Hormonal Modulation in Aging Patients with Erectile Dysfunction and Metabolic Syndrome - 0 views
www.ncbi.nlm.nih.gov/...PMC3888699
low T Testosterone hypogonadism MetS metabolic syndrome men male hormone hormones
shared by Nathan Goodyear on 05 Feb 14
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Hypogonadism and MetS are strongly associated [12, 13, 16], having even been demonstrated that with the increasing number of MetS parameters there is a proportional raise in the incidence of hypogonadism
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the presence of MetS did not prove to be a significant determinant of hypogonadism, as it did not lead to a decline in T levels, in MetS patients with already established hypogonadism, the increasing number of MetS features was associated with further decline in T
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In the setting of MetS, hypertriglyceridemia and increased WC have been reported as the most important determinants of hypogonadism
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recent literature consistently associates obesity not only with higher risk of hypogonadism [4, 6, 27] but also with lower T levels
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Visceral adiposity has been particularly related with reduction of T and SHBG levels (independent of other metabolic disorders)
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WC was one of the MetS parameters with the greatest influence in T levels decrease, presenting itself as a strong risk factor for hypogonadism development
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MetS-related T decline was not accompanied by an increase in pituitary LH levels, suggesting impairment in gonadotropin secretion
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The molecules behind this smoothing compensatory effect of GnRH/LH are still unknown, but estrogens and insulin, as well as leptin, TNF-α, and other adipokines, were proposed candidates
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fat stores undertake an increase aromatization of androgens, therefore raising estrogen levels [9, 15], which in turn decrease LH secretion
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our data contradicts the concept that estradiol exerts a negative feedback on hypothalamic GnRH secretion
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taking into account that high estradiol levels have already been described as the only abnormality in a subset of patients with ED, the hypothesis that the later might not only be caused by androgen deficiency is becoming increasingly evident
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it has been reported that the chronic exposure to phosphodiesterase type 5 inhibitors (PDE5i), widely used for the treatment of ED, may influence serum estradiol levels
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thyroid disorders (specially hyperthyroidism) have been related to ED and hypogonadism, and so must be considered in a sexual-dysfunction setting
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It is clear from the current literature that collecting a more thorough hormonal panel might be a wise approach to further uncover hormonal relations
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We concluded that in ED patients with hypogonadism and MetS, the attenuated response of HPG axis (normal or low LH levels) might not always be due to an underlying adiposity-dependent estrogen-raising effect.
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our findings indicate that ED, aging, and estradiol might have a stronger connection than what is currently described in the literature.