Aging Male最新文献

Purpose: The pathophysiology of benign prostatic hyperplasia (BPH), a prevalent condition among aging males, remains unclear. Given emerging evidence implicating oxidative stress (OS) in prostatic pathogenesis, this study investigated the association between the comprehensive Oxidative Balance Score (OBS) and BPH prevalence.

Materials and methods: The National Health and Nutrition Examination Survey (NHANES) database was selected to determine BPH using a self-report questionnaire, and multivariate logistic regression was performed to explore the correlation between OBS and BPH. Smoothed curve fitting, threshold effect analysis, and stratified analysis were performed.

Results: The present study, which ultimately included 621 participants, showed that after adjusting for potential confounders, an increase in OBS was associated with a slightly increased risk of developing BPH compared with the lowest tertile (T1) (OR = 1.07, 95% CI: 1.02,1.13, P = 0.015; OR = 1.09, 95% CI: 1.01, 1.17, P = 0.029). Smoothed curve fitting showed that when OBS was >21, the risk of developing BPH was associated with a 27% increase in the risk (OR = 1.27, 95% CI: 1.13, 1.43).

Conclusion: This study reveals a significant non-linear association between OBS and BPH: when OBS > 21, higher OBS scores are associated with an increased risk of BPH.

Background: The frailty index (FI), reflecting cumulative health deficits, is a strong predictor of adverse outcomes in older adults. However, its prognostic value for mortality among patients with testosterone deficiency (TD) remains unclear.

Methods: We analyzed 1,688 adults with TD from three NHANES cycles (2011-2016) with mortality follow-up through 2019. FI was constructed using a 49-item deficit model. Survival differences were evaluated with Kaplan-Meier curves, and survey-weighted Cox models assessed the association between FI and all-cause mortality. Restricted cubic splines and threshold analyses explored dose-response relationships. Mediation analysis examined the role of the platelet-to-HDL-C ratio (PHR).

Results: Frail participants exhibited significantly higher mortality risk than non-frail individuals (log-rank P < 0.001). Per 1-SD increase in FI, mortality risk rose by 76% (HR = 1.76, 95% CI: 1.57-1.96, P < 0.001). Threshold analysis showed a sharp increase in mortality when FI exceeded 0.095, approximating the conventional pre-frailty cut-off. PHR mediated 8.46% of the FI-mortality association.

Conclusion: Higher FI was independently associated with increased all-cause mortality in TD patients, partly mediated by PHR. These findings highlight the prognostic significance of frailty and suggest PHR as a potential marker for personalized risk stratification and targeted intervention.

Objective: Benign prostatic hyperplasia (BPH) is a common urinary disease in elderly men, with acute urinary retention (AUR) severely impacting quality of life. Urodynamic abnormalities and prostate-specific antigen (PSA) levels reflect urinary obstruction and prostate enlargement/inflammation. This study was to correlate the two factors with AUR in BPH patients.

Methods: A total of 120 BPH patients were divided into AUR group and non-AUR group, with 60 cases in each group. Clinical, laboratory, and urodynamic data were collected. Independent variables with significant differences in univariate analysis were included in multifactorial logistic regression analysis. The diagnostic value of urodynamic parameters and PSA for AUR in BPH patients was assessed. A spline regression model was established to analyze the relationship between AUR and PSA.

Results: Elevated levels of urodynamic parameters volume at first desire to void (FDV), bladder compliance (BC), total PSA (tPSA), and free PSA (fPSA) were independent risk factors for AUR in BPH patients. FDV and tPSA showed high predictive efficacy, while BC and fPSA relatively weaker. tPSA was positively correlated with both FDV and BC. fPSA was positively correlated only with FDV.

Conclusion: FDV and BC with tPSA and fPSA are significantly elevated in BPH patients with AUR and show a strong association.

Background: Normozoospermia does not guarantee fertility. Sperm DNA fragmentation (SDF) reflects intrinsic sperm quality and adverse reproductive outcomes, and double-strand breaks (DSBs) indicate more severe DNA damage.

Methods: From July 2021 to February 2025, semen parameters, total motile sperm count (TMSC), and SDF from 534 normozoospermic men at National Cheng Kung University Hospital were retrospectively analyzed. Total DNA fragmentation (Total DFI) was measured using the sperm chromatin dispersion (SCD) test, and DSB DFI was assessed using the SDF Releasing (SDFR) assay.

