Effects of running a marathon on irisin concentration in men aged over 50.

Our aim was to verify whether running a marathon is associated with changes in irisin concentration in healthy, endurance-trained men. In an observational study, we assessed baseline biochemical and fitness parameters of 28 middle-aged runners (mean ± SD age, BMI, VO2max: 58 ± 8 years; 24.5 ± 3 kg/m2; 51.1 ± 1.7 ml/kg/min). We evaluated irisin before, immediately after, and 7 days after the marathon. Irisin concentration decreased from a baseline value of 639 ± 427 to 461 ± 255 ng/ml immediately after the marathon (p < 0.05). After 7 days, it was still significantly lower than before the race, at 432 ± 146 ng/ml (p < 0.05). We found no correlations between irisin concentration and the training history of the studied subjects. We conclude that a long-distance run may have a negative impact on irisin release in men. This effect was not correlated with the training history of runners.

Trends in the prevalence of autoimmune thyroiditis in the leading private health-care provider in Poland.

BACKGROUND: Autoimmune thyroiditis (AT) is one of the most common endocrine disorders affecting a significant percent of the population, especially women. It may have serious and long-lasting consequences. The etiology of AT is multifactorial and it arises from an interplas between environmental and genetic factors. Tendencies in AT prevalence and incidence are unclear. In Poland there are no national registers covering the data on AT prevalence. OBJECTIVES: The aim of the investigation was to assess changes in diagnosing AT in the largest chain of outpatient medical centers in Poland. MATERIAL AND METHODS: We compared freqnancy at which AT and hypothyroidism diagnoses were made during endocrinology consultations in the period 2006-2013. The data was extracted from the database of LUXMED (part of BUPA). RESULTS: Within 8 years, the prevalence of newly diagnosed AT dropped from 10.4% to 4.8% (p < 0.001) alongside with a decrease in the prevalence of newly diagnosed hypothyroidism from 17.8% to 7.7% (p < 0.00001). AT was widespread in young women aged 20-39. There were relatively more cases in the southern areas of Poland. CONCLUSIONS: The analyzed data does not support a hypothesis indicating a growing incidence of AT in the last years. Detailed epidemiological studies would be helpful in designing screening strategies for patients with this common disorder.

Associations between physical activity and semen quality in young healthy men.

OBJECTIVE: To evaluate whether the level of everyday physical activity is associated with semen quality in young men. DESIGN: Cross-sectional study. SETTING: Universities, clubs, and societies. PATIENT(S): Young healthy men (aged 18-35 years) with unknown fertility (n = 177). INTERVENTIONS(S): Collection of data on medical history, lifestyle factors (physical activity, nutrition, addictions), and environmental threats (exposure of gonads to cellular phones, laptops). Collection of semen samples. MAIN OUTCOME MEASURE(S): Semen parameters. RESULT(S): Men who were physically more active (3rd and 4th quartiles) had a higher percentage of immotile sperm than less active subjects (1st and 2nd quartiles). The mean (95% confidence interval) percentages were, respectively: 53% (38%-69%) and 51% (41%-61%) versus 38% (28%-49%) and 39% (29%-48%). Other semen parameters were unrelated to physical effort. CONCLUSION(S): Physical activity might be associated with an altered percentage of immotile sperm in young, lean, educated men who have not fathered children.

Associations between the lower esophageal sphincter function and the level of physical activity.

BACKGROUND: Gastroesophageal reflux disease (GERD) is a very frequent and multifactorial disease. It has been found that GERD is associated with obesity, smoking, esophagitis, diet and lifestyle. Physical activity is among the factors involved in the occurrence of GERD. OBJECTIVES: The aim of the study was to evaluate the associations between the different parameters of lower esophageal pressure (LES) and the level of everyday physical activity in patients with GERD. MATERIAL AND METHODS: The authors examined 100 consecutive patients who underwent manometry and pH-metry because of symptoms suggesting GERD. Physical activity was assessed by means of the International Physical Activity Questionnaire (IPAQ). In accordance with IPAQ categorical scoring, the authors divided the studied subjects into 3 groups according to their level of physical activity. The investigation comprised 59 men and 41 women, with the mean age 49 ± 14 years. RESULTS: The authors analyzed the relationships between the LES parameters (pressure, total LES length and HPZ length) and physical activity. The authors did not find any significant correlations between the studied parameters and the amount of physical activity. The authors also did not observe any association between the LES pressure and the level of physical activity. The subgroups distinguished on the basis of LESP did not differ as to the amount of everyday physical activity as well. CONCLUSIONS: Although most data indicates that intense exercise exacerbates GERD symptoms, the authors did not find any associations between LES parameters and physical activity. In view of the present results maintaining the recommended level of everyday physical activity does not interfere with the mechanisms of GERD.

