Association between Coffee Consumption and Polycystic Ovary Syndrome: An Exploratory Case-Control Study.

Polycystic ovary syndrome (PCOS) is a leading cause of infertility, with an estimated worldwide prevalence between 5% and 15%. We conducted a case-control study with 121 PCOS patients and 155 controls to assess the association between coffee intake and the presence of having a diagnosis of PCOS in women in Murcia, Spain. The PCOS diagnosis was determined following Rotterdam criteria (the presence of two of the following three conditions: hyperandrogenism, oligo-anovulation, and/or polycystic ovarian morphology). Coffee consumption was assessed using a validated food frequency questionnaire. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multiple logistic regression. Coffee consumption was categorized into never, less than one cup per day, one cup per day, and two or more cups per day. We found a significant inverse linear trend: the higher the coffee consumption, the lower the probability of having PCOS in multivariable analysis (p-trend = 0.034). Women who presented with PCOS were less likely to drink one cup of coffee compared to those who had never drunk coffee (OR = 0.313, 95% CI: 0.141-0.69). The consumption of at least one cup of coffee per day may be associated with a decrease in PCOS symptoms.

Sugar-sweetened beverage intake in relation to reproductive parameters in young men.

BACKGROUND: There has been a decrease in sperm concentration in recent years. Concurrently, there were important dietary changes, including an increase in sugar-sweetened beverage intake (SSB). The relation between SSB and male reproduction functions in humans are barely described in the literature. METHODS: Cross-sectional study with 209 participants (18-23 years old) recruited during one year in Murcia, Spain. All men provided semen and blood samples the same day. SSB consumption was evaluated using a 101-item validated food frequency questionnaire. Reproductive hormones were analysed from serum samples, obtaining levels of follicle-stimulating hormone, inhibin B, luteinizing hormone, estradiol, and testosterone. The evaluation of semen analysis followed the WHO guidelines and consisted of seminal volume, sperm concentration, total sperm count, percentage of morphologically normal sperm, and percentage of motile sperm. SSB intake association with semen parameters and hormone levels were examined using multiple linear regression. RESULTS: Men in the highest quartile of the SSB intake had a higher percentage of morphologically normal sperm, 37.4% [6.1, 68.3] (p, trend=0.047) and higher estradiol levels (9.5% [-3.5, 22.5] (p, trend=0.047) than those in the first quartile. SSB intake was unrelated to other semen quality parameters or reproductive hormone levels. CONCLUSIONS: Our results indicate that sperm morphology and estradiol levels may be associated with sugar-sweetened beverage intake. These findings might be explained by physiological metabolism homeostasis, though more studies are required to confirm these results and draw conclusions in other male populations.

Fat intake pattern in women with polycystic ovary syndrome.

RESEARCH QUESTION: Do women with polycystic ovary syndrome (PCOS) have a different fat intake pattern to women without PCOS? DESIGN: Case-control study of 276 women between 20 and 35 years old from the Murcia region of Spain. Cases (n = 121) attended the Department of Gynaecology and Obstetrics of the University Clinical Hospital and were diagnosed with PCOS using Rotterdam criteria. Controls (n = 155) were women without PCOS attending the gynaecological outpatient clinic for routine gynaecological examinations. Data from clinical, gynaecological and analytical examinations were collected, including a food frequency questionnaire. Associations between fat intake and presence of PCOS and its phenotypes were examined using multiple logistic regression, adjusting for potential confounding factors. RESULTS: Although no association was found between fatty acid intake and PCOS, significant associations were observed for some PCOS phenotypes. The PCOS phenotype characterized by hyperandrogenism + oligo/amenorrhoea + polycystic ovarian morphology ('H+O+POM') was significantly associated with a higher intake of polyunsaturated fat (odds ratio [OR] 4.0; 95% confidence interval [CI] 1.1-14.2; fourth quartile of highest intake [Q4] versus lowest intake quartile as reference [Q1]) and omega-6 fatty acids (OR 3.5; 95% CI 1.01-12.4; Q3 versus Q1). The 'H+O' phenotype was positively associated with saturated fat intake (OR 6.9; 95% CI 1.1-41.6; Q4 versus Q1). CONCLUSION: This exploratory study suggests that higher intakes of specific fatty acids are related to some PCOS phenotypes although no association was found for PCOS on a global basis. It is recommended that studies with larger sample size be performed to further explore these associations, thus contributing to establishing recommendations about fat intake adapted to different PCOS phenotypes.

Anogenital distance and anti-Müllerian hormone combined improves the diagnosis of polycystic ovary syndrome.

