (Hep G2) cells have shown that
estrogens and thyroxine stimulate SHBG secretion,
by increasing the steady state of its mRNA
concentrations. These observations are in good
agreement with studies showing that SHBG levels
increase during oral administration of estrogens
as well as in patients with
thyrotoxicosis. Interestingly, SHBG
levels are normal in syndromes such as the
abnormal transport of thyroid hormones and/or the
syndrome of thyroid hormone resistance, which can
be confused with thyrotoxicosis. By contrast, the
effects of androgens are controversial. In many
patients with hirsutism, SHBG concentrations are
low and correlate negatively with both body mass
index and fasting insulin levels. Because of the
inhibitory effect of both insulin and insulin-like
growth factor-1 on SHBG secretion by Hep G2 cells
in vitro, it has been proposed that SHBG levels
could be a marker of insulin resistance and/or
hyperinsulinism in humans. Furthermore, an
increased risk for either noninsulin-dependent
diabetes and/or the overall mortality are
associated with decreased SHBG levels in
postmenopausal women. Finally, in men, SHBG levels
are positively correlated with the concentration
of high-density lipoprotein cholesterol.
Therefore, the measurement of SHBG in
clinical practice can be a useful diagnostic tool
for: (1) correctly interpretating testosterone and
estradiol serum concentrations; (2) investigating
androgen-estrogen balance in gonadal and sexual
dysfunctions; (3) assessing the
peripheral effect of the hormones which regulate
SHBG productions, and (4) evaluating insulin
resistance and cardiovascular risk.
281.
Sex hormone binding globulin: origin, function and
clinical significance.
Selby C
Department of Clinical Chemistry, City Hospital,
Nottingham, UK.
Ann Clin Biochem 1990 Nov;27 ( Pt 6):532-41
Sex hormone binding globulin (SHBG) is
a glycoprotein possessing high affinity binding
for 17 beta-hydroxysteriod hormones such as
testosterone and oestradiol. It is
probably synthesized in the liver, plasma
concentrations being regulated by, amongst other
things, androgen/oestrogen balance, thyroid
hormones, insulin and dietary factors, it is
involved in transport of sex steroids in plasma
and its concentration is a major factor regulating
their distribution between the protein-bound and
free states. Its detailed role in the delivery of
hormones to target tissues is not yet clear.
Plasma SHBG concentrations are affected by a
number of different diseases, high values being
found in hyperthyroidism, hypogonadism, androgen
insensitivity and hepatic cirrhosis in men. Low
concentrations are found in myxoedema,
hyperprolactinaemia and syndromes of excessive
androgen activity. Concentrations are also
affected by drugs such as androgens, oestrogens,
thyroid hormones and anti-convulsants. Measurement
of SHBG is useful in the evaluation of mild
disorders of androgen metabolism and enables
identification of those women with hirsutism who
are more likely to respond to oestrogen therapy.
Testosterone:SHBG ratios correlate well with both
measured and calculated values of free
testosterone and help to discriminate subjects
with excessive androgen activity from normal
individuals.
282.
Androgens, estrogens, and sex hormone-binding
globulin in middle-aged men.
Longcope C, Goldfield SR, Brambilla DJ,
McKinlay J
Department of Obstetrics and Gynecology,
University of Massachusetts Medical School,
Worcester 01655.
J Clin Endocrinol Metab 1990 Dec;71(6):1442-6
Although the administration of estrogens and
androgens can affect the concentrations of sex
hormone-binding globulin (SHBG) in men, the
relationships between endogenous estrogens and
androgens and SHBG are uncertain. Therefore, in a
randomly selected cohort of 1640 middle-aged men
we measured androgen, estrogen, and SHBG
concentrations and obtained the subjects' weight,
ethanol intake, and smoking histories. The data
were analyzed by stepwise multiple regression,
with SHBG as the dependent variable, to compare
the role of hormones with that of other factors in
the control of SHBG levels. Neither
estrone or estradiol nor the
testosterone/estradiol ratio was predictive of
SHBG levels. However, SHBG concentrations
were positively correlated with total testosterone
and negatively correlated with percent free and
percent albumin-bound testosterone. SHBG
concentrations were negatively correlated with
estrone sulfate, but were positively correlated
with the testosterone/estrone sulfate ratio and
the concentrations of free and albumin-bound
testosterone. In addition, in all models tested
age and body mass index (wt/ht2), but not smoking
or ethanol, were strong predictors of SHBG
concentrations. Thus, when present in
physiological amounts in the blood as a result of
glandular secretion, there is a positive
relationship between SHBG concentrations and
testosterone and, to a lesser extent, free- and
albumin-bound testosterone, but age and body mass
index appear to be more important in predicting
the SHBG concentration.
283.
Sex hormone changes in male
epileptics.
Toone BK, Wheeler M, Fenwick PB
Clin Endocrinol (Oxf) 1980 Apr;12(4):391-5
Mean plasma levels of LH, FSH, PRL, and
sex-hormone binding globulin (SHBG) were raised in
twenty-seven epileptics on anticonvulsants
compared with age matched controls. Sexual
activity appeared to be reduced.
