Aging Male最新文献

Background: The impact of air pollutants on cognitive aging remains uncertain. This study investigates whether sarcopenia mediates the association of ozone (O₃), nitrogen dioxide (NO₂), and particulate matter (PM₁₀) with cognitive decline.

Methods: Using data from adults (≥45 years) in the 2015 and 2018 China Health and Retirement Longitudinal Study (CHARLS) waves, we employed linear regression, mediation, and restricted cubic spline analyses to assess the associations of air pollutants and sarcopenia with cognitive function (measured by mental status and episodic memory), controlling for confounders.

Results: O₃, NO₂, PM₁₀, and sarcopenia demonstrated significant negative associations with cognitive function (all β < 0, all 95% CI excluded 0, all P < 0.05). Sarcopenia mediated 12.79% and 6.65% of the effect of PM₁₀ and O₃, respectively. Subgroup analyses identified sex and marital status as significant effect modifiers.

Conclusions: O₃, NO₂, PM₁₀, and sarcopenia were negatively associated with cognitive function. Sarcopenia partially mediated the effects of O₃ and PM₁₀.

This is the inaugural recommendation for the management of the Aging Male with Klinefelter Syndrome (KS), a demographic characterized by primary hypogonadism in the presence of one or more supernumerary X-chromosomes with irregular gene-inactivation, and metabolic dysregulation, contributing a component of functional hypogonadism as aging in these men progresses. The unique constellation of symptoms spanning multiple organ systems and health domains necessitates specialized diagnostic and therapeutic strategies. Neglecting the specific needs of this population can precipitate a considerable decline in quality of life and overall health outcomes. Our recommendations advocate for a multidisciplinary approach involving endocrinologists, urologists, geneticists, mental health professionals, and other specialists, to address the complex interplay of hormonal imbalances, metabolic disorders, cardiovascular risk factors including arrhythmia, bone health concerns, psychological and sexual challenges, ophthalmological problems, and dental issues. By providing a structured framework for comprehensive and individualized care, these recommendations aim to bridge existing healthcare gaps, optimize well-being, and enhance the overall quality of life for aging men with KS.

Background: This study aimed to evaluate the prevalence of erectile dysfunction (ED) and assess its associations in a large cohort of patients with metastatic renal cell carcinoma (mRCC) prior to initiating and during therapy.

Methods: In this prospective multicenter study, male patients with clear-cell mRCC were assessed. Erectile function was evaluated using the 5-item International Index of Erectile Function (IIEF-5), and general health status was assessed using the Functional Assessment of Cancer Therapy-Kidney Symptom Index (FKSI-19). Associations between clinical factors and IIEF-5 scores were analyzed using multiple regression models.

Results: Among 357 patients (median age 62.9 years), 69% reported negative changes in sexual life, and 77.8% had some degree of ED. 62% of patients reported no sexual activity. Although older age, poor or intermediate IMDC risk, and greater symptom severity were associated with lower IIEF-5 scores in univariate analyses, age was not an independent predictor of ED. Instead, ECOG performance status, hemoglobin levels, and FKSI-19 scores significantly predicted ED level.

Conclusions: ED is highly prevalent among patients with mRCC and appears to be more strongly associated with general health and disease burden rather than age. These findings highlight the importance of evaluating sexual health in oncology settings, irrespective of age.

Background: Erectile dysfunction (ED) is associated with metabolic disorders like hypertension and diabetes. The lipid accumulation product (LAP), a marker of visceral fat and dyslipidemia, has not been well studied in relation to ED in these populations. This study examined the relationship between LAP and ED.

Methods: A cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) 2001-2004 data included 756 men with hypertension or diabetes. Weighted multivariable logistic regression and restricted cubic spline (RCS) analysis evaluated LAP-ED associations, with subgroup analysis for effect modification.