Results: Paternal age correlated negatively with ejaculatory volume (ρ = -0.214, p < 0.001), progressive motility (ρ = -0.184, p < 0.001), and TMSC (ρ = -0.118, p = 0.003), but positively with total DFI (ρ = 0.186, p = 0.025). Although Total DFI did not differ significantly across the three age groups (p = 0.081), men ≥ 40 years had higher Total DFI than those < 40 years (p = 0.032). DSB DFI showed no difference. Total DFI correlated with DSB DFI (ρ = 0.298, p = 0.005). Oligoasthenoteratozoospermic men exhibited higher total DFI than normozoospermic men (p = 0.048).

Conclusion: Advancing paternal age is associated with reduced semen quality and increased sperm DNA fragmentation even among normozoospermic men.

Background: Prostate cancer (PCa) is a leading cause of male cancer-related death globally. While the gut microbiota is linked to PCa, its genetic association remains unclear.

Methods: We screened genetic instruments related to the gut microbiota and paired them with PCa genome-wide association study data to conduct Mendelian randomization (MR) analysis. Positive MR findings were then subjected to colocalization analysis. Subsequently, we utilized the Gene Expression Omnibus (GEO) dataset to perform differential expression analysis, aiming to identify differentially expressed associated genes (DEAGs). We determined the importance scores of these DEAGs through four machine learning models and constructed a nomogram based on these findings, and then validated it in another group of the GEO dataset.

Results: MR analysis found 16 gut bacteria causally linked to PCa (7 risk, 9 protective), with 144 related genes. PLCL1, VSNL1, ROR2, NRXN3, and TEAD1 were identified as feature genes for constructing a nomogram that provides a quantitative prediction of the risk of PCa onset.

Conclusions: This study indicates that there are causal links between the gut microbiota and PCa. Feature genes may affect the occurrence of PCa by inhibiting the epithelial-mesenchymal transition, proliferation, migration, and invasion of cells.

Background: The present study aims to investigate the associations between the allostatic load index (ALI), prostate-specific antigen (PSA) levels, and certain causes of death among the participants.

Methods: Participants in this study were selected from the NHANES database (2003-2010) and linked to mortality files (the National Death Index, 2003-2010). Multivariate Cox proportional hazards models were used to analyze the effect of the allostatic load (AL) on PSA levels and all-cause mortality in participants.

Results: This study found that an increase in ALI exerted a certain impact on PSA levels in the entire participant population (especially in the subgroup with WWI < 0.5). Participants in the third quartile (T3) with the highest ALI index had a significantly 52% increased probability of all-cause mortality compared to those in T1 (OR = 1.52, 95% CI: 1.28, 1.76, P < 0.01). Both RCS analysis and the K-M curve provide corroboration. When treated as a continuous variable, it is also associated with cardiac mortality (OR = 1.14, 95% CI: 1.04, 1.26, P < 0.01).

Conclusions: In a specific range, higher ALI was significantly and positively associated with PSA levels, all-cause mortality, and cardiovascular disease risk, though its link to cancer-specific mortality risk was not statistically significant in this study.

Background: The relationship between metabolic syndrome (MetS) and cancer risk, and the potential mediating role of biological aging as measured by Phenotypic Age Acceleration (PhenoAgeAccel), remains insufficiently characterized.

Methods: We conducted a cross-sectional study of 12,664 participants from the National Health and Nutrition Examination Survey (NHANES, 1999-2010, 2015-2020). MetS was defined according to established criteria, cancer status was self-reported, and PhenoAgeAccel was derived from clinical biomarkers. Weighted multivariable logistic regression and formal causal mediation analysis were employed.

Results: After full adjustment, MetS was significantly associated with increased cancer prevalence (OR = 1.338, 95% CI: 1.074-1.666, p = 0.010). This association was more pronounced in males (OR = 2.383, p < 0.05) and adults aged 20-65 years (OR = 1.573, p < 0.05). Mediation analysis revealed that PhenoAgeAccel significantly accounted for 16.5% of the total effect of MetS on cancer (Average Causal Mediation Effect = 0.00352, p < 0.001). Gender stratification indicated a statistically significant mediating effect in males (proportion mediated = 10.9%, p = 0.002) but not in females (proportion mediated = 10.9%, p = 0.086). The direct effect of MetS remained significant (OR = 1.265, p = 0.050).

