Iron metabolism in patients with rheumatoid arthritis.

OBJECTIVE: Anemia is the hematological issue that occurs most often as a manifestation in RA. The aim of the study was to assess iron deficiency in RA patients. PATIENTS AND METHODS: The study was carried out on 62 RA patients treated between 2016 and 2017. RESULTS: A higher percentage of RA patients compared to the control group had TSAT below 20% (43% vs. 5%), ferritin below the reference range (15% vs. 7%), sTfR above 1.59 mg/l (26% vs. 0%) and hepcidin below 14.5 ng/ml (56% vs. 2%). 60% of RA patients had iron deficiency, and 18% - anemia. Correlations were found between reduced levels of ferritin and patients being younger, female, with lower GGT and higher platelet counts. Correlations were also found between iron deficiency and patients being younger, female, having reduced hemoglobin, increased platelet counts, increased GFR, reduced GGT, lower disease activity, and less frequent use of sulfasalazine. CONCLUSIONS: Iron deficiency is common (64%) in RA patients where there is high disease activity. RA patients had lower transferrin, lower ferritin, lower hepcidin, and higher sTfR. Decreased DAS-28 and reduced hemoglobin were the strongest determinants of iron deficiency.

Elevated troponin I level assessed by a new high-sensitive assay and the risk of poor outcomes in patients with acute heart failure.

BACKGROUND: The interpretation and clinical usefulness of elevated levels of cardiac troponins in acute heart failure (AHF) remain controversial. We aimed to characterize the relationship between changes in cardiac troponin I (measured using a new high-sensitive immunoassay by single-molecule counting technology, Singulex, Alameda, USA; hs-TnI) during first 48h of hospital stay and patients' characteristics and the outcomes. METHODS AND RESULTS: We measured hs-TnI at baseline, after 24 and 48h in 130 AHF patients (mean age: 65±13years, 77% men). The percentage of patients with elevated hs-TnI (i.e., above the upper reference limit [URL]>10.19pg/mL) were: on admission - 59%, after 24h - 61%, and after 48h - 58%. Elevated baseline level of hs-TnI was associated with more severe dyspnoea on admission but neither peak level nor changes in hs-TnI during first 48h were related to the dyspnoea severity or magnitude of dyspnoea relief. During 1-year follow-up there were 32 (25%) cardiovascular deaths. Neither absolute baseline nor peak values of hs-TnI predicted cardiovascular mortality. Only changes in hs-TnI were independently associated with cardiovascular mortality with the strongest relationship seen in peak change in hs-TnI: patients with an increase vs. remaining patients - hazard ratio (95% confidence interval): 3.22 (1.52-6.82)p=0.002. CONCLUSIONS: Using the new assay (proved to be more sensitive that the other available troponin assays) we observed that approximately 60% of patients with AHF presented elevated hs-TnI above URL during first 48h of hospital stay. Only significant increase in hs-TnI predicted cardiovascular mortality.

Increased gene expression of catecholamine-synthesizing enzymes in adrenal glands contributes to high circulating catecholamines in pigs with tachycardia-induced cardiomyopathy.

High levels of circulating catecholamines have been established as fundamental pathophysiological elements of heart failure (HF). However, it is unclear whether the increased gene expression of catecholamine-synthesis enzymes in the adrenal glands contributes to these hormone abnormalities in large animal HF models. We analyzed the mRNA levels of catecholamine-synthesizing enzymes: tyrosine hydroxylase (TH), aromatic L-amino acid decarboxylase (AAAD), dopamine-ß-hydroxylase (DBH) and phenylethanolamine N-methyltransferase (PNMT) in adrenal glands of 18 pigs with chronic systolic non-ischaemic HF (tachycardia-induced cardiomyopathy due to right ventricle pacing) and 6 sham-operated controls. Pigs with severe HF demonstrated an increased expression of TH and DBH (but neither AAAD nor PNMT) as compared to animals with milder HF and controls (P<0.05 in all cases). The increased adrenal mRNA expression of TH and DBH was accompanied by a reduced left ventricle ejection fraction (LVEF) (P<0.001) and an elevated plasma B-type natriuretic peptide (BNP) (P<0.01), the other indices reflecting HF severity. There was a positive relationship between the increased adrenal mRNA expression of TH and DBH, and the high levels of circulating adrenaline and noradrenaline (all P<0.05). The association with noradrenaline remained significant also when adjusted for LVEF and plasma BNP, suggesting a significant contribution of adrenals to the circulating pool of catecholamines in subjects with systolic HF.