Results: ED prevalence was 43.65% (330/756). LAP correlated positively with ED risk (continuous: OR = 1.005, 95%CI:1.000-1.005). Highest vs lowest LAP quartile (Q4 vs Q1) showed 2.92-fold higher ED risk (OR = 2.92, 95%CI:1.21-7.06). RCS analysis indicated linear association (P for non-linearity = 0.290). Subgroup analysis showed no significant interactions.

Conclusion: This study demonstrates a positive correlation between LAP and ED in men with diabetes or hypertension; further studies are needed to confirm findings and explore mechanisms.

Background: The goal of this meta-analysis intended to identify the efficacy of platelet-rich plasma (PRP) alone or in combination with low intensity shock wave therapy (Li-SWT) as a therapy for erectile dysfunction (ED).

Methods: This study integrated and analyzed the data using Cochrane method and GRADEpro GDT grading system. The registration number for this study was CRD42024618240.

Result: Seven randomized controlled trials with 660 patients were analyzed. The results indicated that compared with the control group, IIEF score of patients in the PRP group improved significantly at 12-week (p = 0.03) and 24-week (p = 0.0004), while there was no significant difference at 4-week. The PRP group had no significant advantages over the control group in terms of MCID and SEP Q3. For peak systolic velocity, patients in the PRP group demonstrated greater improvement than those in the control group (p < 0.00001). Subgroup analysis revealed that adding PRP regimen can considerably improve IIEF scores of ED patients compared to using Li-SWT alone (p < 0.0001).

Conclusion: PRP demonstrated a better efficacy in treating ED, especially during a follow-up period of 6 months. Compared with using Li-SWT alone, the addition of PRP can considerably improve the IIEF score of ED patients. These findings still required large-scale clinical trials for verification.

Background: The 5-repetition sit-to-stand (5STS) test, a common physical performance measure, has been associated with various health outcomes, but its relationship with cardiovascular disease (CVD) risk warrants further investigation.

Objectives: This study examined the association between 5STS test duration and CVD risk in middle-aged and elderly Chinese adults.

Methods: Data were from the China Health and Retirement Longitudinal Study (CHARLS). Cross-sectional and longitudinal analyses using linear and logistic regression models assessed the relationship between 5STS duration and CVD risk. Subgroup analyses and restricted cubic spline models explored effect modifiers and non-linear trends.

Results: Longer 5STS duration was independently associated with higher CVD risk. Each additional second increased CVD odds (cross-sectional: OR = 1.03, 95% CI: 1.02-1.04; longitudinal: OR = 1.04, 95% CI: 1.02-1.06). A graded association was observed, with the highest quartile demonstrating approximately 1.5 times the risk compared to the lowest. Restricted cubic spline analysis indicated a steep risk increase at approximately 9.81 s.

Conclusions: The 5STS test is a potential non-invasive predictor of CVD risk and may be useful for early detection in clinical settings. Further research across diverse populations is needed.

Background and objectives: This study aimed to evaluate the potential associations between asprosin, Macrophage inhibitory cytokine-1 (MIC-1), and metabolic parameters related to appetite regulation in elderly individuals with and without type 2 diabetes mellitus (T2DM).

Materials and methods: Eighty-six elderly patients (44 with T2DM, 42 non-diabetics) were evaluated. Appetite was assessed using the Three-Factor Eating Questionnaire (TFEQ), and serum levels of asprosin and (MIC-1) were measured using ELISA.

Results: Asprosin and MIC-1 levels were significantly lower in T2DM patients (p = 0.032 and p < 0.001, respectively; compared to non-diabetics. In the diabetic group, uncontrolled eating was positively associated with waist circumference and ferritin levels, while emotional eating showed a positive correlation with systolic blood pressure and an inverse correlation with vitamin D levels, based on multivariate regression analysis. Among non-diabetics, triglyceride levels were negatively associated with emotional eating (p = 0.019). No statistically significant associations were found between appetite scores and serum levels of asprosin or MIC-1.

Conclusion: Metabolic and circulatory factors, including waist circumference, serum ferritin, vitamin D [25(OH)D], triglycerides, and systolic blood pressure, appear to influence appetite regulation in elderly individuals. Despite reduced levels of asprosin and MIC-1 in T2DM patients, their independent roles in appetite regulation were not evident. Further studies to clarify these relationships.

