Could gonadal and adrenal androgen deficiencies contribute to the depressive symptoms in men with systolic heart failure?

BACKGROUND: Testosterone (TT) and dehydroepiandrosterone sulphate (DHEAS) are neurosteroids and their deficiencies constitute the hormone risk factors promoting the development of depression in elderly otherwise healthy men. We investigated the link between hypogonadism and depression in accordance with age and concomitant diseases in men with systolic HF using the novel scale previously dedicated for elderly population. METHODS: We analysed the prevalence of depression and severity of depressive symptoms in population of 226 men with systolic HF (40-80 years) compared to 379 healthy peers. The severity of depression was assessed using the Polish long version of Geriatric Depression Scale (GDS). RESULTS: In men aged 40-59 years the severity of depressive symptoms was greater in NYHA classes III-IV compared to NYHA classes I-II and reference group. In men aged 60-80 years depressive symptoms were more severe in NYHA class III-IV compared to controls (all p ≤ 0.001). In multivariate logistic regression model in men aged 40-59 years advanced NYHA class was associated with higher prevalence of mild depression (OR = 2.14, 95%CI: 1.07-4.29) and chronic obstructive pulmonary disease (COPD) with higher prevalence of severe depression (OR = 69.1, 95%CI: 2.11-2264.3). In men aged 60-80 years advanced NYHA class and TT deficiency were related to higher prevalence of mild depression (respectively: OR = 2.9, 95%CI: 1.3-6.4; OR = 3.6, 95%CI: 1.2-10.63). CONCLUSION: TT deficiency, COPD and advanced NYHA class were associated with higher prevalence of depression in men with systolic HF.

Self-reported versus measured body height and weight in Polish adult men: the risk of underestimating obesity rates.

BACKGROUND: In some epidemiological studies, self-reported height and weight are often used to save time and money. Self-reported height and weight are commonly used to assess the prevalence of obesity. The aim of this study was to assess the differences between self-reported and measured height and weight in adult men, and to determine how the accuracy of self-reported data depended on age and education. The prevalence of obesity was also calculated based both on self-reported and measured data. MATERIAL AND METHODS: Data were collected during two population studies carried out in Wroclaw in 2010. One study included 1,194 19-year-old males who reported for the health examination mandated by the National Conscription Board (younger group). The other group included 355 men between 35 and 80 years old who reported for a ten-year follow-up (older group). Data were analyzed separately for both age groups. RESULTS: Both younger and older subjects overestimated their height by 1.4 cm and 1.0 cm (1.4 cm, 95 % CI: 1.26, 1.51, and 1.0 cm, 95 % CI: 0.85, 1.26, respectively). On average, younger subjects overestimated their weight by 0.7 kilograms (95 % CI: 0.55, 0.92), whereas older subjects underestimated their weight by 0.9 kilograms (95 % CI: -1.15, -0.48). The lower the level of education, the more the subjects overestimated their height. CONCLUSIONS: Adult men systematically overestimate their height and underestimate their weight. The magnitude of the inaccuracy depends on level of education. When self-reported data are used, the prevalence of obesity is generally underestimated. Using self-reported data to calculate BMI can lead to a substantial underestimation of the proportion of underweight and obese individuals in a population. Finally, using self-reported values for height in studies on social inequality may lead to false conclusions.Background: In some epidemiological studies, self-reported height and weight are often used to save time and money. Self-reported height and weight are commonly used to assess the prevalence of obesity. The aim of this study was to assess the differences between self-reported and measured height and weight in adult men, and to determine how the accuracy of self-reported data depended on age and education. The prevalence of obesity was also calculated based both on self-reported and measured data. Material and methods: Data were collected during two population studies carried out in Wroclaw in 2010. One study included 1,194 19-year-old males who reported for the health examination mandated by the National Conscription Board (younger group). The other group included 355 men between 35 and 80 years old who reported for a ten-year follow-up (older group). Data were analyzed separately for both age groups. Results: Both younger and older subjects overestimated their height by 1.4 cm and 1.0 cm (1.4 cm, 95   %CI: 1.26, 1.51, and 1.0 cm, 95   %CI: 0.85, 1.26, respectively). On average, younger subjects overestimated their weight by 0.7 kilograms (95   %CI: 0.55, 0.92), whereas older subjects underestimated their weight by 0.9 kilograms (95   %CI: ­1.15, ­0.48). The lower the level of education, the more the subjects overestimated their height. Conclusions: Adult men systematically overestimate their height and underestimate their weight. The magnitude of the inaccuracy depends on level of education. When self-reported data are used, the prevalence of obesity is generally underestimated. Using self-reported data to calculate BMI can lead to a substantial underestimation of the proportion of underweight and obese individuals in a population. Finally, using self-reported values for height in studies on social inequality may lead to false conclusions.