Matrix metalloproteinase 9/neutrophil gelatinase associated lipocalin/tissue inhibitor of metalloproteinasess type 1 complexes are localized within cardiomyocytes and serve as a reservoir of active metalloproteinase in porcine female myocardium.

Matrix metalloproteinase 9 (MMP-9) is crucial for physiological tissue repair and pathophysiological myocardial remodeling. The regulation of its functioning has been shown to be mediated by formation of complexes with tissue inhibitor of metalloproteinases 1 (TIMP-1) and neutrophil gelatinase associated lipocalin (NGAL). We investigated the mRNA and protein expression of MMP-9, TIMP-1 and NGAL, the formation of complexes, their gelatinolytic activity and cellular localization in left ventricle (LV) from 10 female pigs with induced systolic heart failure (HF), 5 control pigs, and a woman with severe HF. The MMP-9, TIMP-1 and NGAL mRNA in LV did not differ between diseased and healthy pigs. In all pigs MMP-9, TIMP-1 and NGAL proteins were present in LV as high molecular weight (HMW) complexes (115, 130, 170 and 220 kDa), and no monomers were found. A 80 and 115 kDa gelatinolytically active bands were present in all LV homogenates. A 130-kDa active band was seen only in LV from pigs with severe HF. Similar results were found in the explanted heart of a female patient with severe HF. The incubation of the homogenates of porcine LV at 37°C resulted in appearance of 88 kDa active band, which was accompanied by a decreased intensity of HMW bands. The incubation of the homogenates of porcine LV (depleted of active MMP-9) with trypsin generated 80 and 115 kDa active bands. Immunohistochemistry revealed the presence of MMP-9 in the cytoplasm of porcine cardiomyocytes, but not in cardiofibroblasts. Our data suggest that MMP-9 originates from cardiomyocytes, forms the gelatinolytically inactive complexes with TIMP-1 and NGAL, present in normal and failing myocardium, likely serving as a reservoir of active MMP-9. Further studies are needed to elucidate the role of these HMW complexes in the extracellular matrix remodeling during the progression of HF, which presence should be considered when developing efficient strategies inhibiting myocardial matrix metalloproteinases.

Effect of short-term rapid ventricular pacing followed by pacing interruption on arterial blood pressure in healthy pigs and pigs with tachycardiomyopathy.

Ventricular tachycardia may lead to haemodynamic deterioration and, in the case of long term persistence, is associated with the development of tachycardiomyopathy. The effect of ventricular tachycardia on haemodynamics in individuals with tachycardiomyopathy, but being in sinus rhythm has not been studied. Rapid ventricular pacing is a model of ventricular tachycardia. The aim of this study was to determine the effect of rapid ventricular pacing on blood pressure in healthy animals and those with tachycardiomyopathy. A total of 66 animals were studied: 32 in the control group and 34 in the study group. The results of two groups of examinations were compared: the first performed in healthy animals (133 examinations) and the second performed in animals paced for at least one month (77 examinations). Blood pressure measurements were taken during chronic pacing--20 min after onset of general anaesthesia, in baseline conditions (20 min after pacing cessation or 20 min after onset of general anaesthesia in healthy animals) and immediately after short-term rapid pacing. In baseline conditions significantly higher systolic and diastolic blood pressure was found in healthy animals than in those with tachycardiomyopathy. During an event of rapid ventricular pacing, a significant decrease in systolic and diastolic blood pressure was found in both groups of animals. In the group of chronically paced animals the blood pressure was lower just after restarting ventricular pacing than during chronic pacing. Cardiovascular adaptation to ventricular tachycardia develops with the length of its duration. Relapse of ventricular tachycardia leads to a blood pressure decrease more pronounced than during chronic ventricular pacing.

Plasma adiponectin in heart failure with and without cachexia: catabolic signal linking catabolism, symptomatic status, and prognosis.

