Body composition and risk for sarcopenia in transgender women.

OBJECTIVES: Body composition and strength of cisgender (cis) individuals are well established. However, those for transgender women (trans women) undergoing gender-affirming hormone therapy remain unclear. This study aimed to detect possible body composition and strength variations related to sarcopenia. METHODS: This was a cross-sectional comparative study of 37 trans women, 34 cis men, and 34 cis women. Body composition was measured in all individuals by bioelectrical impedance analysis; prehensile strength by dynamometry was studied in trans women. RESULTS: In this study, trans women had higher body mass index values than cis individuals (P < 0.01). Fat mass was 41% higher for trans women than cis men. Muscle mass (MM) was lower in trans women than cis men (-10%), and higher than cis women (24%). Bone mass was lower in trans women than cis men and higher in cis women (P < 0.01). Trans women's prehensile strengths were 25.26 kg for the right hand and 24.8 kg for the left. Appendicular skeletal muscle mass was 23.63 kg, and appendicular skeletal muscle mass index was 8.14 kg. CONCLUSION: Trans women undergoing gender-affirming hormone therapy show a tendency to adapt body compartments to those of cis women with increased fat mass and reduced muscle mass. Prehensile strength in trans women was close to the cutoff points for sarcopenia risk. Nutrition, physical activity, strength, and body composition are important to avoid the possible risk for sarcopenia. More studies along these lines are necessary, especially in older adults.

Capacidad antioxidante total de la dieta de las mujeres gestantes de la Comunidad de Madrid / Total antioxidant capacity of the diet of pregnant women in the Community of Madrid

INTRODUCCIÓN Y OBJETIVO: el embarazo es una etapa de la vida con alta vulnerabilidad nutricional y aumento de los niveles de estrés oxidativo en la madre. La capacidad antioxidante total (CAT) identifica el efecto protector de la dieta equilibrada, rica en alimentos de origen vegetal con actividad antioxidante. El objetivo de este estudio fue relacionar la CAT con la ingesta dietética y el índice de masa corporal (IMC) en mujeres gestantes pertenecientes a la Comunidad de Madrid. MÉTODOS: se realizó un estudio transversal comparativo de 89 mujeres gestantes y 61 mujeres sanas en edad reproductiva. Se registraron la edad, el lugar de origen, el peso, la estatura, el IMC, la ingesta de macronutrientes y micronutrientes, y la CAT dietética por frecuencia alimentaria; la CAT se clasificó como deseable (≥ 19.301,0 μm/g) y no deseable (< 19.301,0 μm/g); el análisis estadístico, con la prueba del χ², la prueba de la t de Student o la prueba de la U de Mann Whitney, se realizó de acuerdo con la normalidad de las variables en la población estudiada. Se utilizó el programa SPSS, versión 23. RESULTADOS: se encontraron diferencias en el perfil calórico, la ingesta de micronutrientes antioxidantes y la CAT dietética (p < 0,05). La CAT promedio en las gestantes fue de 23.163,0 ± 10.829,0 μm/g, frente a 25.916,0 ± 9.703,0 μm/g en las no gestantes (p = 0,035). Las gestantes con CAT deseable (56,2 %) preferían consumir frutas y verduras, mientras que el 65,6 % de las mujeres no gestantes preferían el pan, la pasta y los cereales (p = 0,03). La fruta de mano, los frutos cítricos, las verduras de hoja verde y el tomate eran consumidos preferentemente por ambos grupos. En las mujeres gestantes, en cuanto al estado nutricional deficiente, la tasa de sobrepeso y obesidad fue del 36,0 %, frente al 28,0 % entre las no gestantes (p < 0,001)