The objective of this study was to assess the accuracy of the combination of anogenital distance (AGD) and anti-Müllerian hormone (AMH) in the diagnosis of polycystic ovary syndrome (PCOS). The study included women diagnosed with PCOS and a control group who attended the Clinical University Hospital 'Virgen de la Arrixaca' in Murcia (Spain). Serum concentrations of AMH were measured and two AGD measurements were obtained: (i) from the anterior clitoral surface to the upper verge of the anus (AGDAC); and (ii) from the posterior fourchette to the upper verge of the anus (AGDAF). Data were assessed by receiver operator characteristic (ROC) curves. Women with PCOS (n = 126) had significantly larger AGDAC (80.5 ± 11.3 versus 76.0 ± 10.4 mm; p < 0.001) and higher AMH (7.2 ± 4.7 versus 3.1 ± 2.2; p < 0.001) compared to control women (n = 159). Women with serum AMH above 3.8 ng/mL (clinical cut-off used in PCOS) were 9.1 times more likely to have PCOS (95% CI: 5.1-16.2). The area under the ROC curve of combined model of AMH and AGDAC was 0.87 (95% CI: 0.83-0.91). The combined model for predicting PCOS based on AMH and AGDAC has better diagnostic accuracy than that of AMH or AGDAC alone. This model could be useful for clinicians and improve diagnosis and clinical management of these women.

Body Composition and Characterization of Skinfold Thicknesses from Polycystic Ovary Syndrome Phenotypes. A Preliminar Case-Control Study.

To describe whether polycystic ovary syndrome (PCOS) phenotypes vary in their body composition and skinfold (SKF) thicknesses and if they differ from women without PCOS, a preiminar case-control study was performed. A total of 117 cases were diagnosed using the Rotterdam criteria. Gynecological examinations and transvaginal ultrasound were performed in all women (266 women). Anthropometric measurements including SKF thickness were taken according to the restricted profile protocol of the international standards for the anthropometric evaluation according to the International Society of the Advancement of Kinanthropometry (ISAK). Women with PCOS had higher body mass index and percentage of fat mass with respect to controls. The endomorphy component was also significantly higher in women with PCOS than in controls. Each PCOS phenotype displayed a different representation in the somatochart respect to the others phenotypes and also compared to controls. Women with PCOS had significantly higher ∑7 SKF (p = 0.013), ∑appendicular SKF (p = 0.017) and ∑arm SKF (p = 0.019) than controls. H-O-POM phenotype had higher 7∑ SKF (p = 0.003), ∑appendicular SKF (p = 0.01), ∑arm SKF (0.005), ∑leg SKF, and ∑trunk SKF (0.008) and also a higher fast mass percentage than controls (p = 0.011). In conclusion, body composition evaluated by ISAK protocol is different in women with PCOS, especially in the complete phenotype (H-O-POM). This could have relevant implications in terms of clinical evaluation and follow-up of these women, although more researches in this field are needed.

Assessment of Optimism in Women with Polycystic Ovary Syndrome: A Case Control-Study.

Polycystic ovary syndrome (PCOS) is a chronic endocrinopathy characterized by hyperandrogenism and anovulation that may pervade psychological dimensions such as dispositional optimism. Considering how PCOS influences mental health and the lack of studies on this matter, this research was aimed at assessing optimism and associated factors in PCOS. A case-control study of 156 patients with PCOS and 117 controls was conducted. All woman filled out the Life Orientation Test-Revised (LOT-R), a self-report questionnaire for measuring dispositional optimism. Medication, pain severity, gynecological, and sociodemographic information was also collected. Lower optimism was found in patients with PCOS compared to controls, even after covariate adjustment (LOT-R global scores: 14.1 vs. 15.9, p = 0.020). Our study provides evidence that a personality characteristic with important implications in illness prognosis may be affected in PCOS. We propose to assess dispositional optimism with the LOT-R scale in the gynecological appointment and tailor medical attention accordingly as a way to improve the comprehensive care of these patients within a multidisciplinary team.

Are Dietary Indices Associated with Polycystic Ovary Syndrome and Its Phenotypes? A Preliminary Study.