Background: In erectile dysfunction (ED) management the partner could support therapies or may sabotage them, as in the phenomenon of the "Viagra Jealousy" (VJ). Thus, we aimed to study the extent of cognitive and emotional discomfort in communicating and sharing ED treatment by creating a new tool, called INTIMA (Impact of Negotiating Treatment Intake on Marital Intimacy/Alliance Assessment).

Methods: 134 men diagnosed with ED completed a series of validated psychometric questionnaires, including INTIMA, the Fear of Intimacy Scale (FIS), and the Relationship Questionnaire (RQ). Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were conducted to assess the dimensionality and factorial validity of the INTIMA and its psychometric strength.

Results: CFA confirmed a single-factor structure with robust goodness-of-fit indices (ꭓ²[9] = 11.7, p = 0.234; SRMR = 0.030; CFI = 0.991; TLI = 0.985; RMSEA = 0.047). The INTIMA demonstrated excellent internal consistency. Convergent validity was supported by significant correlation with FIS and adequate Average Variance Extracted. ROC analysis revealed high discriminatory power for detecting insecure attachment patterns, with an optimal cut-off score of 17.

Conclusion: INTIMA is a reliable psychometric tool for assessing perceived VJ and predicting the risks of involving or not the partner in ED treatment and to identify optimal strategies for better adherence and outcomes.

Background: The link between obstructive sleep apnea (OSA) and serum testosterone levels is still unclear.

Method: This cross-sectional study analyzed data from the 2015-2016 NHANES cycle and an independent polysomnography (PSG) cohort (validation cohort). We examined associations between OSA severity and risks of testosterone deficiency. Additionally, we quantified the capacity of BOADAI and apnea-hypopnea index to assess testosterone deficiency in OSA patients.

Results: The study included 2,359 participants from the NHANES cohort and 172 from the standardized PSG cohort. A negative correlation was identified between OSA and serum testosterone levels. After multivariable adjustment, OSA patients exhibited a 31% increased risk of testosterone deficiency (odds ratio [OR] = 1.31, 95% confidence interval [CI]: (1.02, 1.70), p = 0.03). This risk escalated to 67% in severe OSA (OR = 1.67, 95% CI: (1.04-2.68), p = 0.03) versus controls. The BOADAI showed stronger inverse correlation with testosterone(r = -0.37) and remained independently associated with testosterone deficiency (OR = 2.37, 95% CI:(1.12-5.32), p = 0.01).

Conclusions: This study provided evidence of a negative association between OSA and serum testosterone levels. The BOADAI, measurable at home via a finger-clip oximeter, provides an effective and more convenient monitoring alternative for monitoring testosterone levels in OSA management.

Objective: Peyronie's disease and hypogonadism are believed to have a linear association; however, research has yielded conflicting results. This is the first histopathological study on this topic.

Methodology: This study randomly assigned 40 three-month-old male Sprague-Dawley rats to five groups. We established Peyronie's model by injecting intratunical TGF-beta and 3% disodium phosphate dihydrate into four groups. One group received intratunical saline. The control group for the Peyronie's disease model was one group. In the other groups, the first had castration orchiectomy. The second group was the Peyronie's disease model control. The third group received intratunical saline injections. The fourth group received intraperitoneal testosterone injections, while the fifth received 0.5 mg of 5-alpha reductase inhibitor orally daily. We excised penile tissue for histopathology after a 30-day follow-up. Masson's trichrome staining found collagen and smooth muscle, picro-sirius staining found collagen III and collagen I, and hematoxylin and eosin staining found fibrosis.

Results: Histopathological examination revealed significant differences in fibrosis, smooth muscle/collagen ratios, and collagen III/collagen I ratios. Comparing groupings without a control group revealed no statistically significant differences.

Conclusion: This study explored testosterone's effect on Peyronie's disease in rats. Fibrosis was analyzed, but no significant changes were observed.