BACKGROUND AND AIMS: Adiponectin (ADPN) as an adipose tissue hormone contributes to regulation of energy metabolism and body composition and is associated with cardiovascular risk profile parameters. Cardiac cachexia may develop as a result of severe catabolic derangement in chronic heart failure (CHF). We aimed to determinate an abnormal ADPN regulation as a link between catabolic signalling, symptomatic deterioration and poor prognosis. METHODS AND RESULTS: We measured plasma ADPN in 111 CHF patients (age 65 ± 11, 90% male, left ventricular ejection fraction (LVEF) 36 ± 11%, peak oxygen consumption (peakVO2) 18.1 ± 5.7 l/kg*min, body mass index (BMI) 27 ± 4 kg/m(2), all mean ± standard deviation) and 36 healthy controls of similar age and BMI. Body composition was assessed by dual energy X-ray absorptiometry, insulin sensitivity was evaluated by homoeostasis model assessment, exercise capacity by spiroergometry. Plasma ADPN did not differ between CHF vs. controls (13.5 ± 11.0 vs. 10.5 ± 5.3 mg/l, p > 0.4), but increased stepwise with NYHA functional class (I/II/III: 5.7 ± 1.4/10.7 ± 8.3/19.2 ± 14.0 mg/l, ANOVA p < 0.01). Furthermore, ADPN correlated with VO2 at anaerobic threshold (r = -0.34, p < 0.05). ADPN was highest in cachectic patients (cCHF, 16%) vs. non-cachectic (ncCHF) (18.7 ± 15.0 vs. 12.5 ± 9.9 mg/l; p < 0.05). ADPN indicated mortality risk independently of established prognosticators (HR: 1.04 95% CI: 1.02-1.07; p < 0.0001). ADPN above the mean (13.5 mg/l) was associated with a 3.4 times higher mortality risk in CHF vs. patients with ADPN levels below the mean. CONCLUSION: Circulating ADPN is abnormally regulated in CHF. ADPN may be involved in impaired metabolic signalling linking disease progression, tissue wasting, and poor outcome in CHF.

Effect of low versus normal birthweight on menarche in 14-year-old Polish girls.

OBJECTIVE: The relationship between intrauterine growth retardation and sexual maturation has not been completely established. The aim of the present study was to compare menarche in 14-year-old Polish girls of low and normal birthweight, along with an evaluation of the impact of socio-economic status and body mass index (BMI). METHODS: We studied 1060 girls (177 pre- and 883 post-menarche) aged 13.5-14.5 years. These girls attended the 7th grade of randomly selected primary schools in Wroclaw, Poland. The BMI was used as a measurement of general adiposity. The cut-off value of the 10th percentile of birthweight for gestational age was used to differentiate between girls born small for gestational age (SGA) and girls with a birthweight appropriate to gestational age (AGA). Parental education level and other measures were used to assess socio-economic status (SES). RESULTS: Birthweight (OR = 2.54; 95% CI 1.22-5.28) and BMI at the age of 14 years (OR = 7.93; 95%CI 4.67-13.48) were factors affecting the onset of menarche among the 14-year-old girls. CONCLUSION: Polish girls born small for gestational age are more likely to have experienced menarche by the age of 14 years, compared with their peers of normal weight at birth. These findings seem to be consistent with the hypothesis that the age of menarche is, to some extent, set by patterns of gonadotropin release, established prior to birth. Additionally, the age of menarche varies depending on levels of fat accumulation during childhood and adolescence.

Birthweight and stature, body mass index and fat distribution of 14-year-old Polish adolescents.

OBJECTIVES: The relationships between intra-uterine growth retardation and stature, relative weight and fat distribution at adolescence have not been comprehensively established. The aim of this report is to assess the effect of low birthweight on stature, relative weight and fat distribution in 14-year-old boys and girls from Wroclaw, Poland. METHODOLOGY: Cross-sectional measurements of 1197 boys and 819 post-menarcheal girls aged 13.50-14.49 years were performed during medical examinations in 1997. Stature, body mass index (BMI; kg/m2), waist-to-hip ratio (WHR) and waist-to-thigh ratio (WTR) were used in the present study. A cut-off value of the 10th percentile of birthweight for particular gestational weeks was used in order to define subjects born small for gestational age (SGA) or appropriate for gestational age (AGA). Two-way ANOVA was used to evaluate the effect of birthweight on anthropometric variables of 14-year-old adolescents, allowing for socioeconomic status (determined by the level of the mother's education). RESULTS: Birthweight affected stature in boys and girls (P < 0.001), BMI in boys (P < 0.05) and WHR and WTR in girls (P < 0.001 and P < 0.05, respectively). At the age of 14 years, both SGA boys and girls were shorter than their AGA peers. The SGA boys had lower BMI, whereas SGA girls accumulated more centralized fat compared with their AGA counterparts. CONCLUSION: Fetal growth retardation has a long-lasting adverse effect on later physical growth. Polish SGA children do not catch up with their peers in terms of stature by adolescence. Moreover, central fat distribution, as observed among SGA girls, constitutes a significant risk for several adult degenerative diseases.

