BackgroundLow total testosterone (TT) and sex hormone-binding globulin (SHBG) concentrations have been associated with the metabolic syndrome (MetS) in men, but the reported strength of association varies considerably.ObjectivesWe aimed to investigate whether associations differ across specific subgroups (according to age and body mass index (BMI)) and individual MetS components.Data sourcesTwo previously published meta-analyses including an updated systematic search in PubMed and EMBASE.Study Eligibility CriteriaCross-sectional or prospective observational studies with data on TT and/or SHBG concentrations in combination with MetS in men.MethodsWe conducted an individual participant data meta-analysis of 20 observational studies. Mixed effects models were used to assess cross-sectional and prospective associations of TT, SHBG and free testosterone (FT) with MetS and its individual components. Multivariable adjusted odds ratios (ORs) and hazard ratios (HRs) were calculated and effect modification by age and BMI was studied.ResultsMen with low concentrations of TT, SHBG or FT were more likely to have prevalent MetS (ORs per quartile decrease were 1.69 (95% CI 1.60-1.77), 1.73 (95% CI 1.62-1.85) and 1.46 (95% CI 1.36-1.57) for TT, SHBG and FT, respectively) and incident MetS (HRs per quartile decrease were 1.25 (95% CI 1.16-1.36), 1.44 (95% 1.30-1.60) and 1.14 (95% 1.01-1.28) for TT, SHBG and FT, respectively). Overall, the magnitude of associations was largest in non-overweight men and varied across individual components: stronger associations were observed with hypertriglyceridemia, abdominal obesity and hyperglycaemia and associations were weakest for hypertension.ConclusionsAssociations of testosterone and SHBG with MetS vary according to BMI and individual MetS components. These findings provide further insights into the pathophysiological mechanisms linking low testosterone and SHBG concentrations to cardiometabolic risk.
This study tested 60 men, aged <40 years, with a BMI 27-35 kg/m(2) to determine whether they had metabolic syndrome. The three definitions used to test this were from the National Cholesterol Education Program (NCEP), the World Health Organization (WHO) and the International Diabetes Federation (IDF). Further, the relationship between a positive definition and plasma testosterone (T) and calculated free T was analysed. Using the above three definitions of metabolic syndrome (MetS), there was a large degree of overlap of identifying obese men as having the syndrome, but there were quantitatively significant differences as well. So, it is relevant in studies to identify which of the present definitions of the syndrome has been used. With aging there is an increasing prevalence of the syndrome and age itself might be a factor in the lower T levels encountered in these men. But low plasma total T and calculated free T were also consistent features of men <40 years with metabolic syndrome, regardless of which definition had been applied. Including low T levels in the definition of metabolic syndrome, may be helpful.
Abstract. This paper is devoted to a ground-based method for diagnostics of the ionosphere and neutral atmosphere. This method uses one of the numerous physical phenomena observed in the ionosphere illuminated by a high-power radio wave, namely, the generation of artificial periodic inhomogeneities. New results on the ionospheric and atmospheric parameter measurements at E region heights are given.
Abstract. Artificial periodic irregularities (API) are produced in the ionospheric plasma by a powerful standing electromagnetic wave reflected off the F region. The resulting electron-density irregularities can scatter other high-frequency waves if the Bragg scattering condition is met. Such measurements have been performed at midlatitudes for two decades and have been developed into a useful ionospheric diagnostic technique. We report here the first measurements from a high-latitude station, using the EISCAT heating facility near Tromsø, Norway. Both F-region and lower-altitude ionospheric echoes have been obtained, but the bulk of the data has been in the E and D regions with echoes extending down to 52-km altitude. Examples of API are shown, mainly from the D region, together with simultaneous VHF incoherent-scatter-radar (ISR) data. Vertical velocities derived from the rate of phase change during the irregularity decay are shown and compared with velocities derived from the ISR. Some of the API-derived velocities in the 75-115-km height range appear consistent with vertical neutral winds as shown by their magnitudes and by evidence of gravity waves, while other data in the 50-70-km range show an unrealistically large bias. For a comparison with ISR data it has proved difficult to get good quality data sets overlapping in height and time. The initial comparisons show some agreement, but discrepancies of several metres per second do not yet allow us to conclude that the two techniques are measuring the same quantity. The irregularity decay time-constants between about 53 and 70 km are compared with the results of an advanced ion-chemistry model, and height profiles of recorded signal power are compared with model estimates in the same altitude range. The calculated amplitude shows good agreement with the data in that the maximum occurs at about the same height as that of the measured amplitude. The calculated time-constant agrees very well with the data below 60 km but is larger above 60 km by a factor of up to 2 at 64 km. The comparisonsCorrespondence to: M. T. Rietveld with the model are considered to be a good basis for more refined comparisons.
The objective of the present work was to estimate the possibility of using the ELISA technique for the quantitative analysis of the metanephrine and normetanephrine levels in urine and to determine the cross-off points for the discrimination between their normal and pathological values for the purpose of diagnostics of pheochromocytoma. Methylated derivatives of adrenaline and noradrenaline were measured in 3,234 urine sample obtained from the patients presenting with elevated arterial pressure, resistance to therapy, and adrenal mass lesions who had visited the inpatient and outpatient departments of the Endocrinological Research Centre during the past 4 years. The measurement of total metanephrine and normetanephrine (free plus deconjugated fractions) was performed using commercial ELISA kits (IBL, Hambutg, Germany). The content of normetanephrine over 612 mcg in daily urine samples was shown to be the borderline between the normal values and those suggesting diagnosis of pheochromocytoma. The sensitivity of this assay was 97,5% (95% CI 91,1-99,6%), specificity 100% (95% CI 93,8-100%). For metanephrine, the level of more than 550 mcg/24 hours was the borderline between the normal values and those suggesting diagnosis of pheochromocytoma. The sensitivity of the method was 100% (95% CI 88-100%), specificity - 96% (95% CI 86-99,4%). The biochemical diagnosis of pheochromocytoma was confirmed by the reference pathomorphological method in 99% of the cases. The incidence of pheochromocytoma predicted by the biochemical analysis of the urine samples delivered to the laboratory during 4 years from the patients with the tentative diagnosis of this pathology (based on the elevated arterial pressure and the presence of adrenal mass lesions) was 4% on the average. It is concluded that the application of ELISA in a "manual" mode provides high sensitivity and specificity of quantitative determination of metanephrines in daily urine comparable to those achieved with the widely used but more expensive high performance liquid chromatography.
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