Polycystic ovary syndrome (PCOS) is a complex hormonal disorder which impairs ovarian function. The adherence to healthy dietary patterns and physical exercise are the first line of recommended treatment for PCOS patients, but it is yet unclear what type of diet is more adequate. In this case-control study, we explored associations between adherence to five dietary quality indices and the presence of PCOS. We enrolled 126 cases of PCOS and 159 controls living in Murcia (Spain). Diagnostic of PCOS and its phenotypes were established following the Rotterdam criteria (hyperandrogenism (H), oligoanovulation (O), polycystic ovaries morphology (POM)). We used a validated food frequency questionnaires to calculate the scores of five dietary indices: alternate Healthy Eating index (AHEI), AHEI-2010, relative Mediterranean Dietary Score (rMED), alternate Mediterranean Dietary Score (aMED) and Dietary Approaches to Stop Hypertension (DASH). We used multivariable logistic regression to estimate adjusted odds ratios and confidence intervals. In the multivariable analysis, AHEI-2010 index was inversely associated with Hyperandrogenism + Oligoanovulation PCOS phenotype (ORQ3 vs. Q1 = 0.1; 95% CI: (0.0; 0.9); Pfor trend = 0.02). We did not find any statistical significant association between dietary indices and total anovulatory or ovulatory PCOS. However, further studies with higher sample sizes exploring these associations among the diverse phenotypes of PCOS are highly warranted.

Asociación entre el cociente del segundo y cuarto dedo y el riesgo de cáncer de próstata: Un estudio de casos y controles en población mediterránea / Second to Fourth Digit Ratio and Prostate Cancer Risk: A Case-control Study in Mediterranean Population

Objetivo Evaluar la asociación entre el cociente de los dedos segundo y cuarto (2D:4D), como un biomarcador de la exposición prenatal a andrógenos, y la presencia de cáncer de próstata (CaP). Métodos Estudio de casos y controles con 260 hombres que consultaron en el Servicio de Urología del Hospital General Universitario Reina Sofía (Murcia, España). Los casos (n = 125) fueron pacientes diagnosticados de CaP por anatomía patológica a los que se les realizó una prostatectomía radical. Los controles (n = 135) fueron pacientes que consultaron en Urología por otro motivo y que no mostraron signos ni síntomas de patología prostática. La longitud del 2D y 4D de la mano derecha fue medida mediante un pie de rey digital y se calculó el cociente entre ambos (2D:4D). Para los análisis estadísticos se utilizaron modelos de regresión logística obteniendo Odds ratios (OR) crudas y ajustadas e intervalos de confianza al 95%. Resultados Los casos presentaron un cociente 2D:4D significativamente menor que los controles. El cociente 2D:4D se relacionó significativamente con la presencia de CaP. Tras el ajuste multivariante, se observó que los varones que se encontraban en el primer tercil de distribución del cociente 2D:4D, presentaban casi el doble de riesgo de padecer CaP (OR 1,9: IC 95% 1,1­4,0; P-valor = 0,040) en comparación con los varones que se encontraban en el segundo y tercer tercil. Conclusiones Una mayor exposición prenatal a andrógenos, reflejada por un cociente 2D:4D menor, podría estar asociado con riesgo aumentado de padecer CaP, pero más estudios son necesarios para corroborar esos hallazgos.

Objective To evaluate the association between second to fourth digit (2D:4D) ratio, as a biomarker of prenatal androgen exposure, and the presence of prostate cancer (PCa). Methods This was a case-control study of 260 men attending a Department of Urology in a Murcia Region hospital (Spain). Cases (n = 125) were patients who underwent radical prostatectomy due to PCa and were diagnosed by specimen's histopathology. Controls (n = 135) were patients who showed no signs or symptoms of prostate disease. The length of 2D and 4D of the right hand was measured two times using a digital caliper, and the ratio calculated (2D:4D). Unconditional multiple logistic regressions [crude and adjusted Odds ratios (OR) and 95% confidence intervals (CI)] were performed to evaluate associations between the 2D:4D ratio and presence of PCa. Results Cases showed significantly lower 2D:4D ratios than controls. 2D:4D ratios were significantly associated with the presence of PCa. After controlling for important covariates, men in the first tertile of the 2D:4D ratio distribution, compared with the second and third tertile, were almost two-times [OR 1.9 (95% CI 1.1­4.0; P-value = 0.040] more likely to have PCa. Conclusions A higher prenatal androgen exposure, indicated by lower 2D:4D ratios, might be associated with higher PCa risk, but further research is needed to confirm these findings in other male populations.

