Impact of body mass index, age and varicocele on reproductive hormone profile from elderly men

ABSTRACT Objectives: To study the impact of obesity, age and varicocele on sexual hormones fof adult and elderly men. Materials and Methods: 875 men who were screened for prostate cancer were enrolled in this study. Data recorded comprised age, body mass index (BMI), serum levels of total testosterone (TT), free testosterone (FT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH) and follicular stimulating hormone (FSH). Patients were divided in groups according to their BMI in underweight, normal weight, overweight and obese grades 1, 2 or 3. First, it was studied the association between age, BMI, and hormone profile. Then, clinical varicocele was evaluated in 298 patients to assess its correlation to the others parameters. Results: Obese patients had lower levels of TT, FT and SHBG (p<0.001) compared to underweight or normal weight patients. There were no differences in age (p=0.113), FSH serum levels (p=0.863) and LH serum levels (p=0.218) between obese and non-obese patients. Obese grade 3 had lower levels of TT and FT compared to obese grade 1 and 2 (p<0.05). There was no difference in the SHBG levels (p=0.120) among obese patients. There was no association between varicocele and BMI; and varicocele did not impact on testosterone or SHBG levels. Conclusions: Men with higher BMI have a lower serum level of TT, FT and SHBG. The presence of clinical varicocele as well as its grade has no impact on hormone profile in elderly men.

White blood cell counts and neutrophil to lymphocyte ratio in the diagnosis of testicular cancer: a simple secondary serum tumor marker

ABSTRACT Purpose The aim of the study was to investigate white blood cell counts and neutrophil to lymphocyte ratio (NLR) as markers of systemic inflammation in the diagnosis of localized testicular cancer as a malignancy with initially low volume. Materials and Methods Thirty-six patients with localized testicular cancer with a mean age of 34.22±14.89 years and 36 healthy controls with a mean age of 26.67±2.89 years were enrolled in the study. White blood cell counts and NLR were calculated from complete blood cell counts. Results White blood cell counts and NLR were statistically significantly higher in patients with testicular cancer compared with the control group (p<0.0001 for all). Conclusions Both white blood cell counts and NLR can be used as a simple test in the diagnosis of testicular cancer besides the well-known accurate serum tumor markers as AFP (alpha fetoprotein), hCG (human chorionic gonadotropin) and LDH (lactate dehydrogenase).

Pre-operative serum level of inhibin b as a predictor of spermatogenesis improvement after varicocelectomy

Due to various reasons, spermatogenesis might not improve after varicocelectomy. Inhibin B, a sertoli cell glycoprotein, has proved itself as a marker of spermatogenesis. In this study, we measured serum level of inhibin B in patients with varicocele and through comparing pre and post operative semen analysis data, we tried to use serum level of inhibin B as a predictor of spermatogenetic improvement. This prospective clinical trial was carried out between September 2007 and September 2008 on 36 infertile men with high grade unilateral or bilateral varicocele. Scrotal ultrasonography and measurement of seminal parameters and serum level of inhibin B were performed for the patients and after confirmation of impaired spermatogenesis, they underwent a subinguinal nonmicroscopic varicocelectomy by a single surgeon. Physical examination, scrotal ultrasonography, and semen analysis were repeated at postoperative months of 3 and 6. Statistical data analysis was done by independent and paired sample t test and Spearman's Rho test. Mean size of the testis remained the same [P = .5], but mean sperm density, normal morphology, and motility all increased statistically significant after the operation [P < .05, P = .042, P = .023]. A significant relationship was found between serum levels of inhibin B and the testis sperm count and morphology [P < .05], but not sperm motility [P > 0.05]. It seems that serum level of inhibin B can be used as a reliable pre-operative marker of testicular potential activity and can also predict chance of spermatogenesis after varicocelectomy and save patients from useless surgical procedures