Anticonvulsant therapy results in raised
SHBG levels which may be associated with a lowered
free testosterone level as indicated by raised LH
levels and lowered sexual activity.
284.
Age, disease, and changing sex hormone levels in
middle-aged men: results of the Massachusetts Male
Aging Study.
Gray A, Feldman HA, McKinlay JB, Longcope C
New England Research Institute, Watertown,
Massachusetts 02172.
J Clin Endocrinol Metab 1991
Nov;73(5):1016-25
To evaluate the hypothesis that endocrine
profiles change with aging independently of
specific disease states, we examined the age
trends of 17 major sex hormones, metabolites, and
related serum proteins in 2 large groups of adult
males drawn from the Massachusetts Male Aging
Study, a population-based cross-sectional survey
of men aged 39-70 yr conducted in 1986-89. Group 1
consisted of 415 men who were free of obesity,
alcoholism, all prescription medication, prostate
problems, and chronic illness (cancer, coronary
heart disease, hypertension, diabetes, and ulcer).
Group 2 consisted of 1294 men who reported 1 or
more of the above conditions. Each age trend was
satisfactorily described by a constant percent
change per yr between ages 39-70 yr. Free
testosterone declined by 1.2%/yr, and
albumin-bound testosterone by 1.0%/yr. Sex
hormone-binding globulin (SHBG), the major serum
carrier of testosterone, increased by 1.2%/yr,
with the net effect that total serum testosterone
declined more slowly (0.4%/yr) than the free or
albumin-bound pools alone. Among the
major androgens and metabolites, androstane-3
alpha,17 beta-diol (androstanediol; 0.8%/yr) and
androstanediol glucuronide (0.6%/yr) declined less
rapidly than free testosterone, while 5
alpha-dihydrotestosterone remained essentially
constant between ages 39-70 yr. Androstenedione
declined at 1.3%/yr, a rate comparable to that of
free testosterone, while the adrenal androgen
dehydroepiandrosterone (3.1%/yr) and its sulfate
(2.2%/yr) declined 2-3 times more rapidly. The
levels of testosterone, SHBG, and several androgen
metabolites followed a parallel course in groups 1
and 2, remaining consistently 10-15% lower in
group 2 across the age range of the study.
Subgroup analyses suggested that obese subjects
might be responsible for much of the group
difference in androgen level. Serum concentrations
of estrogens and cortisol did not change
significantly with age or differ between groups.
Of the pituitary gonadotropins, FSH increased at
1.9%/yr, LH increased at 1.3%/yr, and PRL declined
at 0.4%/yr, with no significant difference between
groups 1 and 2.
285.
The influence of age, alcohol consumption, and
body build on gonadal function in
men.
Sparrow D, Bosse R, Rowe JW
J Clin Endocrinol Metab 1980 Sep;51(3):508-12
Basal plasma levels of testosterone,
dihydrotestosterone, estradiol, and gonadotropins
and testosterone-binding capacity (percent
radioactive testosterone bound to protein) were
measured in health carefully screened young (31-44
yr old; n = 44) and older (64-88 yr old; n = 42)
male participants in the Normative Aging Study of
the V.A. There was no statistically significant
effect of age on testosterone [younger group, 4.16
+/- 0.27 (SEM) ng/ml; older group, 4.62 +/- 0.32
(SEM) ng/ml] or the free testosterone index
[younger group, 2.05 +/- 0.14 (SEM) ng/ml; older
group, 1.76 +/- 0.11 (SEM) ng/ml]. The
testosterone-binding capacity was higher in the
older group (younger group, 50.10 +/-
1.18% (SEM); older group, 60.10 +/- 1.18% (SEM); P
less than 0.001). Of the two products of
testosterone metabolism studied, estradiol did not
change with age, while dihydrotestosterone was
lower [young group, 0.25 +/- 0.02 (SEM) ng/ml;
older group, 0.20 +/- 0.01 (SEM) ng/ml; P = 0.03]
in the older group. FSH levels were increased
among the older men [older group, 92.9 +/- 6.0
(SEM) ng/ml; younger group, 61.1 +/- 5.0 (SEM)
ng/ml; P less than 0.001]. LH levels were not
significantly influenced by age. There was no
effect of level of chronic stable alcohol intake
on gonadal function, as estimated by testosterone
levels and the free testosterone index. Analysis
of the relationship between body build and hormone
levels indicated that estradiol levels were
highest in gynandromorphic men and lowest in
mesomorphic men.
286.
Serum testosterone and sex hormone-binding
globulin concentrations and the risk of prostate
carcinoma: a longitudinal study.
Heikkila R, Aho K, Heliovaara M, Hakama M,
Marniemi J, Reunanen A, Knekt P
Kanta-Hame Central Hospital, Hameenlinna,
Finland.
Cancer 1999 Jul 15;86(2):312-5
BACKGROUND: It has been hypothesized that high
androgen levels are determinants of prostate
carcinoma.