Secular trends in body height and body mass in 19-year-old Polish men based on six national surveys from 1965 to 2010.

OBJECTIVES: The aim was to determine whether an intergenerational trend toward increased stature is slowing down, and whether body weight has recently increased among young men in Poland, as it has in Western European countries. METHODS: Data were taken from six national surveys of 19-year-old Polish male conscripts from cohorts 1965, 1976, 1986, 1995, 2001, and 2010. RESULTS: The mean stature of this population increased throughout the last 45 years from 170.5 cm in 1965 to 178.3 in 2010. However, the average gain in stature per decade declined from 2.4 cm in the period 1965 to 1976 to 0.8 cm per decade in 1995 to 2001, but increased to 1.0 cm in the last period. The average of body weight increased from 63.2 kg in 1965 to 73.1 in 2010 and body mass index (BMI) rose from 21.73 to 22.94 in the same period. The tempo of increase varied in different periods; between 1965 and 1986 an insignificant increase was observed (of circa 0.12); in 1986 to 1995 there was no increase, whereas the period of 2001 to 2010 witnessed a significant increase (of circa 0.76). CONCLUSIONS: The trend of body size and stature increase within the Polish population, although decelerating, remained positive and steady during the last 45 years. No significant impact of the past half-century's socioeconomic crises was observed in these measures of growth. We concluded that during the economic crises some effective mechanism protecting the living conditions of the children and youth were operating within the population.

Secular trends in BMI and the prevalence of obesity in young Polish males from 1965 to 2010.

BACKGROUND: Obesity is a serious public health problem, the prevalence of which is increasing dramatically all over the world. The aim of this study was to examine trends in body mass index (BMI) and the proportion of overweight and obese individuals among 19-year-old Polish males reporting for mandatory military fitness exams from 1965 to 2010. METHODS: Height, weight and BMI [weight (kg)/height (m(2))] in five 10% nationwide random samples of 19-year-old conscripts examined in 1965, 1986, 1995, 2001 and 2010 were analysed. RESULTS: From 1965 to 2010, mean BMI in 19-year-old Polish males increased from 21.7 to 22.9. The rate of change was not uniform, with a rapid increase in mean BMI from 1995 to 2010. Beginning in 1965, the proportion of men with a BMI over 25 has been steadily increasing from one decade to the next, and was four times higher in 2010 than it was in 1965. The rate of increase per decade was twice as high from 2001 to 2010 than it was from 1995 to 2001. In 2010, only 70.8% of young men were of ideal weight. CONCLUSION: Increase in obesity can be attributed to the social and economic changes brought about by the transformation of the country from a communist to a free-market economy in 1989. The challenges of the obesity epidemic for public health services and its impact on morbidity and life expectancy are also discussed.

Life satisfaction and cardiovascular disease risk in Poland.

INTRODUCTION: Cardiovascular disease is the most common cause of death. Life satisfaction is a predictor of morbidity and mortality, irrespectively of objective measures of health status. The aim of the study was to evaluate the relationship between life satisfaction (LS) and cardiovascular disease risk (CVD) assessed with the Framingham Risk Score (FRS) in Polish adults. MATERIAL AND METHODS: Past, present and projected LS were estimated. The FRS reflecting 10-year CVD risk was calculated from health indices and lifestyle parameters. Relationships between LS and FRS were tested by two-way analysis of variance in 489 men and 591 women, 40-50 years of age. RESULTS: Subjects with a reduction in LS over time had a higher FRS compared to peers with an improvement in LS. The relationship between current LS and FRS had a J-shape in men; FRS was lowest in men with an LS of 5-7 (average LS), slightly higher in men with an LS of 8-10 (highest LS), and highest in men with an LS of 1-4 (lowest LS). Among women, there was an inverse linear relationship between LS and FRS: the higher the LS, the lower FRS. There was a strong linear relationship between predicted LS and CVD risk. Highest risk was evident in subjects with low LS in whom low LS was predicted over the next five years. CONCLUSIONS: Low LS (dissatisfaction) thus has a long-term negative effect on CVD risk in Polish adults of both sexes.