INTRODUCTION AND OBJECTIVE: pregnancy is a stage of life with high nutritional vulnerability and increased levels of maternal oxidative stress. Total antioxidant capacity (CAT) identifies the protective effect of a balanced diet rich in foods of plant origin with antioxidant activity. The aim of this study was to relate CAT with dietary intake and body mass index (BMI) in pregnant women in the Community of Madrid. METHODS: a cross-sectional, comparative study was conducted in 89 pregnant women and 61 healthy women of reproductive age. Age, place of origin, weight, height, BMI, macronutrient and micronutrient intake, and dietary CAT by food frequency were recorded; CAT was classified as desirable (≥ 19,301.0 μm/g) or undesirable (< 19,301.0 μm/g); the statistical analysis, including χ², Student's t-test or Mann Whitney U-test, was made using the SPSS program V.23. RESULTS: differences were found in caloric profile, intake of antioxidant micronutrients, and dietary CAT (p < 0.05). Mean CAT in pregnant women was 23,163.0 ± 10,829.0 μm/g, whereas in non-pregnant women it was 25,916.0 ± 9,703.0 μm/g (p = 0.035). Pregnant women with a desirable CAT (56.2 %) preferred to consume fruits and vegetables, and 65.6 % of non-pregnant women preferred bread, pasta and cereals (p = 0.02). Hand fruit, citrus fruits, green leafy vegetables, and tomato were preferentially consumed by both groups. In pregnant women, poor nutritional status, overweight, and obesity rates of 36.0 % were found versus 28.0 % in non-pregnant women (p < 0.001). CONCLUSION: the BMI of pregnant women is not related to dietary CAT or the relatively low consumption of antioxidant components

[Total antioxidant capacity of the diet of pregnant women in the Community of Madrid]. / Capacidad antioxidante total de la dieta de las mujeres gestantes de la Comunidad de Madrid.

INTRODUCTION: Introduction and objective: pregnancy is a stage of life with high nutritional vulnerability and increased levels of maternal oxidative stress. Total antioxidant capacity (CAT) identifies the protective effect of a balanced diet rich in foods of plant origin with antioxidant activity. The aim of this study was to relate CAT with dietary intake and body mass index (BMI) in pregnant women in the Community of Madrid. Methods: a cross-sectional, comparative study was conducted in 89 pregnant women and 61 healthy women of reproductive age. Age, place of origin, weight, height, BMI, macronutrient and micronutrient intake, and dietary CAT by food frequency were recorded; CAT was classified as desirable (≥ 19,301.0 µm/g) or undesirable (< 19,301.0 µm/g); the statistical analysis, including χ², Student's t-test or Mann Whitney U-test, was made using the SPSS program v.23. Results: differences were found in caloric profile, intake of antioxidant micronutrients, and dietary CAT (p < 0.05). Mean CAT in pregnant women was 23,163.0 ± 10,829.0 µm/g, whereas in non-pregnant women it was 25,916.0 ± 9,703.0 µm/g (p = 0.035). Pregnant women with a desirable CAT (56.2 %) preferred to consume fruits and vegetables, and 65.6 % of non-pregnant women preferred bread, pasta and cereals (p = 0.02). Hand fruit, citrus fruits, green leafy vegetables, and tomato were preferentially consumed by both groups. In pregnant women, poor nutritional status, overweight, and obesity rates of 36.0 % were found versus 28.0 % in non-pregnant women (p < 0.001). Conclusion: the BMI of pregnant women is not related to dietary CAT or the relatively low consumption of antioxidant components.

