Is serum PSA a predictor of male hypogonadism? Testing the hypothesis

ABSTRACT Objective: Male hypogonadism (MH) is common among infertile men. Besides testosterone, limited MH biomarkers are available, while researchers have suggested the use of prostate-specific antigen (PSA) to help diagnose MH. Hence, we sought to evaluate the potential use of PSA to predict MH among relatively young men with infertility in Nigeria. Materials and methods: The study included 707 male partners (35-44 years) in infertile couples seeking infertility evaluation at a third-level care center in Nigeria. MH was diagnosed using standard guidelines. Receiver operating characteristic (ROC) and regression analyses explored the potential of serum free PSA (fPSA) and total PSA (tPSA) in predicting MH and MH-related clinical features. Results: In all, 29.7% of the patients had MH (MH+ve). The MH+ve group had lower mean values of fPSA and tPSA than the group without MH (MH-ve). The best fPSA threshold of < 0.25 μg/L compared with the best tPSA threshold of < 0.74 μg/L had higher accuracy (area under the curve [AUC] 0.908 versus 0.866, respectively), sensitivity (87% versus 83%, respectively), and specificity (42% versus 37%, respectively) for MH diagnosis. After adjustment for confounders, fPSA level ≤ 0.25 μg/L was more likely to predict MH-related decreased libido (odds ratio [OR] 2.728, p<0.001) and erectile dysfunction (OR 3.925, p<0.001) compared with tPSA ≤ 0.74 μg/L in the MH+ve group. Conclusion: For MH diagnosis, fPSA and tPSA had good sensitivity but very poor specificity, although fPSA had better potential for MH diagnosis and association with MH-related clinical features than tPSA. Hence, fPSA could complement other biomarkers for MH diagnosis in men 35-44 years, although we recommend further studies to confirm these findings.

Pattern of dysglycemia among Nigerian adult patients with vitiligo: a 10-year retrospective study

Background: The prevalence of dysglycemia among adult patients with vitiligo is higher than the general population. However, data is scarce in our region regarding this hypothesis. This study was to define the pattern of dysglycemia in adult Nigerian patients with vitiligo.Methods: The study was conducted retrospectively among vitiligo patients who visited the University of Port Harcourt Teaching Hospital between 1st January 2007 and 31st December 2016. The laboratory characteristics of this patients were evaluated. Data collected irrespective of vitiligo variant were age, sex, and fasting plasma glucose concentrations. Shapiro-Wilk test, descriptive statistics, chi-square test, Fisher抯 exact test, and two-sample t-test were used for analysis. The level of p < 0.05 was considered statistically significant.Results: There were a total of 160 vitiligo patients consisting of 55 (34.4%) males and 105 (65.6%) females. The overall patients mean age was 35�9 years (range 19 -61 years). The mean fasting plasma glucose concentration was 5.3�1mmol/l. Impaired fasting plasma glucose was detected in 41(26.6%) subjects with female dominance (female 61.0% versus male 39.0%). Diabetes mellitus was documented in 6 (3.8%) subjects with no sex difference (female 50% versus male 50%).Conclusions: Dysglycemia is frequent in vitiligo patients. Screening for dysglycemia should be incorporated into the management protocol of patients with vitiligo.