Occupational exposure to impulse noise associated with shooting.

Shooting training is associated with exposure to a considerable amount of unique noise. We wanted to evaluate noise exposure during such training. Our observations especially apply to professional sport shooters, but they are also valid for shooting coaches/instructors. We collected acoustic signals in 10-, 25- and 50-m as well as open-air shooting ranges. The recorded material was analysed with orthogonal, adaptive parameterization by Shur. The mean duration of a single acoustic signal was 250-800 ms with the C-weighted sound peak pressure level of 138.2-165.2 dB. Shooters may be exposed to as many as 600-1350 acoustic impulses during a training unit. The actual load for the hearing organ of a professional shooter or a shooting coach is ~200 000 acoustic stimuli in a year-long training macrocycle. Orthogonal, adaptive parameterization by Shur makes safe scheduling of shooters' training possible.

Transsexualism--diagnostic and therapeutic aspects.

Gender identity disorder (GID, transsexualism) is a multidisciplinary problem of an unclear aetiology. Although the diagnosis of GID is generally established by psychiatrists, the diagnostic team always includes an endocrinologist, who is responsible for hormonal therapy. Hormonal therapy is the first step in the sex reassignment procedure and requires careful monitoring in the initial phase and in later years of treatment. In this paper we review the latest aspects of the diagnosis and treatment of transsexualism and the most common complications of hormonal intervention.

[The CAG repeat polymorphism in androgen receptor gene repeat and frequency of chosen parameters of metabolic syndrome in 45-65 aged men in Wroclaw population]. / Polimorfizm CAG genu receptora androgenowego a wystepowanie wybranych parametrów zespolu metabolicznego u mezczyzn w wieku 45-65 lat w populacji wroclawskiej

INTRODUCTION: The activity of androgen receptor (AR) is modulated by a polymorphic CAG trinucleotide repeat in receptor gene. There are suggestion, that there are association between polymorphism androgen receptor gene and the occurrence typical features of metabolic syndrome in men. The metabolic syndrome is more frequent with aging. We knows, that polymorphism androgen receptor gene is associated with risk of prostate cancer and with occurrence Kennnedy's syndrome. However the association of this polymorphism for occurrence of hypertension, obesity and lipid and glucose concentration disturbance is not examined. MATERIAL AND METHODS: The original study population consisted 268 randomly selected wroclaw population men aged 45-65. The physician examination include mensuration of blood pressure and antropometrical analysis. The men were coming on an empty stomach between 8.00 and 10.00 am for blood taken. The blood were taken for biochemical measurements and for genetic analysis CAG repeat in androgen receptor gene. RESULTS: There is statistical significant differences between number of CAG repeat in men with normal and higher concentration of cholesterol LDL. There were no significant differences between number of CAG repeat in men in dependent of value of blood pressure and concentration of insulin, glucose, cholesterol HDL, total cholesterol and triglicerides. CONCLUSIONS: The investigation results are not unambiguous with regard to influence of polymorphism androgen receptor gene for occurrence of metabolic syndrome in men. We found only association between number of CAG repeat an androgen receptor gene and concentration of cholesterol LDL (which it is as we knows atherogenic factor).

The relationship between gastroesophageal reflux disease and the level of physical activity.