INTRODUCCIÓN: Introducción y objetivo: el embarazo es una etapa de la vida con alta vulnerabilidad nutricional y aumento de los niveles de estrés oxidativo en la madre. La capacidad antioxidante total (CAT) identifica el efecto protector de la dieta equilibrada, rica en alimentos de origen vegetal con actividad antioxidante. El objetivo de este estudio fue relacionar la CAT con la ingesta dietética y el índice de masa corporal (IMC) en mujeres gestantes pertenecientes a la Comunidad de Madrid. Métodos: se realizó un estudio transversal comparativo de 89 mujeres gestantes y 61 mujeres sanas en edad reproductiva. Se registraron la edad, el lugar de origen, el peso, la estatura, el IMC, la ingesta de macronutrientes y micronutrientes, y la CAT dietética por frecuencia alimentaria; la CAT se clasificó como deseable (≥ 19.301,0 µm/g) y no deseable (< 19.301,0 µm/g); el análisis estadístico, con la prueba del χ², la prueba de la t de Student o la prueba de la U de Mann Whitney, se realizó de acuerdo con la normalidad de las variables en la población estudiada. Se utilizó el programa SPSS, versión 23. Resultados: se encontraron diferencias en el perfil calórico, la ingesta de micronutrientes antioxidantes y la CAT dietética (p < 0,05). La CAT promedio en las gestantes fue de 23.163,0 ± 10.829,0 µm/g, frente a 25.916,0 ± 9.703,0 µm/g en las no gestantes (p = 0,035). Las gestantes con CAT deseable (56,2 %) preferían consumir frutas y verduras, mientras que el 65,6 % de las mujeres no gestantes preferían el pan, la pasta y los cereales (p = 0,03). La fruta de mano, los frutos cítricos, las verduras de hoja verde y el tomate eran consumidos preferentemente por ambos grupos. En las mujeres gestantes, en cuanto al estado nutricional deficiente, la tasa de sobrepeso y obesidad fue del 36,0 %, frente al 28,0 % entre las no gestantes (p < 0,001). Conclusión: el IMC de las mujeres gestantes no está relacionado con la CAT dietética ni con el relativo bajo consumo de componentes antioxidantes.

Disforia de género/incongruencia de género: transición y detransición, persistencia y desistencia / Gender dysphoria/gender incongruity: Transition and discontinuation, persistence and desistance

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Recommended vitamin D levels in the general population. / Recomendaciones de vitamina D para la población general.

OBJECTIVE: To provide recommendations based on evidence on the management of vitaminD deficiency in the general population. PARTICIPANTS: Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. METHODS: Recommendations were formulated using the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed) using the term VitaminD and the name of each issue. Papers in English and Spanish with publication date before 17 March 2016 were included. Recommendations were jointly discussed by the Working Group. CONCLUSIONS: This document summarizes the data about vitaminD deficiency in terms of prevalence, etiology, screening indications, adequate levels and effects of supplementation on bone and non-skeletal health outcomes.

Prevalence, Incidence, and Sex Ratio of Transsexualism in the Autonomous Region of Madrid (Spain) According to Healthcare Demand.

In recent years, different studies have provided estimates of the prevalence of transsexualism with very diverse results. The purpose of this study was to ascertain the prevalence, incidence, and sex ratio of transsexualism in the autonomous region of Madrid (Spain). A total of 1234 patients who attended from 2007 to the end of 2015 in the only Gender Identity Unit (GIU) in Madrid were analyzed. Sixty-three patients were excluded for various reasons; thus, 1171 could be included: 803 male-to-female (MtF) and 368 female-to-male (FtM) transsexual patients. Transsexualism was diagnosed based on the ICD-10, World Health Organization, 1992, and/or gender identity disorder based on the DSM-IV-TR, American Psychiatric Association, 2000. The demographic statistics were calculated on the basis of the population over 15 years old of Madrid. Based on healthcare demand, the prevalence of transsexualism was 22.1 in 100,000 inhabitants: 31.2 for MtF and 12.9 for FtM, making the MtF/FtM ratio approximately 2.2:1. The incidence rate was 2.5 in 100,000 inhabitants, representing an annual average of 130 demands. Although transsexualism occurs in all countries with different rates of prevalence, in our area, this prevalence was higher than reported from other European countries. We believe that two main circumstances might influence this high prevalence: the easy accessibility and the absence of a waiting list to the GIU, and the permissive social and legal climate and openness of Spain, especially in Madrid.