Conclusion: MetS is associated with elevated cancer risk, with PhenoAgeAccel serving as a significant mediating pathway, particularly among males. These findings identify younger males as a high-risk subgroup for targeted preventive strategies.

Purpose: This study investigated the causal effect of 3-carboxy-4-methyl-5-propyl-2-furanpropanoic acid (CMPF) on erectile dysfunction (ED) and elucidated its underlying molecular mechanisms through multi-omics integration.

Methods: Mendelian randomization (MR) was applied to evaluate the causal effects of CMPF on ED and metabolic risk factors. Network pharmacology was used to identify overlapping molecular targets, followed by molecular docking to assess binding affinity. Multi-omics validation incorporated Summary-data-based MR (SMR) analyses of expression and protein quantitative trait loci (eQTL/pQTL) to confirm genetically regulated CMPF-related targets.

Results: MR analyses demonstrated a protective effect of CMPF on ED in both discovery (OR: 0.78, 95% CI: 0.62-0.98) and replication cohorts (OR: 0.82, 95% CI: 0.69-0.98), along with favorable associations with glucose metabolism, blood pressure, and lipid traits. Network analysis identified 42 shared targets, with DPP4, LGALS3, and NR3C2 as hub targets. Molecular docking showed strong binding affinities (≤-6.0 kcal/mol). SMR analyses highlighted LGALS3 as a key genetic mediator, supported by consistent eQTL and pQTL signals.

Conclusions: CMPF exerts protective effects against ED and metabolic dysfunction through multi-target modulation, with LGALS3, DPP4, and NR3C2 as central regulators. These findings support CMPF as a diet-derived bioactive metabolite with potential for nutritional interventions and multi-target therapeutic strategies in ED.

Background: The ZJU index is a composite metric incorporating triglyceride (TG), fasting plasma glucose (FPG), the alanine aminotransferase (ALT) to aspartate aminotransferase ratio (AST) (ALT/AST), and body mass index (BMI). This study aimed to investigate the relationship between the ZJU index and the risk of erectile dysfunction (ED).

Methods: This analysis utilized data from 1,906 participants in the 2001-2004 National Health and Nutrition Examination Survey (NHANES) dataset. We employed logistic regression modeling, smooth curve fitting, subgroup analysis, and threshold effect analysis to evaluate the association between the ZJU index and ED. The missing values in the covariates were filled by multiple interpolation.

Results: A significant positive association was observed between the ZJU index and ED risk (OR [95% CI] = 1.03 [1.01,1.05]). Analysis revealed a threshold at a ZJU index of 33.4, above which ED risk increased markedly, while the association was not significant below this value. Subgroup analysis indicated a stronger association in participants under 60 years of age.

Conclusion: Higher ZJU index values are positively associated with an increased risk of erectile dysfunction, particularly among individuals under 60 years old. These findings suggest the potential utility of the ZJU index as a screening tool for ED risk assessment.

Background: Digital health literacy (e-HL) is an increasingly popular analysis of patients' awareness of appropriate treatment modalities. This study aimed to evaluate e-HL levels in men undergoing Holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia (BPH) and its potential impact on their quality of life.

Methods: A total of 106 patients scheduled for HoLEP were included. Age, body mass index (BMI), prostate-specific antigen (PSA), prostate volume, preoperative uroflowmetry values, e-HL scores, International Standard Classification of Education (ISCED) levels, and internet usage data were recorded. The EuroQoL Quality of Life (EQ-5D-5L) questionnaire was administered at three months postoperatively. Follow-up uroflowmetry results, IPSS scores, and quality of life (QoL) assessments were compared with e-HL scores. A cutoff value for digital health literacy was identified.

Results: The mean age was 68 years, BMI 29.1 kg/m², prostate volume 86.6 cc, and PSA 7.5 ± 4.6 ng/ml. The mean e-HL score was 16.8 ± 9.8, which was negatively correlated with age and BMI, positively with ISCED level and internet use (p < 0.001). The cutoff for adequate e-HL was 18.5. No significant correlation was found between e-HL and postoperative IPSS, EQ-5D-5L scores.

Conclusion: e-HL levels in HoLEP patients were not associated with symptom severity, postoperative outcomes, or quality of life. Further multicenter studies are needed.