Health-related quality of life in women with polycystic ovary syndrome attending to a tertiary hospital in Southeastern Spain: a case-control study.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a chronic condition with symptoms affecting many women at reproductive age and evaluating their health-related quality of Life (HRQoL) is an important issue. Moreover, differences in the HRQoL between women with different PCOS phenotypes have never been analyzed. Therefore, the aim of our study was to compare the HRQoL between women with PCOS -and its phenotypes- and controls attending to a tertiary hospital. METHODS: A group of 117 women with PCOS and 153 controls were studied between 2014 and 2016. Controls were women without PCOS attending the gynecological outpatient clinic for routine examinations. Cases were women attending the same setting and diagnosed with PCOS. PCOS diagnose was performed following the Rotterdam Criteria and women were further classified by anovulatory or ovulatory phenotypic subtype. Women underwent physical and gynecological exams and completed health questionnaires including the Short Form-12v2. Eight scales and two component summary scores [Physical (PCS) and Mental (MCS), respectively] were calculated. Bivariate and multivariate analyses were performed to assess differences in HRQoL between women with PCOS and controls. RESULTS: All women with PCOS and anovulatory PCOS presented lower score in PCS compared to controls [mean (95%CI): 53.7 (52.5-54.9) and 52.9 (51.5-54.4) vs. 55.8 (54.8-56.8); p-values< 0.01], as well as lower scores for five out of the eight scales (p-values < 0.05) after adjusting by age, body mass index, infertility, educational level and current occupation. No significant differences were observed for the MCS between women with or without PCOS or its phenotypic subtypes. CONCLUSIONS: HRQoL was significantly decreased in adult women with PCOS and its anovulatory phenotype compared to controls attending the outpatient clinic of a tertiary hospital. These results may have implications for the clinical practice and suggest the need for specific interventions in women with PCOS.

[Study of anogenital distance as a diagnostic tool for prostate cancer]. / Análisis de la distancia anogenital como herramienta diagnóstica del cáncer de próstata.

INTRODUCTION AND OBJECTIVE: The distance from the genitals to the anus (anogenital distance [AGD]) reflects androgen concentration during prenatal development in mammals. At the present time, there is only one study suggesting the relationship between AGD and risk of prostate cancer (CaP). The goal of this study was to assess the performance and clinical utility of AGD, as a biomarker of prenatal androgenic milieu, and risk of CaP in a larger population, in CaP diagnosis. MATERIAL AND METHODS: A case-control study was conducted on 260 men seen in a hospital outpatient clinic where underwent a physical and andrological examination and completed a brief questionnaire. CaP patients were confirmed by biopsy of the tumor. Controls were men without CaP seen in the urology outpatient clinic for routine examinations. Two variants of AGD (from the anus to the posterior base of the scrotum [AGDAS] and to the cephalad insertion of the penis [AGDAP]) were measured. Parametric and non-parametric tests and receiver operating characteristic (COR) analyses were used to determine relationships between AGD and presence of CaP. RESULTS: The highest area under the curve (0.69; 95% CI 0.60 to 0.78 and 0.69; 95% CI 0.61 to 0.77) was obtained for the Gleason=7 subgroup with the AGDAS and AGDAP measurement, with a sensitivity and specificity of 83% and 55%, and 91% and 41%, the predictive positive value of 39% and 35% and negative value of 90% and 93% respectively. CONCLUSION: AGD may be a useful clinical tool for the CaP diagnosis.

Are there differences in basal thrombophilias and C-reactive protein between women with or without PCOS?

RESEARCH QUESTION: Polycystic ovary syndrome (PCOS) women have increased cardiovascular risks, although it is unclear whether the haemostatic system and coagulation contribute to that increased risk. DESIGN: Women attending the Gynecology Unit of the 'Virgen de la Arrixaca' University Hospital (Murcia, Spain) for routine gynaecological examinations between September 2014 and May 2016 were assessed for PCOS using the Rotterdam criteria (hyperandrogenism [H], oligo/amenorrhoea [O] and polycystic ovarian morphology [POM]) and were classified into four phenotypic. In total, 126 cases were identified and 159 control women were selected. All women underwent physical and gynaecological examinations, and blood tests between the second and fifth day of the menstrual cycle. Differences in hormonal, basal thrombophilia and metabolic parameters, and C-reactive protein (CRP) between PCOS and controls were analysed. RESULTS: After adjusting by BMI and age, PCOS women had higher LH (P < 0.001), testosterone (P < 0.001), free testosterone (P = 0.01) and anti-Müllerian hormone (P < 0.001) and lower FSH (P = 0.03) compared with controls, whereas sex hormone-binding globulin was no different. Cases showed significantly higher protein S, glucose, insulin and insulin resistance (HOMA-IR) compared with controls (P < 0.05). There were no differences in protein C levels, antithrombin III, prothrombin time, homocysteine, D-dimer, factor V Leyden, prothrombin G20210A polymorphism or CRP. The H+O phenotype showed the poorest results for insulin and HOMA-IR (P = 0.04 and 0.05). CONCLUSIONS: The results suggest that there are no differences in the basal thrombophilias between women with and without PCOS. However, PCOS with H+O shows the poorest metabolic profile.