Andropausal syndrome in men with systolic heart failure.

INTRODUCTION: Andropausal syndrome (AS) is an element of male aging, being associated with the age-related decline in circulating androgens. OBJECTIVES: We investigated the prevalence of AS, the severity of andropausal symptoms, and their clinical and hormonal determinants in men with heart failure (HF) and healthy peers. PATIENTS AND METHODS: We examined 232 men with systolic HF aged from 40 to 80 years (New York Heart Association [NYHA] class I/II/III-IV: 17%/54%/29%, left ventricular ejection fraction: 30% ±8%) and 362 healthy peers. The severity of 17 andropausal symptoms were assessed using the Aging Males' Symptoms Rating Scale. RESULTS: In men with HF aged from 40 to 59 years, the prevalence of AS and the severity of andropausal symptoms were greater than in healthy peers (28% vs. 7%; 40 ±14 vs. 35 ±10 points; both P <0.001), while in the age group of 60 to 80 years, there were no differences in the prevalence of AS and the severity of andropausal symptoms between men with HF and healthy peers (31% vs. 40%; 44 ±12 vs. 46 ±10 points; respectively; both P >0.1). In men with HF aged from 40 to 59 years, advanced NYHA class, low hemoglobin, increased platelet number, and low serum dehydroepiandrosterone sulphate were independently associated with the greater prevalence of AS (all P <0.05). In men aged from 60 to 80 years, only reduced hemoglobin was borderline related to the higher prevalence of AS (P = 0.07). CONCLUSIONS: AS affects almost one-third of men with HF regardless of the age group. The clinical and hormonal determinants of the severity of andropausal symptoms differ between younger and older male patients. Endocrinological and sexual counseling is recommended in men with HF.

[Assessment of severity of depressive symptoms using the Polish version IA of Beck Depression Inventory in healthy men, inhabitants of Wroclaw]. / Ocena nasilenia objawów depresyjnych z zastosowaniem polskiej wersji IA Inwentarza Depresji Becka u zdrowych mezczyzn, mieszkanców Wroclawia.

BACKGROUND: Aging is accompanied by progression of depressive symptoms, which significantly impair the prognosis and quality of life of elderly men. Currently, there are no Polish reference values reflecting age-related changes in the intensity of depressive symptoms in healthy men. AIM: An assessment of the severity of depressive symptoms in a population of healthy Polish men, and an evaluation of the effects of age and education on the analyzed variables. METHODS: We examined 341 healthy men, inhabitants of Wroclaw, aged 32-79, without any significant medical history. The intensity of depressive symptoms was assessed using the Polish version IA of Beck Depression Inventory (BDI). RESULTS: We observed an increase in the severity of depressive symptoms in the subsequent age categories in the examined men, in all the analyzed symptoms (32-45, 46-55, 56-65, 66-79 years--4.1 +/- 4.4, 8.2 +/- 4.2, 10.4+/- 3.6, 13.4 +/- 3.4 points, respectively, r = 0.65, p < 0.0001), and in cognitive-affective symptoms (respectively--2.8 +/- 3.1, 5.0 +/- 2.8, 5.8 +/- 2.5, 7.3 +/- 2.6 points, r = 0.5 1, p < 0.0001) as well as in somatic symptoms related to mood changes (respectively - 1.3 +/- 1.5, 3.2 +/- 2.0, 4.6 +/- 1.5, 6.1 +/- 1.7 points r = 0.73, p < 0.0001). Mild (BDI > or = 10 and <20 points) and moderate depression (BDI > or = 20 and < 30 points) were found in 12.6% and 0%, 34.5% and 0.8%, 50.0% and 2.9%, 80.0% and 2.9% of men aged 32-45, 46-55, 56-65, 66-79 years, respectively (p < 0.0001). There were differences in the intensity of depressive symptoms in the examined men (p > 0.2). CONCLUSIONS: In Poland, male aging is accompanied by an increase in the severity of depressive symptoms. Age, but not education, constitutes a major determinant of these symptoms. The presented data may be used as reference values for BDI scores of healthy Polish men in subsequent age categories.

Deficiencies in circulating testosterone and dehydroepiandrosterone sulphate, and depression in men with systolic chronic heart failure.

