RESUMO
Lifestyle measures (LSMs) should be the first-line approach offered for obesity-related functional hypogonadism (FH). When LSMs fail, the role of testosterone replacement treatment (TRT) is unclear. GLP1 receptor agonist liraglutide is linked to progressive and sustained weight loss. A potential direct impact of GLP1 on hypothalamus-pituitary-testicular (HPT) axis was reported in animal models. We aimed to compare the effects of liraglutide and TRT on FH in obese men that had been poor responders to LSM, by means of reversal of FH and weight reduction. We designed a 16-week prospective randomized open-label study with 30 men (aged 46.5 ± 10.9 years, BMI 41.2 ± 8.4 kg/m2, mean ± s.d.) that were randomized to liraglutide 3.0 mg QD (LIRA) or 50 mg of 1% transdermal gel QD (TRT). Sexual function and anthropometric measures were assessed. Fasting blood was drawn for determination of endocrine and metabolic parameters followed by OGTT. Model-derived parameters including HOMAIR and calculated free testosterone (cFT) were calculated. Total testosterone significantly increased in both arms (+5.9 ± 7.2 in TRT vs +2.6 ± 3.5 nmol/L in LIRA) and led to improved sexual function. LIRA resulted in a significant increase of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) (P < 0.001 for between-treatment effect). Subjects treated with LIRA lost on average 7.9 ± 3.8 kg compared with a 0.9 ± 4.5 kg loss in TRT (P < 0.001). Metabolic syndrome was resolved in two patients in LIRA and in no subjects in TRT. Liraglutide was superior to TRT in improving an overall health benefit in men with obesity-associated FH after LSM failed.
RESUMO
BACKGROUND AND OBJECTIVE: Body piercings have increased tremendously in popularity in recent years. For oral piercing, late complications include gingival trauma and localized periodontitis. The purpose of this cross-sectional study was to investigate the prevalence and contributing factors of gingival recession associated with labial piercing. MATERIAL AND METHODS: The test group included 50 subjects with lower-lip studs. Nonpierced controls were matched according to gender, age and smoking status. Clinical examination included plaque and bleeding indices, probing depth, recession, clinical attachment level, width of keratinized gingiva, periodontal biotype, insertion of frenula, evaluation of hard tissues, trauma of occlusion, characteristics of the stud, radiographs and photographs. RESULTS: Gingival recessions were noted on teeth opposite the stud in 68% of the test group compared with 4% of the controls. Localized periodontitis was recorded in 4% of test subjects. Time since piercing and the position of the stud in relation to the cemento-enamel junction were significantly associated with the prevalence of buccal recessions. There were no significant associations between piercing and abnormal tooth wear. CONCLUSION: The prevalence of gingival recessions is associated with labial piercing. The position of the intra-oral disc and time since piercing are associated with a greater prevalence of gingival recession. A narrow width of keratinized gingiva is associated with increased buccal recessions.