[Prostate cancer is associated with the anogenital distance, a biomarker of prenatal androgen milieu.] / El cáncer de próstata está asociado con la distancia anogenital, un biomarcador del ambiente androgénico prenatal.

OBJECTIVE: To evaluate the associationbetween anogenital distance (AGD), as a biomarker ofprenatal androgen milieu, and risk of prostate cancer(PCa). METHODS: A case-control study was conducted on260 men attending a university hospital where theyunderwent physical and andrological examination andcompleted a brief questionnaire. PCa patients were confirmedby biopsy of the tumor. Controls were men withoutPCa attending the urology outpatient clinic for routineexaminations. Two variants of AGD [from the anus to theposterior base of the scrotum (AGDAS) and to the cephaladinsertion of the penis (AGDAP)] were measured.Unconditional multiple logistic regression was used toestimate the association between AGD measurementsand presence of PCa, and Odds Ratios and 95% confidenceintervals (CI) were calculated. RESULTS: Cases showed significantly shorter AGDAPand AGDAS than controls. Subjects with AGDAP andAGDAS in the lowest compared to the upper tertile were2.6 times (95% CI 1.2-5.6) and 3.2 times (95% CI 1.5-6.9) more likely to have PCa, respectively. CONCLUSIONS: We found that shorter measurementsof both distances (AGDAS and AGDAP) were associatedwith higher risk of PCa. A previous study reportedsimilar results, showing that longer AGDAP was associatedwith lower risk of PCa, but this relationship was notfound for AGDAS, as it was in our study with a largersample size.

OBJETIVO: Evaluar la asociación entre la distancia anogenital (AGD) como biomarcador de la ventana androgénica prenatal y el riesgo de padecer cáncer de próstata (PCa).MATERIAL Y MÉTODO: Estudio de casos y controles realizado en 260 pacientes. Todos los pacientes fueron sometidos a examen físico y andrológico y completaron un breve cuestionario. Los pacientes con PCa tenían diagnóstico histológico por biopsia prostática. Los controles fueron varones sin sospecha de PCa que acudieron a la consulta externa de Urología para exámenes rutinarios. Se midieron dos variantes de AGD [del ano a la base posterior del escroto (AGDAS) y del ano a la inserción dorsal del pene (AGDAP)]. Se utilizóanálisis de regresión logística múltiple para estimar la asociación entre las medidas de AGD y la presencia de PCa. Se calcularon Odds Ratios (ORs) e intervalos de confianza (IC) 95%. RESULTADOS: Los casos mostraron unas AGDAP y AGDAS  significativamente más cortas que los controles.Los pacientes con AGDAP y AGDAS en el tercil inferior comparado con los pacientes del tercil superior mostraron 2,6 (IC 95% 1,2-5,6) y 3,2 veces (IC 95% 1,5-6,9) más riesgo, respectivamente, de padecer PCa. CONCLUSIONES: Encontramos que las medidas acortadas de ambas AGDs se asociaron con un mayor riesgo de padecer PCa. Un estudio previo obtuvo resultados similares, mostrando que una AGDAP alargada se asoció con un menor riesgo de padecer PCa, pero noobservó ninguna relación con respecto a la AGDAS, como sí objetivamos en este estudio con un mayor tamaño muestral.

Accuracy of anogenital distance and anti-Müllerian hormone in the diagnosis of endometriosis without surgery.

OBJECTIVE: To assess the predictive ability of a combination of anogenital distance (AGD) and anti-Müllerian hormone (AMH) to diagnosis the presence of endometriosis without surgery. METHODS: The present study included women diagnosed with endometriosis and a control group who attended the "Virgen de la Arrixaca" University Hospital, Murcia, Spain, between September 1, 2014, and May 31, 2015. Serum concentrations of AMH were measured, and two AGD measurements were obtained: from the anterior clitoral surface to the upper verge of the anus (AGDAC ), and from the posterior fourchette to the upper verge of the anus (AGDAF ). Data were assessed by receiver operator characteristic (ROC) curves. RESULTS: Women in the endometriosis group (n=57) had significantly shorter AGDAF (22.8 ± 4.6 vs 27.2 ± 5.7 mm; P<0.001) and lower AMH (2.2 ± 2.5 vs 3.3 ± 1.9 ng/mL; P<0.003) compared with the control group (n=93). Women with serum AMH below the clinical cut-off (1 ng/mL) were 17.40-times more likely to have endometriosis (95% confidence interval [CI] 5.64-53.82). The area under the ROC curve of combined AMH and AGDAF was 0.77 (95% CI 0.70-0.85). CONCLUSION: The model for predicting endometriosis on the basis of AMH and AGD could be useful for clinicians and epidemiologists to improve diagnosis and prognosis of this condition.