Prevalencia de hiperandrogenismo y síndrome de ovario poliquístico en transexuales de mujer a hombre / Prevalence of hyperandrogenism and polycystic ovary syndrome in female to male transsexuals

INTRODUCCIÓN: La prevalencia de hiperandrogenismo (HA), que incluye el síndrome de ovario poliquístico (SOP), es alta en los pacientes transexuales de mujer a hombre (TMH). Este hecho se ha relacionado con el síndrome metabólico (SM), lo que parece aumentar la morbimortalidad cardiovascular a lo largo del tratamiento hormonal cruzado (THC). OBJETIVOS: Determinar la prevalencia de HA y SOP en pacientes TMH antes del inicio del THC, y su asociación con el SM y sus componentes, la insulinorresistencia (IR) y otros factores de riesgo cardiovascular (RCV). MATERIALES Y MÉTODOS: Setenta y siete TMH fueron valorados clínica y analíticamente para HA antes de iniciar el THC. También se determinaron los factores de RCV, la IR y otros parámetros del SM. RESULTADOS: La prevalencia de HA fue del 49,4% (el 73,7% de ellos con SOP [criterios de Rotterdam]), y del total de la muestra el 36,4% presentaron SOP. La prevalencia global de SM fue del 38,4 y 51,7% (criterios ATP-III e IDF, respectivamente). Los pacientes con HA frente a aquellos sin HA presentaban SM (criterios ATP-III e IDF, respectivamente) en el 36,8 y 57,9% frente al 25,6 y 41% (p < 0,0001 y p < 0,01, respectivamente). El 54,5% de los pacientes tenía normopeso (índice de masa corporal [IMC] 18,5-24,9 kg/m2), el 26% sobrepeso (IMC 25-29,9 kg/m2) y el 19,5% eran obesos (IMC ≥ 30 kg/m2). Al ajustar por el IMC la comparación de parámetros hormonales, metabólicos y antropométricos mostró diferencias estadísticamente significativas en los valores de glucemia, HOMA-IR y perímetro abdominal (p < 0,001), así como en los de colesterol-HDL (HDL) (p = 0,033), pero no en las concentraciones de testosterona total o de testosterona libre calculada. Del total de la muestra el 27,3% presentaron niveles de HDL por debajo de 50mg/dl. CONCLUSIONES: El HA y el SOP son muy prevalentes en la población TMH. HA y SOP se relacionan con el desarrollo temprano de SM, IR y otros factores de RCV, de consecuencias desconocidas en la edad adulta

INTRODUCTION: Prevalence of hyperandrogenism (HA), including the polycystic ovary syndrome (PCOS), in female-to-male transsexuals (FMT) is high. This has been related to metabolic syndrome (MS), which appears to increase cardiovascular morbidity and mortality throughout cross-sex hormone (CSH) therapy. OBJECTIVES: To assess the prevalence of HA and PCOS in FMT patients before the start of CSH therapy, and their association to MS and its components, insulin resistance (IR) and other cardiovascular risk (CVR) factors. MATERIALS AND METHODS: Seventy-seven FMTs underwent clinical and biochemical assessment for HA before the start of CSH therapy. CVR, IR, and other MS parameters were also assessed. RESULTS: Prevalence of HA was 49.4% (73.7% were cases of PCOS [Rotterdam criteria]), and prevalence of PCOS in the overall sample was 36.4%. Prevalence of MS was 38.4% and 51.7% according to ATP-III and IDF criteria respectively). MS (according to ATP-III and IDF criteria respectively) was found in 36.8% and 57.9% as compared to 25.6% and 41% of patients with and without HA respectively (p < 0.0001 and P < 0.01 respectively). Of total patients, 54.5% had normal weight (body mass index [BMI] 18.5-24.9 kg.m-2), 26% were overweight (BMI 25-29.9 kg.m-2), and 19.5% were obese (BMI ≥ 30 kg.m-2). After adjusting for BMI, the comparison of hormonal, metabolic, and anthropometric parameters showed statistically significant differences in plasma glucose, HOMA-IR, and abdominal circumference (P < 0.001 for all), as well as HDL cholesterol (HDL) (P = 0.033), but not in total testosterone or calculated free testosterone levels. In the total sample, 27.3% had HDL levels less than 50mg/dL. CONCLUSIONS: Overall HA, and PCOS in particular, are highly prevalent in FMTs. HA and PCOS are related to early development of SM, IR, and other CVR factors with unknown consequences in adulthood

Prevalence of hyperandrogenism and polycystic ovary syndrome in female to male transsexuals.