The inverse relationship between bone status and blood pressure among Polish men.

PRIMARY OBJECTIVE: An evaluation of relationships between bone density and blood pressure in healthy men. RESEARCH DESIGN: A cross-sectional population-based survey. METHODS AND PROCEDURES: An ethnically homogeneous sample of 208 men, aged 35-63, healthy and occupationally active inhabitants of the city of Wroclaw, Lower Silesia, Poland were studied. Trabecular, cortical and total bone mineral content (BMC) at the ultra-distal radius of the non-dominant hand were assessed by peripheral Quantitative Computed Tomography (pQCT: Stratec 960 apparatus). Body mass index (BMI) was used as a measure of general obesity. Systolic and diastolic blood pressure (BP) were measured using an MPC-350 sphygmomanometer. Multiple linear regression was used to evaluate the relationships between BP and BMC. A two-way analysis of covariance was carried out to test for the significance of inter-group differences in BMC with regard to age and BP with BMI as a contiuous covariable. Multiple logistic regression was used to verify whether some select factors (age, BMI, systolic and diastolic BP) could significantly predict male bone status. RESULTS: Systolic BP was not related to bone status at the ultra-distal radius. There were no differences in any BMC between systolic hyper- and normotensive subjects. Additionally, systolic hypertension did not affect the probability of an occurrence of male osteopenia (independently of age and BMI). In contrast, there were significant negative relationships between diastolic BP, and trabecular and total (but not cortical) BMC (even when controlled for age and BMI). Moreover, diastolic hypertensive men had reduced BMC at the ultra-distal radius when compared with normotensive subjects. It is noteworthy that Polish men of diastolic BP exceeding 90 mmHg had an approximately 1.50-fold increased relative risk of being osteopenic when compared with normotensive subjects (even when controlled for age, BMI and systolic BP). CONCLUSIONS: In the light of the inverse relationship between BMC and diastolic BP, Polish men with elevated diastolic BP seem to be more prone to the excessive age-related bone loss.

Are general obesity and visceral adiposity in men linked to reduced bone mineral content resulting from normal ageing? A population-based study.

Associations between fat accumulation and distribution and bone mineral status in men have not been comprehensively established, and available results are inconsistent. The aims of this study were as follows: (1) to evaluate relationships between anthropometric parameters of general obesity (body mass index, BMI) and fat distribution (waist/hip ratio, WHR) and bone mineral content (BMC), and (2) to compare BMC (a) between obese men (BMI >or= 27) and nonobese men and (b) between abdominally obese men (WHR >or= 0.95) and men without visceral adiposity, in a population-based sample of Polish men. The sample comprised a group of 272 men, aged 20-60, randomly selected from healthy and occupationally active inhabitants of Wroclaw, Lower Silesia, Poland. Trabecular, cortical and total BMC at the ultra-distal radius of the nondominant hand were assessed by pQCT using the Stratec 960 apparatus. BMI and WHR were used as parameters of general obesity and fat distribution, respectively. The relationships among the analysed variables were established using a multiple linear regression. The differences in BMC depending on BMI and WHR values were tested using an analysis of covariance (ancova). BMI was positively related only to trabecular BMC (r = 0.17; P = 0.03). Only trabecular BMC was higher in men with BMI >or= 27 compared to nonoverweight subjects (F = 5.38; P = 0.02). WHR was inversely related to trabecular (r = - 0.30; P < 0.001), cortical (r = - 0.30; P < 0.001) and total BMC (r = - 0.34; P < 0.001). All densitometric parameters were lower in males with WHR >or= 0.95 than in normal men (results of ancova: for trabecular BMC, F = 6.33, P = 0.01; for cortical BMC, F = 5.52, P = 0.02, and for total BMC, F = 7.73, P = 0.006). In the healthy Polish male population, BMI was of minor significance as a predictor of BMC at the ultra-distal radius, whereas visceral adiposity (assessed by WHR) was significantly linked to reduced bone mass in men.

Bone mineral status of Polish men in the course of normal ageing.