Assessment of anogenital distance as a diagnostic tool in polycystic ovary syndrome.

RESEARCH QUESTION: Is anogenital distance (AGD) a useful clinical tool for predicting polycystic ovarian syndrome (PCOS) and its main National Institutes of Health (NIH) phenotypes? DESIGN: Case-control study conducted between September 2014 and May 2016 at the Department of Obstetrics and Gynecology of the University Clinical Hospital 'Virgen de la Arrixaca' in the Murcia region (south-eastern Spain). One hundred and twenty-six cases of PCOS and 159 controls without PCOS were included. AGD measurements were taken from the anterior clitoral surface to the upper verge of the anus (AGDAC), and from the posterior fourchette to the upper verge of the anus (AGDAF). Parametric and non-parametric tests and receiver operating characteristic (ROC) curves were used to assess associations between AGD and the presence of PCOS and its phenotypes. RESULTS: AGDAC, but not AGDAF, was associated with PCOS and all its phenotypes (P-values < 0.001 to 0.048). The highest area under the curve (0.62; 95% confidence interval 0.55 to 0.71) was obtained for all PCOS with AGDAC with a sensitivity and specificity of 50.0% and 73.0%, and positive and negative predictive value of 59.0% and 64.4%, respectively. CONCLUSIONS: AGDAC could moderately discriminate the presence of PCOS and may be a useful clinical tool.

Urinary concentrations of benzophenone-type ultra violet light filters and reproductive parameters in young men.

BACKGROUND: Benzophenone (BP)-type ultraviolet (UV) light filters are chemicals frequently added to personal care products, insect repellents, sunscreens, and beverage and food packaging to diminish the harmful effects of UV sunlight on human skin or foodstuffs. BP-type UV filters have shown negative effects on male reproduction function in in vitro and animal models, but human epidemiologic studies are limited. The goal of this study was to examine associations between urinary concentrations of BP-type UV filters and semen quality and reproductive hormone levels. METHODS: This is a cross-sectional study with 215 young university students (18-23 years old) recruited between 2010 and 2011 in Southern Spain (Murcia Region). All men provided a urine, blood and semen sample on a single day. Urinary concentrations of 2,4-dihydroxybenzophenone (BP-1); 2,2',4,4'-tetrahydroxybenzophenone (BP-2); 2-hydroxy-4-methoxybenzophenone (BP-3); 2,2'-dihydroxy-4-methoxybenzophenone (BP-8) and 4-hydroxybenzophenone (4OH-BP) were measured by dispersive liquid-liquid microextraction and ultra-high performance liquid chromatography with tandem mass spectrometry detection. Semen quality was evaluated by measuring volume, sperm counts, motility and morphology. Serum samples were analyzed for reproductive hormones, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), inhibin B and estradiol (E2). Associations between urinary concentrations of BP-type UV filters and semen quality parameters and reproductive hormone levels were examined using linear regression, adjusting for potential confounders. RESULTS: Ninety-seven percent of the men had detectable urinary concentrations of at least one of the five BP-type UV filters quantified. After adjustment for important covariates (body mass index, smoking status and time of blood sample collection), there was a significant positive association between urinary BP-1 and BP-3 concentrations and serum FSH levels (ß = 0.08, 95%CI: 0.009; 0.15 and ß = 0.04, 95%CI: 0.0002; 0.08, respectively). Urinary BP-1 concentration was also significantly positively associated with T/E2 (ß = 0.04, 95%CI: 0.002; 0.07) and negatively with inhibin b/FSH (ß = -0.11, 95%CI: -0.21; -0.006) ratio. No significant associations were found between other urinary BP-type UV filters and other reproductive hormone levels or between any semen parameters and any of the urinary BP-type UV filters quantified. CONCLUSIONS: Our results suggest that, in young men, urinary BP-type UV filters may be associated with a modest alteration of some reproductive hormones, but the effects we report on reproductive function are likely to be small, and of unclear clinical significance. Further research is needed to replicate these findings in other male populations.

Presence of polycystic ovary syndrome is associated with longer anogenital distance in adult Mediterranean women.