INTRODUCTION: Prevalence of hyperandrogenism (HA), including the polycystic ovary syndrome (PCOS), in female-to-male transsexuals (FMT) is high. This has been related to metabolic syndrome (MS), which appears to increase cardiovascular morbidity and mortality throughout cross-sex hormone (CSH) therapy. OBJECTIVES: To assess the prevalence of HA and PCOS in FMT patients before the start of CSH therapy, and their association to MS and its components, insulin resistance (IR) and other cardiovascular risk (CVR) factors. MATERIALS AND METHODS: Seventy-seven FMTs underwent clinical and biochemical assessment for HA before the start of CSH therapy. CVR, IR, and other MS parameters were also assessed. RESULTS: Prevalence of HA was 49.4% (73.7% were cases of PCOS [Rotterdam criteria]), and prevalence of PCOS in the overall sample was 36.4%. Prevalence of MS was 38.4% and 51.7% according to ATP-III and IDF criteria respectively). MS (according to ATP-III and IDF criteria respectively) was found in 36.8% and 57.9% as compared to 25.6% and 41% of patients with and without HA respectively (p<0.0001 and P<0.01 respectively). Of total patients, 54.5% had normal weight (body mass index [BMI] 18.5-24.9 kg.m(-2)), 26% were overweight (BMI 25-29.9 kg.m(-2)), and 19.5% were obese (BMI ≥ 30 kg.m(-2)). After adjusting for BMI, the comparison of hormonal, metabolic, and anthropometric parameters showed statistically significant differences in plasma glucose, HOMA-IR, and abdominal circumference (P<0.001 for all), as well as HDL cholesterol (HDL) (P=0.033), but not in total testosterone or calculated free testosterone levels. In the total sample, 27.3% had HDL levels less than 50mg/dL. CONCLUSIONS: Overall HA, and PCOS in particular, are highly prevalent in FMTs. HA and PCOS are related to early development of SM, IR, and other CVR factors with unknown consequences in adulthood.

Transexualidad: un capítulo importante de la Andrología / Transsexuality: An important area of Andrology

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Perfil psicológico de personas transexuales en tratamiento / Psychological profile of transgender people under treatment

Introducción: La transexualidad es un campo emergente dentro de la atención sanitaria. Por ello, está llena de tópicos. Dos de los mitos más extendidos acerca de las personas transexuales es que presentan graves alteraciones psicopatológicas y que son personas sumamente infelices. Objetivo: El objetivo principal de esta investigación fue estudiar el perfil psicológico de los pacientes transexuales. Especialmente, se quiso comprobar la presencia de rasgos psicopatológicos en el perfil de personalidad. Por otro lado, también se deseaba evaluar la presencia de problemas de depresión. Un segundo objetivo fue buscar diferencias en el perfil según el sexo (transexuales de hombre a mujer o de mujer a hombre). Material y método: El presente estudio tuvo un diseño transversal. Los pacientes fueron seleccionados consecutivamente por orden de acceso a la unidad de trastornos de identidad de género al inicio del estudio. La muestra se formó con 121 pacientes de la Unidad de Trastornos de Identidad de Género de Madrid. Todos acabaron el estudio. El criterio de entrada fue tener el diagnóstico de transexualidad. Se les aplicaron test psicológicos: la Entrevista diagnóstica de identidad de género, el Cuestionario general de salud de Goldberg, el Cuestionario de competencia emocional, la Escala de bienestar psicológico, la Escala de satisfacción con la vida, la Escala de felicidad subjetiva, el nuevo Inventario de personalidad NEO y el Inventario clínico multiaxial de Millon III. Resultados: Se encontró un alto bienestar psicológico. No se encontraron alteraciones psicopatológicas significativas. Se encontraron pocas aunque llamativas diferencias por sexos. Finalmente, apareció un único factor significativo en su perfil de personalidad. Conclusiones: Las personas transexuales no tienen un perfil psicopatológico de personalidad, y hay pocas pero significativas diferencias por sexos (AU)