AIMS: Elderly men with androgen deficiencies are prone to develop late-onset depression. We investigated links between circulating androgens and depression, and their combined impact on outcome in men with chronic heart failure (CHF). METHODS AND RESULTS: Serum total testosterone (TT) and dehydroepiandrosterone sulphate (DHEAS) were measured using immunoassays in 163 men with stable systolic CHF [age: 60 +/- 10 years, NYHA class (I/II/III/IV): 27/84/46/6] and 316 healthy men. Depression was assessed using Beck Depression Inventory (BDI) and defined as BDI > or =16 points. In men with CHF, reduced TT and DHEAS, advanced NYHA class, elevated N-terminal pro-B type natriuretic peptide (NT-proBNP), reduced glomerular filtration rate, and reduced haemoglobin independently predicted severity of depressive symptoms (all P < 0.05). Depression was present in 20, 37 and 77% of men with no androgen deficiency, either TT or DHEAS deficiency, and both androgen deficiencies, respectively (P < 0.0001). During follow-up (median: 28 months), there were 87 (53%) cardiovascular deaths or unplanned hospitalizations. TT and DHEAS deficiencies (defined as < or = the 10th percentile of serum androgen levels in healthy controls) and BDI > or =16 points independently predicted unfavourable outcome (all P < 0.05). CONCLUSION: TT and DHEAS deficiencies predict severity of depression in men with CHF. Depression and combined androgen deficiencies are independently related to poor outcome in these patients.

The negative health consequences of unemployment: the case of Poland.

In the 1990s Poland began to make a transition to a free-market economy: a transition accompanied by a variety of negative socio-economic developments, most notably a rise in unemployment. The aim of this study is to shed light on the relationship between occupational status (including unemployment) and the risk of cardiovascular disease (CVD), by examining the experience of 542 men and 572 women between the ages of 40 and 50 of the town of Wroclaw in 2006. The Framingham Risk Score (FRS), which uses certain health and life-style parameters to predict the risk of major coronary problems over a 10-year period, was calculated, and the effect of occupational status on the FRS was assessed. The results showed that the FRS varied according to sex and to occupational status, with the highest FRS rating among unemployed men. Thus governmental policies to counter the adverse effects of unemployment should be developed to remedy the problem.

[Regional differences in premature mortality in Poland]. / Terytorialne zróznicowanie przedwczesnej umieralnosci w Polsce.

The aim of the study was to investigate the regional and social differences in men and women premature mortality. Individual death data for men and women aged 25-64 were obtained from the national mortality database of the Central Statistical Office (CSO). As the data on living Polish adults were available only from the National Population Census, which took place in Poland in 2002 (National Population and Housing Census 2002). The measure of mortality used in this analysis was the sex-, age-, education-specific rate of mortality. The higher mortality rate was observed in the western, north-western and south-western voivodeships. In the Lublin Voivodeship the level of premature mortality was the highest in Poland. The highest mortality of rural men was in the north-eastern, south-western and central regions of Poland, whereas higher mortality rates than average of rural women were in four voivodeships from different parts of Poland. The largest social inequalities in premature mortality was found in Lublin Voivodeship, especially sharp social contrasts were observed in towns. Wider social gaps in mortality than average was discovered for men in Masovian and Lower Silesian Voivodeships and Opole Voivodeship for women. Knowledge about regional differences in mortality helps to construct the adequate preventive programs.

Age and social gradients in the intensity of aging males' symptoms in Poland.

BACKGROUND: We performed the study in order to describe the age-related changes and social gradients in the intensity of aging males' symptoms in healthy men in Poland. METHODS: We examined 405 men aged 32-79, healthy inhabitants of Poland. Severity of aging males' symptoms was assessed using the Polish version of AMS scale. The social position was expressed using their educational level, commonly accepted as a reliable and specific index of social status in Poland. RESULTS: Male aging in Poland was accompanied by an increase in the intensity of all groups of evaluated symptoms (psychological, sexual and somato-vegetative symptoms, respectively: r = 0.36, r = 0.72, r = 0.59, all p < 0.0001). The results of ANOVA revealed the independent effects of both age and social status on the intensity of psychological symptoms (F = 17.89, p < 0.0001 and F = 9.51, p < 0.0001 for age and educational level, respectively), sexual (F = 114.70, p < 0.0001 and F = 5.90, p < 0.01), and somato-vegetative symptoms (F = 52.86, p < 0.0001 and F = 3.85, p < 0.05). The better the education of Polish men, the less intense the aging males' symptoms, irrespective of their age. CONCLUSIONS: Age and social position constitute major determinants of the intensity of aging males' symptoms in Poland.