STUDY QUESTION: Is polycystic ovary syndrome (PCOS) associated with anogenital distance (AGD), a biomarker of fetal androgen exposure, in adult Mediterranean women? SUMMARY ANSWER: Longer AGD is associated with PCOS in adult Mediterranean women. WHAT IS KNOWN ALREADY: AGD is a biomarker of prenatal androgen milieu. Human observational studies have reported that associations between AGD and reproductive parameters in both sexes. Exposure of the female fetus to intrauterine androgens may be a risk factor for PCOS in adulthood. STUDY DESIGN, SIZE, DURATION: This was a case-control study of 126 women with PCOS and 159 controls between September 2014 and May 2016. PARTICIPANTS/MATERIALS, SETTING, METHODS: Cases were attending the gynecology unit of the 'Virgen de la Arrixaca' University Clinical Hospital (Murcia, Spain), and were diagnosed following the Rotterdam criteria. Phenotypic subtypes of PCOS were also assessed. Both prevalent and incident (newly diagnosed) cases were included. Controls were women without PCOS attending the gynecological outpatient clinic for routine gynecological exams. All women completed health questionnaires, and underwent physical and gynecological examinations, including transvaginal ultrasound and blood draw. We obtained measures from the anterior clitoral surface to the upper verge of the anus (AGDAC), and from the posterior fourchette to the upper verge of the anus (AGDAF). Gynecologists performing the AGD measures were blind to the status of the patients. We used unconditional multiple logistic regression to evaluate the association between AGD measurements and PCOS while accounting for relevant covariates and confounders, such as BMI, age and episiotomy. MAIN RESULTS AND THE ROLE OF CHANCE: Cases showed significantly longer AGDAF and AGDAC compared to controls in bivariate analyses (P-values < 0.05). In the final adjusted models, AGDAC, but not AGDAF, was associated with the presence of PCOS (P-values = 0.002-0.008). Women with AGDAC in the upper compared to the lowest tertile were 2.9-times (95% CI 1.4-5.9; P-trend = 0.008) more likely to have PCOS. AGDAC measures were also significantly associated with all of the different phenotypic subtypes of PCOS (ORs = 3.1-5.1; P-values < 0.05). LIMITATIONS REASONS FOR CAUTION: We took into account known and suspected covariates and confounders, but the possibility of chance findings or residual confounding should be noted. As with all observational studies, causal inference is limited, and study selection and information bias should not be ruled out. WIDER IMPLICATIONS OF THE FINDINGS: Our results support the hypothesis that PCOS has an intrauterine origin, and that the hormonal environment in which the fetus develops may be highly relevant. STUDY FUNDING/COMPETING INTEREST: This work was supported by the Ministry of Economy and Competitiveness, Instituto de Salud Carlos III (ISCIII) (AES, Acción Estratégica en Salud), grant No. PI13/01237, and The Seneca Foundation, Murcia Regional Agency of Science and Technology, grant No. 19443/PI/14. There are no competing interests. TRIAL REGISTRATION NUMBER: Not applicable.

Anogenital Distance, a Biomarker of Prenatal Androgen Exposure Is Associated With Prostate Cancer Severity.

BACKGROUND: Anogenital distance (AGD), the distance from the centre of the anus to the genitals, is a sexually dimorphic phenotype in mammals. Experimental studies have shown that AGD is a biomarker of prenatal androgen exposure during the masculinisation period of development. The aim of this study is to assess the relationship between anogenital distance (AGD), as an indirect marker of prenatal hormonal environment, and prostate cancer (PCa) severity. MATERIALS: We conducted a cross-sectional study with a total of 120 PCa patients with confirmed biopsy of the tumour from April 2007 to July 2015. Two variants of the anogenital distance were assessed, from the anus to the posterior base of the scrotum (AGDAS ) and to the cephalad insertion of the penis (AGDAP ). We compared differences in groups to evaluate the association between AGD measurements and severity of the preoperative biopsy and clinical scores. RESULTS: Longer AGDAS was significantly associated with the highest Gleason score (P = 0.015) and D'Amico nomogram (P = 0.048). In contrast, no statistical differences were found in the AGDAP and severity of the preoperative biopsy. CONCLUSIONS: These findings are consistent with the hypothesis that a higher prenatal androgen exposure is associated with higher severity of PCa. Prostate 77: 406-411, 2017. © 2016 Wiley Periodicals, Inc.

Fatty acid intake in relation to reproductive hormones and testicular volume among young healthy men.

Emerging evidence suggests that dietary fats may influence testicular function. However, most of the published literature on this field has used semen quality parameters as the only proxy for testicular function. We examined the association of fat intake with circulating reproductive hormone levels and testicular volume among healthy young Spanish men. This is a cross-sectional study among 209 healthy male volunteers conducted between October 2010 and November 2011 in Murcia Region of Spain. Participants completed questionnaires on lifestyle, diet, and smoking, and each underwent a physical examination, and provided a blood sample. Linear regression was used to examine the association between each fatty acid type and reproductive hormone levels and testicular volumes. Monounsaturated fatty acids intake was inversely associated with serum blood levels of calculated free testosterone, total testosterone, and inhibin B. A positive association was observed between the intake of polyunsaturated fatty acids, particularly of omega-6 polyunsaturated fatty acids, and luteinizing hormone concentrations. In addition, the intake of trans fatty acids was associated with lower total testosterone and calculated free testosterone concentrations (P trend = 0.01 and 0.02, respectively). The intake of omega-3 polyunsaturated fatty acids was positively related to testicular volume while the intake of omega-6 polyunsaturated fatty acids and trans fatty acids was inversely related to testicular volume. These data suggest that fat intake, and particularly intake of omega 3, omega 6, and trans fatty acids, may influence testicular function.