Introduction: Transsexualism is an emergent field in healthcare and consequently is plagued by stereotypes. Two of the most widespread misconceptions are that transgender people have serious psychopathological disorders and that they are less happy than the general population. Objective: The main aim of this study was to characterize the psychological profile of transgender people and, in particular, the presence of psychopathological features in their personality profile. The presence of depressive features was also investigated. A second aim was to assess the differences in psychological profile between the s exes (female-to-male or male-to-females transgender people). Material and Method: A cross-sectional study was carried out. The patients were selected consecutively according to their order of access to the Gender Identity Disorder Unit (GIDU) of Madrid at the beginning of the study. The sample was composed of 121 patients from the GIDU. All patients completed the study. The access criterion was a diagnosis of transsexualism. The patients were administered the following psychological tests: Gender Identity Diagnosis Interview, the General Health Questionnaire (GHQ-28), Emotional Competence Questionnaire, Psychological well-being Scale, Life Satisfaction Scale, Subjective Happiness Scale, the NEO Personality Inventory (NEO-PI) and the Millon Clinical Multiaxial Inventory-III (MCMI-III). Outcomes: The subjects showed a high level of well-being. No serious psychopathological alterations were found. Differences between sexes were few but striking. Only one significant factor was found in the subjects’ personality profile. Conclusions: Transgender people do not have a psychopathological personality profile. The differences between sexes are few but important (AU)

Documento de posicionamiento: evaluación y manejo de la hipoglucemia en el paciente concon diabetes mellitus. Grupo de Trabajo de Diabetes Mellitus de la Sociedad Española de Endocrinología y Nutrición / Position statement: Hypoglycemia management in patients with diabetes mellitus. Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition

Objetivo Proporcionar unas recomendaciones prácticas para la evaluación y el manejo de la hipoglucemia en pacientes con diabetes mellitus. Participantes Miembros del Grupo de Trabajo de Diabetes Mellitus de la Sociedad Española de Endocrinología y Nutrición (SEEN).Métodos Las recomendaciones se formularon de acuerdo al sistema Grading of Recommendations, Assessment, Development, and Evaluation para establecer tanto la fuerza de las recomendaciones como el grado de evidencia. Se realizó una búsqueda sistemática en MEDLINE (PubMed) de la evidencia disponible para cada tema, y se revisaron artículos escritos en inglés y castellano con fecha de inclusión hasta el 15 de febrero de 2013. Para las recomendaciones acerca del uso de fármacos, se consideraron tratamientos aprobados por la Agencia Europea de Medicamentos con esa misma fecha. Tras la formulación de las recomendaciones estas se discutieron conjuntamente por el Grupo de trabajo. Conclusiones El documento establece unas recomendaciones prácticas basadas en la evidencia acerca de la evaluación y manejo de la hipoglucemia en pacientes con diabetes mellitus (AU)

Objective To provide practical recommendations for evaluation and management of hypoglycemia in patients with diabetes mellitus. Participants Members of the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition. Methods Recommendations were formulated according to the Grading of Recommendations, Assessment, Development, and Evaluation system to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (PubMed). Papers in English and Spanish with publication date before 15 February 2013 were included. For recommendations about drugs only those approved by the European Medicines Agency were included. After formulation of recommendations, they were discussed by the Working Group. Conclusions The document provides evidence-based practical recommendations for evaluation and management of hypoglycemia in patients with diabetes mellitus (AU)

Position statement: hypoglycemia management in patients with diabetes mellitus. Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition.