Inter-generation social mobility modifies framingham risk score in Polish middle-aged men, but not in women.

In modern societies, there are regular social gradients in most health parameters, and also in the structure of morbidity and mortality. However, the significance of inter-generation social mobility for general health status still remains equivocal. This study was therefore performed in order to compare the effect of social mobility on coronary heart disease (CHD) risk between middle-aged Polish men and women. A total of 342 men and 458 women, aged 40 and 50 and inhabitants of Wroclaw, were examined. Risk of CHD was estimated using the Framingham Risk Score (FRS), calculated for each individual. Social mobility was defined as an inter-generation change in social status expressed as educational level between the examined individual and his/her father. Using two-variable regression models, it was demonstrated that FRS in men was determined by both their father's education level (beta=0.33, p<0.0001) and inter-generation change in educational status (beta=0.18, p=0.008). In contrast, FRS in women was related only to their father's education level (beta=0.35, p<0.0001), but not to inter-generation social mobility (beta=0.35, p=0.25). In particular, an incremental change in educational level among those men whose father had finished primary school at the very most or among those whose father had finished basic trade school was accompanied by a significant decrease in FRS (F=4.12, p=0.009 and F=3.25, p=0.04, respectively). It is concluded that inter-generation social mobility modifies CHD risk (as estimated using FRS) in middle-aged Polish men, but not in women. The precise mechanisms responsible for the observed sex difference in this phenomenon need to be established in further studies.

Biological condition of adult migrants and nonmigrants in Wroclaw, Poland.

Human migration and its economic, social, and demographic effects can lead to health consequences for individuals and populations. In the present study, we estimated differences in health status between migrant (those who had come to Wroclaw at the age of > or =16 years) and nonmigrant (those who had lived in Wroclaw since birth or had come with their parents) inhabitants of Wroclaw, Poland. Three hundred and sixty seven males and 496 females aged 40 and 50 underwent medical examination, and were asked to fill out a questionnaire comprising social, demographic, and life style information. Health status was assessed by blood pressure, heart rate, fasting lipid profile, glucose, height, and measures of fatness (BMI, WHR, sum of skinfolds). Comparisons were made based on Borkan's and Norris's profiles. Student's t-test showed significant differences in diastolic blood pressure, heart rate, total cholesterol, and glucose levels between two groups of males, in favor of migrants. Male migrants were also significantly taller than their peers born in Wroclaw. In females, migrants had significantly lower blood pressure and heart rate than nonmigrants. In interpreting the results two possible, not mutually exclusive, mechanisms are proposed: selective spatial mobility, and changes toward healthier life style as an adaptation to new urban environment.

Decrease in sex difference in premature mortality during system transformation in Poland.

In recent years, sex differences in mortality have followed diverse patterns of change in developed countries. As there is no analogous evidence from Poland, the aim of this study was to describe the pattern of change in excess male mortality among Polish inhabitants aged 35-64 during 1995-2002, when the major socioeconomic transformation occurred, and compare it with sex differences in mortality observed in the late 1980s. During the study period, excess male mortality decreased significantly, independently of age and educational level. The reduction in mortality was observed in both sexes, but its magnitude was greater in men. These changes resulted mainly from a reduction in mortality rates due to cardiovascular disease and lung cancer in males and a concomitant increase in mortality rates due to lung cancer and suicides in females. Although, in general, excess male mortality decreased, social gradients related to this phenomenon increased. Subjects (in particularly men) who had graduated from university benefited the most, their magnitude of reduction in mortality rates being the greatest. Changes in social environment during the transformation period in Poland are suggested as major determinants of these changes, but further studies are needed.

Social inequality in premature mortality among Polish urban adults during economic transition.