Sperm counts may have declined in young university students in Southern Spain.

Several studies have investigated temporal trends in semen quality in Northern Europe, but none has examined this question in Southern Europe. A prior study conducted in Almeria Province (Southern Spain) reported higher sperm count and concentration among Spanish young men recruited from 2001 to 2002 compared with young men from Northern Europe. The aim of this new study was to examine whether semen quality has changed among Spanish young men in the last decade. In this cross-sectional study, questionnaires and semen samples were collected from 215 healthy young university students from Murcia Region between 2010 and 2011. The 273 men from the Almeria study previously studied were included in a trend analysis of the two populations from Southern Spain. Descriptive statistics were calculated for the Murcia study population and these and semen variables for the Murcia and Almeria study populations were compared. Study methods and population characteristics were similar across the two studies. Therefore, we used multiple linear regression analyses on the combined population (controlling for study centre, age, ejaculation abstinence time, season, smoking, medication during the last 3 months, Body mass index (BMI), presence of varicocoele and prenatal exposure to tobacco) to look for a birth-cohort effect over the combined study period (2001-2011). Sperm concentration and total sperm count declined significantly with year of birth in the pooled analysis (ß = -0.04 and ß = -0.06, respectively, both p < 0.01). Sperm counts were significantly lower in Murcia study subjects than in the Almeria participants; sperm concentration median (5th-95th) = 44.0 (8.9-129) million/mL vs. 51.0 (5.0-206) million/mL; p < 0.01 and total sperm count = 121 (17.8-400) million vs. 149 (8.0-599) million; p < 0.01. Other semen variables did not differ significantly between the two studies. Our study suggests that total sperm count and sperm concentration may have declined in young Spanish men over the last decade.

Dietary intake of antioxidant nutrients is associated with semen quality in young university students.

STUDY QUESTION: What are the associations between the dietary intake of antioxidant nutrients and semen parameters in young men? SUMMARY ANSWER: Our study suggests that some sperm parameters are sensitive to dietary intake of antioxidant nutrients. WHAT IS KNOWN ALREADY: A few reports have suggested that some dietary factors might be related to semen quality. However, the relationship between the intake of antioxidant nutrients and semen quality in young men remains unexplored. STUDY DESIGN, SIZE, DURATION: In this cross-sectional study, 215 young men were included between October 2010 and November 2011. PARTICIPANTS/MATERIALS, SETTING, METHODS: Healthy university students with complete dietary and semen quality data were analyzed. Dietary intake was recorded using a validated food frequency questionnaire. The associations between the energy-adjusted nutrient intake of antioxidants in quartiles and the semen volume, sperm concentration, sperm motility, sperm morphology, total sperm count and total motile sperm count were assessed using multivariate linear regression. MAIN RESULTS AND THE ROLE OF CHANCE: Out of 240 students who contacted us, 223 (92.9%) were eligible to participate in this study, and 215 attended the clinical appointment. In the multivariate adjusted linear regression models, there was a positive association between dietary intakes of cryptoxanthin (P(trend) = 0.03), vitamin C (P(trend) = 0.04), lycopene (P(trend) = 0.03) and ß-carotene (P(trend) = 0.04) and total motile sperm count. The semen volume increased with higher intakes of vitamin C (P(trend) = 0.04). LIMITATIONS, REASONS FOR CAUTION: Only one sample of semen was taken for each subject. However, there are indications that one semen sample may be sufficient to characterize the semen quality of the individuals in epidemiological studies. Bias due to measurement errors may also occur since there is no perfect method to assess diet. However, any bias due to measurement error would be non-differential and would reduce, not increase, the strength of the associations. Although selection bias in cross-sectional studies might not always be ruled out, our subjects were university student volunteers who were rewarded for their participation and the study was not advertised as a fertility study. WIDER IMPLICATIONS OF THE FINDINGS: Previous articles in this area have focused mainly on men attending fertility clinics, thus our study brings generalizability to young men of the general population with unknown or untested fertility. Some of our results are in agreement with the previously reported papers.