OBJECTIVE: To provide practical recommendations for evaluation and management of hypoglycemia in patients with diabetes mellitus. PARTICIPANTS: Members of the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition. METHODS: Recommendations were formulated according to the Grading of Recommendations, Assessment, Development, and Evaluation system to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (PubMed). Papers in English and Spanish with publication date before 15 February 2013 were included. For recommendations about drugs only those approved by the European Medicines Agency were included. After formulation of recommendations, they were discussed by the Working Group. CONCLUSIONS: The document provides evidence-based practical recommendations for evaluation and management of hypoglycemia in patients with diabetes mellitus.

Documento básico de consenso sobre el síndrome de hipogonadismo de inicio tardío / Basic consensus document on late-onset hypogonadism

Uno de los aspectos más importantes de la vida del varón es su capacidad para desarrollar una actividad sexual normal; su pérdida siempre ha sido considerada como un acontecimiento de especial trascendencia. La relación entre la actividad sexual y otras características masculinas con los testículos es un hecho conocido desde los más remotos tiempos y se ha relacionado con el descenso lento de la secreción de testosterona que se produce con la edad avanzada. Este hipogonadismo del varón es una de las más frecuentes e infradiagnosticadas endocrinopatías. Para denominar las situaciones clínicas motivadas por el declinar de la función gonadal en el varón en relación con la edad, se han propuesto diversos términos, y el que parece más universalmente aceptado hoy en día es hipogonadismo de inicio tardío (HIT). Se trata de un síndrome clínico y bioquímico asociado a la edad avanzada (del varón), caracterizado por síntomas típicos y disminución de las concentraciones de testosterona sérica, que puede afectar a múltiples órganos y sistemas y puede deteriorar la calidad de vida. Este síndrome puede ser tratado y se pueden recuperar las alteraciones producidas por él. Para ello es necesario un protocolo diagnóstico que aborde multitud de aspectos relacionados con los riesgos y beneficios del tratamiento (AU)

One of the most important elements in men's live is the ability to engage in normal sexual activity; loss of this activity has always been considered especially important. The relationship between sexual activity, as well as other masculine characteristics, and the testicles has been well known since ancient times and has been related to the slow decrease in testosterone secretion with advanced age. Male hypogonadism is one of the most frequent and under-diagnosed endocrine diseases. Several terms have been proposed to refer to clinical situations caused by the age-related decline in male gonadal function; currently, the most widely accepted term is late-onset hypogonadism (LOH). LOH consists of a clinical and biochemical syndrome associated with advanced age (in men), characterized by typical symptoms and reduced serum testosterone concentrations, which can affect multiple organs and systems and reduce quality of life. This syndrome can be treated and the alterations produced can be reversed. To achieve this, a diagnostic protocol that approaches the multiple factors related to the risks and benefits of treatment is required (AU)

Basic consensus document on late-onset hypogonadism.

One of the most important elements in men's live is the ability to engage in normal sexual activity; loss of this activity has always been considered especially important. The relationship between sexual activity, as well as other masculine characteristics, and the testicles has been well known since ancient times and has been related to the slow decrease in testosterone secretion with advanced age. Male hypogonadism is one of the most frequent and under-diagnosed endocrine diseases. Several terms have been proposed to refer to clinical situations caused by the age-related decline in male gonadal function; currently, the most widely accepted term is late-onset hypogonadism (LOH). LOH consists of a clinical and biochemical syndrome associated with advanced age (in men), characterized by typical symptoms and reduced serum testosterone concentrations, which can affect multiple organs and systems and reduce quality of life. This syndrome can be treated and the alterations produced can be reversed. To achieve this, a diagnostic protocol that approaches the multiple factors related to the risks and benefits of treatment is required.

La menopausia, una etapa de la vida de la mujer / The menopause, a stage of the woman's life

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The metabolic syndrome. Uncertain criteria.

The metabolic syndrome was defined with the aim of clustering several risk factors of cardiovascular disease present in some patients. Due to its high prevalence, different organizations have tried to simplify the diagnosis of this entity proposing practical, evidence based and applicable criteria. This effort of simplifying is being unworthy because of multiple errors published in recent articles (wrong cut-off points, incomplete figures, etc.). We remark with this editorial comment the challenge of universalising these criteria in order to prevent errors.