METHODS: Serum concentrations of testosterone,
sex hormone-binding globulin (SHBG), and
androstenedione were analyzed to determine their
role as predictors of prostate carcinoma in a
longitudinal, population-based, nested
case-control study. The serum concentrations of
testosterone, SHBG, and androstenedione were
determined from serum samples collected by the
Finnish Mobile Clinic Health Examination Survey
between 1968-1972 and stored at -20 degrees C.
During a follow-up period of 24 years, a total of
166 prostate carcinoma cases occurred among men
who originally were cancer free. Two controls
(matched for age and municipality) were
chosen.
RESULTS: There was no association between serum
testosterone, SHBG, or androstenedione
concentrations and the occurrence of subsequent
prostate carcinoma in the total study population
or in subgroups determined based on age or body
mass index. The association was not strengthened
by simultaneous adjustment for the hormonal
variables.
CONCLUSIONS: The results of the current study
do not appear to corroborate the hypothesis that
serum testosterone, SHBG, or androstenedione are
determinants of the subsequent occurrence of
prostate carcinoma.
287.
Effect of testosterone treatment on body
composition and muscle strength in men over 65
years of age.
Snyder PJ, Peachey H, Hannoush P, Berlin JA,
Loh L, Lenrow DA, Holmes JH, Dlewati A, Santanna
J, Rosen CJ, Strom BL
Department of Medicine, University of
Pennsylvania School of Medicine, Philadelphia
19104-6087, USA.
J Clin Endocrinol Metab 1999
Aug;84(8):2647-53
As men age, serum testosterone concentrations
decrease, the percentage of body mass that is fat
increases, the percentage of lean body mass
decreases, and muscle strength decreases. Because
these changes are similar to those that occur in
hypogonadal men, we hypothesized that increasing
the serum testosterone concentration of men over
65 yr of age to that in young men would decrease
their fat mass, increase their lean mass, and
increase their muscle strength. We randomized 108
men over 65 yr of age to wear either a
testosterone patch or a placebo patch in a double
blind study for 36 months. We measured body
composition by dual energy x-ray absorptiometry
and muscle strength by dynamometer before and
during treatment. Ninety-six men completed the
entire 36-month protocol. Fat mass decreased
(-3.0+/-0.5 kg) in the testosterone-treated men
during the 36 months of treatment, which was
significantly different (P = 0.001) from the
decrease (-0.7+/-0.5 kg) in the placebo-treated
men. Lean mass increased (1.9+/-0.3 kg) in the
testosterone-treated men, which was significantly
different (P < 0.001) from that (0.2+/-0.2 kg)
in the placebo-treated men. The decrease in fat
mass in the testosterone-treated men was
principally in the arms (-0.7+/-0.1 kg; P <
0.001 compared to the placebo group) and legs
(-1.1+/-0.2 kg; P < 0.001), and the increase in
lean mass was principally in the trunk (1.9+/-0.3
kg; P < 0.001). The change in strength of knee
extension and flexion at 60 degrees and 180
degrees angular velocity during treatment,
however, was not significantly different between
the two groups. We conclude that increasing the
serum testosterone concentrations of normal men
over 65 yr of age to the midnormal range for young
men decreased fat mass, principally in the arms
and legs, and increased lean mass, principally in
the trunk, but did not increase the strength of
knee extension and flexion, as measured by
dynamometer.
288.
Approaches to prostatic cancer chemotherapy using
the Dunning R3327H prostatic
adenocarcinoma.
Padilla GM, Petrow V, Marts SA, Mukherji S
Prostate 1985;6(2):129-43
Androgen-responsive cells: To determine
if testosterone or dihydrotestosterone is the main
trophic hormone of prostatic adenocarcinoma, we
have treated Dunning R3327H prostatic
adenocarcinoma-bearing rats with 6-methylene
progesterone, which blocks conversion of
testosterone to dihydrotestosterone.
Copenhagen-Fisher rats were treated with steroid
(20 mg/Kg daily) immediately following
implantation of tumor and thereafter for 117 days.
There was a 92% inhibition of growth of
tumors and a lesser effect upon prostate and
seminal vesicles. Tumor-free body weights
remained unchanged. Both treated and untreated
tumors had equivalent DNA content on a per weight
basis. This result supports the thesis
that prostatic adenocarcinoma requires
dihydrotestosterone for growth.
Androgen-insensitive cells: Advanced prostate
cancer does not respond to endocrine therapy but
is temporarily controlled by the cytotoxic steroid
estramustine. The latter shows significant
selective binding to prostatic protein. To develop
chemotherapeutic agents that will control
androgen-insensitive cells and possess improved
selectivity for prostatic protein, we have studied
a number of steroids for their ability to displace
3H-labeled estramustine from prostatic cytosolic
proteins. Surprisingly, a carbamido substituent at
the C17 position was found to confer significant
binding affinity for prostatic
estramustine-binding protein. Extension of this
structural characteristic to the estramustine type
of molecule is being studied.
289.
[No Title]
Endocrine News;1996, Vol 21, No. 3, p-2
No abstract.
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