Rates of premature mortality among adults are important measures of the economic and psychosocial well-being of human populations. In many countries, such rates are, as a rule, inversely related to the level of attained education. We examined changes in educational group-specific mortality rates among urban adults in Poland during the country's rapid transition in the 1990s from a socialist command economy to a free market system. Two census-based analyses of individual death records of urban dwellers aged 35-64 years were compared. We utilized all records of death, which occurred during the 2-year periods 1988-89 and 2001-02. Population denominators were taken from the censuses of 1988 and 2002. The age-specific mortality rates were used to evaluate absolute differences in mortality. To assess relative differences between educational levels, mortality rate ratios (MRRs) with 95% CI (confidence interval) were calculated using Poisson regression. A regular educational gradient in mortality persisted in each 10-year age group throughout the period covered by our data. Moreover, age-specific mortality rates declined steadily in all educational groups, and this decline was most marked in the two oldest age groups (45-54 and 55-64 years). The trend was accompanied by widening of educational differences in mortality as expressed by MRRs. Systemic political transformation in Poland has brought a mixture of beneficial and detrimental effects on the well-being of society. With regard to the changes in rates of premature mortality among adults, the benefits have prevailed, although individuals with the lowest educational level benefited less than those with the highest education.

Anabolic deficiency in men with chronic heart failure: prevalence and detrimental impact on survival.

BACKGROUND: The age-related decline of circulating anabolic hormones in men is associated with increased morbidity and mortality. We studied the prevalence and prognostic consequences of deficiencies in circulating total testosterone (TT) and free testosterone, dehydroepiandrosterone sulfate (DHEAS), and insulin-like growth factor-1 (IGF-1) in men with chronic heart failure (CHF). METHODS AND RESULTS: Serum levels of TT, DHEAS, and IGF-1 were measured with immunoassays in 208 men with CHF (median age 63 years; median left ventricular ejection fraction 33%; New York Heart Association class I/II/III/IV, 19/102/70/17) and in 366 healthy men. Serum levels of free testosterone were estimated (eFT) from levels of TT and sex hormone binding globulin. Deficiencies in DHEAS, TT, eFT, and IGF-1, defined as serum levels at or below the 10th percentile of healthy peers, were seen across all age categories in men with CHF. DHEAS, TT, and eFT were inversely related to New York Heart Association class irrespective of cause (all P<0.01). DHEAS correlated positively with left ventricular ejection fraction and inversely with N-terminal pro-brain natriuretic peptide (both P<0.01). Circulating TT, eFT, DHEAS, and IGF-1 levels were prognostic markers in multivariable models when adjusted for established prognostic factors (all P<0.05). Men with CHF and normal levels of all anabolic hormones had the best 3-year survival rate (83%, 95% CI 67% to 98%) compared with those with deficiencies in 1 (74% survival rate, 95% CI 65% to 84%), 2 (55% survival rate, 95% CI 45% to 66%), or all 3 (27% survival rate, 95% CI 5% to 49%) anabolic endocrine axes (P<0.0001). CONCLUSIONS: In male CHF patients, anabolic hormone depletion is common, and a deficiency of each anabolic hormone is an independent marker of poor prognosis. Deficiency of >1 anabolic hormone identifies groups with a higher mortality.

Marital differences in blood pressure and the risk of hypertension among Polish men.

The aim of the study was to evaluate the relationship between marital status and blood pressure, and to assess the risk of hypertension in adult Polish men, after adjustment for BMI. Material comprised the data of 2,271 healthy men, aged 25-60, occupationally active inhabitants of Wroclaw (south-western Poland). Arterial hypertension was diagnosed when systolic blood pressure (SBP) > or =140 mm Hg and/or diastolic blood pressure (DBP) > or = 90 mm Hg. The following categories of marital status and educational level were applied: never married vs. currently married, and well-educated vs. poorly educated, respectively. The data on lifestyle elements were obtained from questionnaires. Multi-factorial analyses of covariance (ANCOVA) were used to compare mean values of SBP and DBP in married vs. never married in subsequent age categories with BMI as a covariate. Independent effects of marital status, life-style variables and body mass index (BMI) on the risk of hypertension in men were analysed using the multifactorial models of logistic regression. In our analysis an interesting epidemiological phenomenon was observed. Never married men had on average higher SBP and DBP than married men. Never married had also a higher risk of hypertension when compared to married men, even when adjusted for different demographic, socio-economic, life-style variables, and even that never married men had lower BMI than married subjects. Marital differences in psychological status (prolonged stress and low social support), dietary intake (mainly sodium and potassium intake) and economic aspects of living alone are suggested as factors, which might explain at least partly the marital diversity in blood pressure and the risk of hypertension in men.

[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.