PRINCIPLES: Data on associations between physical activity and gastroesophageal reflux disease (GERD) have been inconsistent. Although experimental and clinical studies prove that exercise increases gastroesophageal reflux, epidemiological observations on the relationship between GERD and everyday physical effort deliver contradictory results. Our aim was to examine the association between the level of everyday physical activity and parameters of the disease (pH-metry, symptoms) in patients diagnosed with GERD. METHODS: We assessed the level of physical activity in a survey of 100 consecutive GERD patients. All subjects had undergone 24-h pH monitoring in a tertiary setting and reported symptoms they experienced daily. Using the criteria of the short form of the International Physical Activity Questionnaire (7-day recall) we identified groups presenting with low (I), moderate (II) or high (III) levels of physical activity. The amount of physical activity was expressed as multiples of resting metabolic rate and minutes of performance during a week (METs-minute/week). For evaluation of relationships between everyday physical activity and pH-metric indices of GERD a multivariate regression analysis was performed. The parameters studied were adjusted for age, BMI, smoking and gender (as covariates). RESULTS: We did not observe any association between the amount of everyday physical activity (expressed as log base 10 METs-minute/week) and pH-metric parameters of GERD evaluated 5 cm and 15 cm above the lower oesophageal sphincter (LES). Furthermore, we analyzed relationships between investigated parameters and covariates: age, BMI, smoking and gender. We found significant correlations only between the number of reflux episodes 15 cm above LES and gender (beta -0.25; p <0.05) and between the number of reflux episodes 5 cm above LES and age (beta -0.24; p <0.05). The number of self-reported symptoms did not differ among the three groups of physical activity level. It reached 6 in groups I and II, and 7 in group III (p = 0.07). However we must note that we found a weak, positive correlation between the number of symptoms reported by patients and METs-minute/week (r = 0.21, p <0.05). CONCLUSIONS: In view of our results the level of everyday physical activity is not associated with symptoms of GERD. This observation should be confirmed in other populations with GERD diagnosed upon pH-metric criteria.

Breast cancer and long-term hormonal treatment of male hypogonadism.

Breast cancer in men is rare and its etiology is multifactorial. Androgens may promote the development of breast carcinoma in men though data on the subject is scarce. We observed 45 men with hypergonadotropic hypogonadism (aged 18-57) who received 250 mg of testosterone esters (Omnadren 250, Jelfa, Poland) every 3-4 weeks for 5-26 years. Seventeen of them were treated for more than 10 years. During the observation period breast cancer was diagnosed in 2 subjects (11% of the followed men). In one case it occurred after 11 years and in the other after 15 years of the therapy. We point to a possible association between long-term androgen replacement and a risk of breast cancer in men.

Hormonal markers of aging in men with laryngeal carcinoma.

BACKGROUND: Cancer of the larynx, a frequent neoplasm in older people, occurs several times more often in men than in women. Surprisingly, the highest incidence of the disease is observed in the period in which concentrations of a number of hormones (eg, androgens, growth hormone) decrease. Our objective was to look for differences in hormonal markers of aging between men with laryngeal carcinoma and healthy control subjects. METHODS: Seventy-eight men with cancer of the larynx and 51 healthy age-matched controls were recruited for the study. In each of the examined men, serum concentrations of total testosterone, free testosterone, dihydrotestosterone, dehydroepiandrosterone sulfate, steroid-hormone binding globulin, estradiol, and insulin-like growth factor type 1 (IGF-1) were determined. RESULTS: Men with laryngeal carcinoma had lower serum concentrations of IGF-1 (136 +/- 75 vs 318 +/- 141 ng/mL, p < .000001), lower free testosterone (11.95 +/- 5.38 vs 15.48 +/- 4.96 pg/mL, p < .001), and lower dihydrotestosterone/total testosterone ratio (0.07 +/- 0.06 vs 0.09 +/- 0.04, p < .05) than healthy controls had. CONCLUSIONS: Somatopause seems to be more evident in men with laryngeal carcinoma than in age-matched controls. In our observation, low concentration of IGF-1 predicted the presence of laryngeal carcinoma more than low concentration of free testosterone did.

[Occupational risk factors and male breast cancer]. / Czynniki ryzyka zwiqzane z praca zawodowa a rak sutka u mezczyzn.

Male breast cancer is rare compared to its female counterpart and makes less than 1% of all breast cancer. Its etiology is less known than that of female breast cancer. Numerous experimental and clinical studies indicate the possibility of an increased risk of male breast cancer in workers occupationally exposed to electromagnetic field, light at night, and high temperature. There are also studies, which reveal the increased risk of this disease induced by occupational exposure to pesticides, aromatic hydrocarbons and ionizing radiation. However, irrefutable epidemiologic data from prospective clinical trials have not yet been obtained.

[Are age and educational level the determinants of hormonal parameters considered as indices of andropause?]. / Czy wiek i wyksztalcenie sa determinantami parametrów hormonalnych uznawanych za wskazniki andropauzy?