Age-related changes in the bone mineral content (BMC) of men are conditioned by both genetic and environmental factors distinctive for particular populations. This results in considerable differences between various populations concerning the prevalence of osteopenia and osteoporosis, and the occurrence of normal variability in BMC among adult and elderly men. The aim of the study was to evaluate the variation of BMC with age in an ethnically homogenous sample of 405 healthy men, aged 20-60 years, all occupationally active inhabitants of the city of Wroclaw, Lower Silesia, Poland. Trabecular and total BMC at the ultradistal radius of the nondominant hand were assessed by peripheral quantitative computerized tomography using the Stratec 960 densitometer. Among Polish men a distinct phase of maximal BMC values (around the age of 30) was distinguished, with a subsequent, quite rapid decline in bone mass. For example, the peak value of trabecular BMC decreased by approximately 13.2% per decade. In Polish men up to 30-34 years old trabecular and total BMC even exceeded reference values by 10%; however, from 35 years onwards their BMC was lower than standard values. This unfavourable phenomenon of BMC decline was augmented with age, and finally BMC values in men aged 55 and over were 30-35% lower than reference values. The significant discrepancies found between the data presented in this study and reference values probably result from inter-populational differences in the lifestyles of healthy ageing men. The results also confirm that bone density (with its age-related changes in the course of normal male ageing) is one of the biological features characteristic of this particular regional population.

Effects of long-term testosterone substitutive therapy on bone mineral content in men with hypergonadotrophic hypogonadism.

Hypogonadism is one of the crucial risk factors for male osteopenia and osteoporosis. There are few studies on the effects of long-term and consistently administered testosterone substitutive therapy on bone mineral density in men with gonadal androgen deficiency, and their results have been susceptible to various interpretations. The aim of our study was an evaluation of bone mineral content in 26 men, aged 18-57 years, with hypergonadotrophic hypogonadism who underwent long-lasting androgen re-placement therapy with testosterone esters (Omnadren 250), which conditioned proper psychosomatic androgenization. The control group comprised 405 healthy men, aged 20-60 years, a representative sample of the local male population. Among all examined men and in the control group, trabecular, cortical and total bone mineral content at the distal radius of the nondominant hand were assessed by peripheral quantitative computed tomography using the Stratec 960 apparatus. In 11 hypogonadal men (42.3%), the trabecular bone mineral content was found to be within normal ranges; in 15 patients (57.7%) its values were below -1 standard deviation (SD) (osteopenia). In six patients (23.1%), the cortical bone mineral content was between +1 SD and the arithmetic mean, X; in 13 examined men (50%), the cortical bone mineral content was below X and above -1 SD. Osteopenia was diagnosed in six hypogonadal males, whereas osteoporosis was found in one man (cortical bone mineral content below -2.5 SD). Only in seven of the examined men (26.9%) was the total bone mineral content found within normal ranges, whereas in 19 men (73.1%) the total bone mineral content was below -1 SD (osteopenia). Despite the testosterone replacement in hypogonadal men, the greatest reduction of bone mineral content was found in its trabecular and total values. Among all the men examined, the trabecular and total bone mineral contents were below the mean of our own reference values. The results show that long-term and consecutively administered testosterone replacement in conventional doses, despite the normalization of serum androgen levels and the promotion of proper somatic development, does not simultaneously eliminate hypogonadal osteopenia in every case. The individually differentiated response to exogenous androgens is a characteristic feature of male hypogonadism. This study emphasizes the necessity of regular measurements of bone mineral density in hypogonadal men, as the densitometric parameters should be accepted as an osteologic (and very important) marker of androgenization of the male organism.

[Dermatoglyphic morphology in some diseases]. / Morfologia dermatoglifów w wybranych schorzeniach.

Dermatoglyphic polymorphism results from the co-operation of genetic and environmental factors during the early stages of ontogenesis. Such elements as intrauterine viral infection, radiation, alcohol, drug or certain medicaments taken by pregnant women are able to essentially disturb the formation of dermatoglyphics, if only act before the 19th week of pregnancy. Also various genetic anomalies can result in improper morphology of ridge traits. Therefore, the dermatoglyphic analysis is a valuable completion of diagnosis of some diseases (phenyloketonuria) and syndromes genetically determined (e.g. Down, Turner or Klinefelter syndromes). Regardless of the mechanism resulting in disturbed ridge traits, the new figures of dermatoglyphics are never formed, instead the altered prevalence of particular forms of ridge traits and/or the changed direction of dermatoglyphics are revealed. The improper types of dermatoglypics--in particular when found in complexes--suggest the existence of developmental instability of an organism.

[Testosterone and dehydroepiandrosterone deficiency, general adiposity and visceral obesity during normal male aging]. / Deficyt testosteronu i dehydroepiandrosteronu a otluszczenie ogólne i otylosc brzuszna w procesie starzenia sie mezczyzn.

