Testosterone deficiency and severity of erectile dysfunction are independently associated with reduced quality of life in men with type 2 diabetes.

Erectile dysfunction (ED) and low testosterone levels are common in men with type 2 diabetes (T2D). We have investigated the impact of testosterone on quality of life (QoL) in diabetic men with ED. Men with ED were identified within a study cohort of 355 men with T2D. All subjects completed SF-36 health and Androgen Deficiency of the Aging Male questionnaires. Total tesosterone (TT), bioavailable testosterone (BT) and sex hormone-binding globulin levels of study participants were measured and free testosterone levels were calculated (cFT). A subgroup of 126 ED patients completed the International Index of Erectile Function-5 (IIEF-5) questionnaire. Linear regression analyses were corrected for age, body mass index (BMI), glycosylated haemoglobin (HbA1c), smoking, alcohol consumption and cardiovascular disease (CVD). Total SF-36 scores significantly and positively correlated with TT levels (r = 0.219, p = 0.001), BT levels (r = 0.199, p = 0.004) and cFT levels (r = 0.185, p = 0.007) among men with ED. These trends were strengthened after adjusting for age, BMI, HbA1c, smoking, alcohol consumption and CVD (TT r = 0.359, p = 0.015; BT r = 0.354, p = 0.024 and cFT r = 0.354, p = 0.024). IIEF-5 scores significantly correlated inversely with TT (r = 0.546, p = 0.001), BT (r = 0.506, p = 0.004) and cFT levels (r = 0.532, p = 0.001). A positive linear relationship was observed between IIEF-5 scores and total SF-36 score (r = 0.491, p = 0.003). Patients who reported having ED had an average SF-36 score of 9.1% less than those without ED (p < 0.001). Lower testosterone and greater severity of ED independently correlated with poorer physical function, social function, vitality and decline in general health domains of the SF-36. This is the first study to report that testosterone deficiency and severity of ED are both independently associated with reduced QoL in men with T2D. Furthermore, ED and low testosterone are markers of poor health which impact on an individual's self-perception of their health status.

Fermentation of wheat bran and gum arabic in rats fed on an elemental diet.

1. Gum arabic and wheat bran were added to an elemental diet (100 g/kg) in order to study their metabolism in the caeca of adult male albino Wistar rats. 2. Dry stool weight (g/d) over 12 weeks was 0.70 (SE 0.05) on the elemental control diet. Wheat bran increased mean dry stool weight to 1.09 (SE 0.08), an increase of 56%. There was no significant difference between faecal weights (0.65 (SE 0.08)) of the gum-arabic-supplemented group and the unsupplemented group. 3. Wet caecal-sac weight, dry caecal-contents weight, and faecal and caecal bacterial mass (measured by 2,6-diaminopimelic acid) all increased significantly with the gum-arabic-supplemented diet but not with the wheat-bran-supplemented diet. 4. Total short-chain fatty acids (mostly acetate) increased in the caecum and faeces with the gum-arabic-supplemented diet but not with the wheat-bran-supplemented diet. 5. Breath hydrogen and methane production decreased to negligible amounts over the 12 weeks of the experiment.

A multiple random staircase method of psychophysical pain assessment.

Three experiments evaluated the reliability and sensitivity of an interactive multiple random staircase (MRS) assessment of painful thermocutaneous sensations. One hundred and sixteen subjects used a 4-point category scale (no pain, mild, moderate, intense) to rate the intensity of sensations produced by 3-sec thermal stimuli applied to the volar forearm at 20-sec intervals by a 1-cm diameter contact thermode. Each of the 3 intervals between the 4 verbal responses was defined as a boundary. A pair of staircases was associated with each boundary. On each trial, 1 of the 6 staircases was chosen randomly and the stimulus intensity indicated by that staircase presented. The response to that stimulus determined the intensity presented by that staircase the next time it was randomly selected. Responses above the associated boundary decreased stimulus intensity, responses below the associated boundary increased stimulus intensity. In the first experiment, 1 staircase from each of the 3 boundaries began at 43 degrees C and 1 began at 48 degrees C. Staircases for each boundary converged to within 0.3 degree C after 12 trials/staircase. The sensitivity of the method to a narcotic analgesic was assessed by open (exp. II) and double-blind (exp. III) intravenous infusion of 1.1 micrograms/kg fentanyl. Administration of fentanyl increased staircase temperatures, indicating that these higher temperatures were now required to elicit the same verbal responses. This shift in temperature reached a peak effect 11 min after fentanyl administration. These results suggest that this method provides a reliable measure of sensory magnitude in units of stimulus intensity. It does not require assumptions about psychological units of pain.(ABSTRACT TRUNCATED AT 250 WORDS)

An experimental design to study colonic fibre fermentation in the rat: the duration of feeding.

1. The time-course of metabolic adaptation by rats to diets containing either wheat bran or gum arabic was studied during a 12-week period. 2. Stool weight was increased with wheat bran but not with gum arabic, and had stabilized after 4 weeks. 3. Bacterial mass as measured by diaminopimelic acid content had stabilized by week 4. Bacterial mass increased on feeding gum arabic but was unchanged with wheat bran. 4. There was increased caecal short-chain fatty acid, hydrogen and methane production with gum arabic but not with wheat bran. The change in caecal metabolic activity was slow to stabilize (8-12 weeks at least). 5. The faecal excretion of bile acids increased twofold with the wheat-bran-supplemented diet compared with the gum-arabic-supplemented and unsupplemented diets. Relatively greater amounts of muricholic acids were present in the caeca and faeces of gum-arabic-fed rats compared with the other groups.