The involutionary processes in gonadal and adrenal glands are significant for male aging. The dynamics of hormonal changes in aging men seems to be individually differentiated and vary in distinct populations. Currently there are no data on social differences in hormonal parameters in men. The study was carried out in order to evaluate the age-related changes of hormonal parameters considered as indices of andropause and analyze the social gradients in these variables in healthy Polish men. Material comprised the data of 414 healthy men, inhabitants of Wroclaw, aged 32-79, examined in 2000 in DOLMED (Wroclaw, Lower Silesia). Serum levels of the following hormones were assessed using radioimmunological assays: free testosterone (FT), total testosterone (TT), estradiol (E2), dehydroepiandrosterone sulphate (DHEAS), luteinizing hormone (LH), sex hormone binding globulin (SHBG) and insulin-like growth factor 1 (IGF-1). The following indices were calculated: FAI (Free Androgen Index), TT/E2 and TT/LH. Among Polish men there were negative correlations between age and serum levels of FT, DHEAS, IGF-1, E2, and between age and FAI, TT/LH. The correlation between the DHEAS level and age was the strongest among all relationships here. The male aging was accompanied by the serum reduction, during 5 years: FT level of 4.8%, DHEAS--8.6% and IGF-1--5.0%. The reduction in serum DHEAS and IGF-1 levels reached 77.3% and 44.9% (respectively) between men aged 32-34 and the oldest subjects aged 75-79. The decrease in serum FT level between men aged 32-34 and those aged 70-74 was 38.2%. The relationships between age and E2 level and between age and TT/LH were not strong (respectively, beta = -0.10, p < 0.05 and beta = -0. 17, p < 0.001). The male aging was also accompanied by the increase in serum SHBG (11.7%/5 years) and LH levels (13.5%/5 years). Among male there were no age-related changes in the serum TT level and TT/E2. The results of a two-way ANOVA revealed that education significantly differentiated serum IGF-1 levels (independently on age). The highest IGF-1 levels were observed in men who had graduated from university, the lowest--in those who had finished the trade school at the very most. In contrast, there were no social differences in other analysed hormonal parameters.

[Hyperprolactinemia and sexual activity of men--clinical aspect]. / Hiperprolaktynemia a aktywnosc seksualna mezczyzn--aspekty kliniczne.

Hyperprolactinemia, particularly resulting from microprolactinoma, is known to induce erectile dysfunction. Contemporary published data do not allow to ascertain which prolactin (PRL) levels result in this type of sexual dysfunctions. The aim of this study was to evaluate the relationship between the extent of hyperprolactinemia and erectile dysfunction in 9 men with microprolactinoma and 8 patients with hyperprolactinemia as side-effects of sulpiride therapy. In all hyperprolactinemic males plasma PRL, LH, FSH and total testosterone levels were measured. The results showed that all patients with iatrogenic hyperprolactinemia were characterised by satisfactory sexual activity, although in 3 men hypotestosteronemia was revealed and in one patient gynecomastia was found. A range of PRL levels was 35-108 ng/ml. Among men with microprolactinoma the capability to lead a satisfactory sexual activity existed, even though in one patient PRL level was 2177 ng/ml, but in 3 other patients importance was observed when PRL concentrations were 281, 195 and 328 ng/ml. After bromocriptine therapy, when PRL levels diminished until 189, 78.3 and 110 ng/ml, the erectile dysfunction disappeared. Authors presume that sexual dysfunctions are not strictly connected with hyperprolactinemia and/or hypotestosterionemia, but probably are conditioned by other unexplicit factors (for example: a heterogeneous structure of PRL complexes).

[Male breast cancer]. / Rak sutka u mezczyzn.

Male breast cancer (MBC) is a rare disease, accounting for less than 1% of all breast cancers. It is an infrequent, but serious clinical problem. This paper discusses epidemiology, potential risk factors, tumor histopathology, clinical features and treatment strategies of the disease. Hormonal, genetic and environmental factors associated with an increased risk of breast cancer in men have been reviewed. Authors suggest that there may be an association between long-term androgen therapy and breast cancer in men. This uncommon malignancy is most commonly seen in men over sixty years. Histologically MBC resembles that seen in women, although lobular cancer is rare in men. Tumors from men are more often estrogen-receptor positive. Treatment strategies draw from experience in women and usually begin with surgery. Modified radical mastectomy is the current treatment of choice for invasive cancer. Additional modalities include hormonal treatment, radio- and chemotherapy. Male breast cancer may be also a problem in the context of androgen replacement therapy during andropause.