Both clinical observations and in vitro studies reveal that sex steroids are essential factors affecting body fat accumulation and distribution of healthy men. An excessive adiposity and visceral obesity are frequently accompanied by an adrenal and gonadal andropenia among men aged 50 and over. The relationships between an age-related increase in BMI and WHR values and an altered androgen-estrogen activity in the course of normal male aging have not been firmly established, as not all studies have thus far produced consistent results. The effects of androgen substitutive therapy (testosterone and dehydroepiandrosterone) in elderly men suggest the possible relationship between androgens and male visceral adiposity; unfortunately the results of available studies on that issue are also not consistent. Therefore, nowadays there is an urgent need to comprehensively establish the androgen contribution in the pathogenesis of male visceral obesity.

[The effect of smoking tobacco and drinking of alcohol and coffee on bone mineral density of healthy men 40 years of age]. / Wplyw palenia tytoniu, picia alkoholu i kawy na gestosc mineralna koscca obwodowego zdrowych mezczyzn po 40 roku zycia.

The aim of the study was to evaluate the effects of smoking, alcohol and coffee drinking on bone mineral content (BMC) in a group of 258 healthy men, aged 40-63, occupationally active inhabitants of Wroclaw. Trabecular, cortical and total BMC at the distal radius of the non-dominant hand were measured by pQCT method using the Stratec apparatus. The data concerning smoking, alcohol and coffee intake were obtained through a questionnaire. The significance of BMC differences between groups were tested using a one-way analysis of variance ANOVA. The extent of alcohol intake did not differentiate BMC values at the distal radius, whereas the significant detrimental effects of both smoking and coffee drinking on trabecular (but not cortical and total) BMC were revealed. Among healthy Polish males coffee drinking was associated with a significant reduction of trabecular BMC. Simultaneously, smokers and ex-smokers (when compared to never-smokers) had lower trabecular BMC.

Relationships between age-related changes of sex steroids, obesity and body fat distribution among healthy Polish males.

During the process of aging in males a trend toward an unfavourable body fat accumulation, especially within the visceral depots, is observed. This fact is presumed to be associated with the age-related decline in androgen levels among aging men. The aim of this study was to determine the relationships between sex steroid levels (DHEAS, estradiol, free and total testosterone) and BMI, percent fat mass, WHR values in 190 healthy and professionally active men, aged 22-67, inhabitants of the city of Wroclaw, Poland. Hormonal levels were measured using standard immunoassays. BMI was used as a measurement of obesity. Obesity was also assessed using percent fat mass equations according to the Crook formula. WHR was used as an index of fat distribution. All the correlations between sex steroids, BMI, WHR, percent fat mass and age were evaluated using statistical non-parametric analyses (Spearman coefficient) in the entire group of examined subjects, and in two age-specific groups: a) younger males (aged 22-39) and b) older males (aged 40-67). The aging of Polish males is accompanied by both a significant increase of BMI, percent fat mass and WHR values, and by a decline in estradiol, gonadal and adrenal androgen levels. In the younger group only total testosterone levels were significantly negatively related to BMI, percent fat mass and WHR. Within the group of older men both estradiol and DHEAS levels are significantly positively related to WHR. The sex steroids seem to be associated with indices of overall obesity and distribution of fat in men, but these relationships differ considerably when they are evaluated in younger and older age categories. Worthy of notice is the fact that free testosterone levels are not related to any anthropometric parameters in any age category, although free testosterone (not total testosterone) is commonly recognised as a reliable and sensitive endocrinological indicator of the general psycho-physical status of an aging man.

[The effect of alcohol on bone mineral density in men]. / Wplyw alkoholu na gestosc mineralna koscca u mezczyzn.

Alcohol abuse is an essential factor promoting an excessive reduction of bone mass during the normal male aging. Authors present an issue of osteopenia and osteoporosis in men, that sometimes is due to the long-term bone tissue exposition on ethanol. They also present actual views on the pathogenesis of this pathology. Ethanol impairs mainly an osteoblastic activity that results in reduced bone formation and mineralisation. Affecting the osteoclasts' function, alcohol is also able to induce bone resorption. Despite the direct toxic effect of ethanol on bone tissue, the indirect influence of ethanol on metabolism of hormones participating in bone homeostasis has been revealed. In chronic alcoholics the deficiency of active metabolites of vitamin D is often observed. The findings on parathormone activity in alcohol male abusers are not consistent. Additionally, chronic alcoholism is frequently accompanied by an increase of cortisol levels, andropenia, dietary, vitamin and electrolyte deficiencies.