Inverse association between serum bilirubin level and testosterone deficiency in middle-aged and older men

Park, Hye Min; Kim, Haeyoung; Lee, Hye Sun; Lee, Yong-Jae

doi:10.1038/s41598-021-87220-z

Cited by 5 publications

(6 citation statements)

References 34 publications

(17 reference statements)

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“…In our cohort more than 40% of patients had TD, which represent a quite large number when compared to the current literature, which establish a prevalence up to 10% in western countries [38], similar in Asian cohorts, in a Indian cohort 22% [39] or 5.8% in a population from Korea [40]. Similar findings were reported by the Hypogonadism In Men study, which reported a prevalence of TD of 38.7% [41], therefore the prevalence might be heterogeneous among different populations.…”

Section: Discussionsupporting

confidence: 77%

Testosterone deficiency is associated with clinically relevant depression symptoms

Vartolomei

Tătaru

Cotruș

et al. 2023

Acta Marisiensis - Seria Medica

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Objective: To investigate the association between testosterone deficiency and depressive and/or anxiety symptoms. Methods: A cross-sectional study was conducted at the urology outpatient clinic from Ludus County Hospital. A set of validated questionnaires ((International Prostate Symptoms Score (IPSS), Depression Anxiety and Stress Scale (DASS-21), Zung Self-rating Depression Scale (Zung SDS)) were self-administrated. Inclusion criteria: age > 40 years. Exclusion criteria: any relevant psychiatric, cardiovascular, or cancer comorbidity. Statistical analyzes were performed using the statistical software Statistical Package for Social Sciences (SPSS, version 23, Chicago, IL, USA). Results: From the total of 55 participants included in the study, 23 (41.8%) had testosterone deficiency. Most were from the 60-69 years decade, 23 participants (41.8%), and the mean age was 59.3 (SD 9.03) years. Eleven (20%) patients had depressive symptoms according to the depression subscale, of these, 7 had mild symptoms and 4 according to Zung SDS. Testosterone deficiency was associated with an increased DASS-21 global score, p=0.021, and depression score, p=0.047. Conclusions: Patients with testosterone deficiency are presenting symptoms of depression. Therefore, these patients need a multi-disciplinary approach that should include a psychological evaluation before making a further management decision.

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Section: Discussionsupporting

confidence: 77%

Testosterone deficiency is associated with clinically relevant depression symptoms

Vartolomei

Tătaru

Cotruș

et al. 2023

Acta Marisiensis - Seria Medica

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“…To explain the discrepancy between men and women in the association between serum total bilirubin and MetS, sex hormone effects may play a role [ 29 ]. Park et al found that serum bilirubin level was independently and inversely associated with testosterone deficiency, and deficiency of testosterone was also related to increased risk of MetS [ 30 ]. Another study demonstrated that estradiol and estrogen-receptors signaling facilitates bilirubin metabolism; as a result, women tended to experience shorter liver function recovery time than men after liver transplantation surgery [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Sex differences in the relationship between serum total bilirubin and risk of incident metabolic syndrome in community-dwelling adults: Propensity score analysis using longitudinal cohort data over 16 years

Kim,

Son,

Moon

et al. 2024

Cardiovasc Diabetol

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Background Research on identifiable risks for metabolic syndrome (MetS) is ongoing, and growing evidence suggests that bilirubin is a potent antioxidant and cytoprotective agent against MetS. However, there have been conflicting results on the association between bilirubin and MetS. Our study aimed to validate the association by separately stratifying data for men and women in a longitudinal prospective study. Methods Data were derived from the Korean Genome Epidemiology Study provided by the Korea Centers for Disease Control and Prevention. Data from 5,185 adults aged 40–69 years (3,089 men and 2,096 women) without MetS were analyzed. The participants were divided according to sex-specific quartiles of serum total bilirubin levels and followed up biennially for 16 years (until 2018). The log-rank test was used for obtaining the Kaplan-Meier curves of cumulative incidence of MetS according to sex-specific serum total bilirubin quartiles, and the hazard ratios (HRs) with 95% confidence intervals (CIs) for incident metabolic syndrome were analyzed with a multiple Cox proportional hazard regression analysis model, after propensity score matching for removing differences at baseline. Results With increasing serum total bilirubin quartiles, the incidence rate per 1000 person-years proportionally decreased in both men and women. After propensity score matching and adjusting for confounding variables, the HRs (95% CIs) for MetS of the highest quartile in reference to the lowest quartile were 1.00 (0.80–1.24) for men and 0.80 (0.65–0.99) for women. Higher quartiles of serum total bilirubin showed significantly lower cumulative incidence of MetS in women (log-rank test p = 0.009), but not in men (log-rank test p = 0.285). Conclusion Serum total bilirubin levels were significantly inversely associated with MetS in women, but there was no significant association observed in men. Sex differences in the effects of serum total bilirubin should be noted when predicting incident MetS by sex in clinical settings.

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“…Meanwhile, Park et al [ 32 ] reported a negative correlation (r = −0.17, p = 0.0096)between total bilirubin and testosterone. Elevated bilirubin is thought to be the mechanism responsible for chronic low-grade inflammation and oxidative damage.…”

Section: Discussionmentioning

confidence: 99%

The sex life of male patients with cirrhosis and its organic factors: What we have got so far?

et al. 2023

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Objective The purpose of this study was to examine the sex lives of male cirrhotic patients organic factors affect them. Method We did an observational study of 220 cirrhotic men’s satisfaction with their sexual lives. Assessment of sex satisfaction was carried out using the New Sexual Satisfaction Scale. The frequency of intercourse and masturbation was estimated. Then, the levels of albumin, total bilirubin, vitamin D, and sex steroids were examined. Ascites and sarcopenia subgroups of our patients were stratified. Results Along with sex steroids, albumin, total bilirubin, and vitamin D all had an impact on how satisfying sex was (r = 0.22), (r = 0.24), and (r = −0.17) affected sex satisfaction. There were strong positive correlations between vitamin D (r = 0.33), albumin (r = 0.59), and free testosterone, along with a negative correlation between total bilirubin (r = −0.63) and free testosterone. An imbalance in sex steroid levels was observed, leading to decreased frequency of intercourse(p < 0.0001), weakened erections(p < 0.0001), and reduced quality of orgasm (p < 0.0001). Significant new sex behavior changes were found, such as an increase in masturbation. Physical limitations such as ascites and sarcopenia also impacted the decreasing sex life. Conclusion The sex life of cirrhotic men is affected. The decrease in the frequency of intercourse and sexual satisfaction is noticeable in male patients and leads to increased masturbation. Free Testosterone, vitamin D, albumin, and bilirubin play role in their sex life. In addition, ascites and sarcopenia not only affect their sex life but also hamper the quality of their well-being.

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Inverse association between serum bilirubin level and testosterone deficiency in middle-aged and older men

Cited by 5 publications

References 34 publications

Testosterone deficiency is associated with clinically relevant depression symptoms

Testosterone deficiency is associated with clinically relevant depression symptoms

Sex differences in the relationship between serum total bilirubin and risk of incident metabolic syndrome in community-dwelling adults: Propensity score analysis using longitudinal cohort data over 16 years

The sex life of male patients with cirrhosis and its organic factors: What we have got so far?

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