Performance of the Androgen deficiency in aging male questionnaire for the clinical detection of androgen deficiency in black sub-Saharan African men with Type-2 diabetes mellitus

Background: The Androgen Deficiency in Aging Male (ADAM) questionnaire is increasingly popular for evaluation of androgen deficiency (AD) in sub-Saharan African men with type 2 diabetes mellitus (DM). However, its reliability in this population is unknown.Methods: Total testosterone < 8 nmol/L was used as the gold standard for diagnosis of AD in this cross-sectional survey of 200 type 2 DM males aged 30­69 years. Participants also completed the Saint Louis University ADAM questionnaire whereby AD was diagnosed by a 'yes' answer to question 1 (reduced libido) or 7 (erectile dysfunction) or any other three questions. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall accuracy of the ADAM tool were computed.Results: The mean age of the participants was 58.0 ± 8.8 years. A total of 142 subjects (71.0%) had AD based on the ADAM questionnaire. However, AD was biochemically confirmed in 59 subjects (29.5%). The ADAM questionnaire rendered a sensitivity of 88.1%, specificity of 44.7%, PPV of 50.0%, NPV of 85.7% and accuracy of 61.4%.Conclusion: Despite an impressive sensitivity, the low specificity and overall accuracy of the ADAM questionnaire makes it unreliable for the detection of AD in sub-Saharan African men with type 2 DM

Relationship between Sex Hormone Levels; Bone Mineral Density and Bone Turnover Markers in Healthy Moroccan Men: a Cross-Sectional Study

Introduction: gonadal steroid hormones play a crucial role during skeletal growth and maturation in both men and women. The aim of this study is to evaluate the relationship of sex hormone levels; bone mineral density and biochemical markers of bone turnover in healthy Moroccan men. Methods: 142 Moroccan men who had no previous diagnosis of osteoporosis were enrolled prospectively in this cross-sectional study between December 2009 and August 2010. Also; subjects were excluded from the study if they had conditions affecting bone metabolism. Different biochemical parameters were assayed: Testosterone; Estradiol; sex hormone binding globulin; Osteocalcin; vitamin D; crosslaps; intact parathyroid hormone and alkaline phosphatase. Dual-energy X-ray absorptiometry was used to measure the Bone mineral density (BMD) (g/cm2). Results: in this study; among the 142 Moroccan men; 29 (20.1%) had densitometry osteoporosis and the prevalence of vitamin D insufficiency was 94%. No correlation was found between Estradiol; Testosterone and bone mineral density but we found significant differences in the levels of Estradiol between patients with osteoporosis; osteopenia and normal patients. Bone mineral density at the lumbar spine was negatively correlated to hormone-binding globulin and positively correlated to free androgen index; free estrogen index and the Body mass index. BMD at the total hip was positively correlated to free androgen index; Body mass index and negatively correlated to sex hormone binding globulin; alkaline phosphatase; intact parathyroid hormone; osteocalcin; Crosslaps and age. Conclusion: our study showed that increasing age; intact parathyroid hormone and alkaline phosphatase levels and decreasing body mass index were the most important independent factors associated to the presence of a low BMD at the total hip. Increasing body mass index and free androgen index level were the most important independent factors associated to the presence of a low BMD at the lumbar spine. The combination of variable that best predicted the male osteoporosis is age; body mass index; alkaline phosphatase and cigarette smoking

Evaluation of Serum Testosterone Levels as Immuno-Enhancer in Nigerian Woman Positive to Autoanti-microsomal Antibodies and Experiencing Secondary Infertility and Spontaneous Abortion

In this study; One hundred and forty-eight (148) healthy euthyroid Nigeria women; all volunteers were grouped into two (2) sets of seventy four (74) in the test (subjects) and control groups. The Anti-thyroperoxidase (anti TPO) antibody; ELISA assay carried out showed that 20 (58) of the secondary infertile and 33 (82) of the spontaneous abortion groups have the anti TPO titer mean value of 22.09+ 11.74 units/ml and 54.91 + 7.64 units/ml respectively. These were compared with anti TPO titer mean value from 9 (26) non pregnant- Nulligravida and 10 (25) pregnant with 28.83+ 2.50unit/ml and 11.87+ 1.52 units/ml respectively. The students t-test statistical analysis at p0.05 showed that there was statistical significance in the differences.There was high level of testosterone titer above the male range in all the categories of women positive to anti TPO antibody. However; the secondary infertile group with the testosterone titer mean value of 3.03 + 0.33 ng/ml showed no significant difference when compared with the pregnant and non-pregnant -nulligravidae control having testosterone titer mean value of 5.37+ 0.42ng/ml and 1.03 + 0.46 ng/ml respectively. Conversely there was statistical significant differences when the testosterone titer mean value of the spontaneous abortion group of 10.81+ 5.55gn/ml was compared with that of the control non-pregnant Nulligravidae of 1.30 + 0.46 ng/ml and pregnant of 5.37+ 0.42ng/ml at p 0.05. This thus showed that the observed increase in the serum free testosterone level in women with anti TPO antibody was significant and may vary with different physiological conditions in women

Andropause: An emerging world health problem

Andropause is an emerging clinical concept that is gaining an increasing recognition; as the world becomes more aging. The clinical features though subtle are easy to identify and appropriate treatment of diagnosed cases will to a good extent alleviate a lot of age-related complaints and improve the general quality of life in the elderly men. Low level of clinical suspicion secondary to inadequate knowledge about this clinical entity remains the major obstacle to appropriate treatment. In this review; the literature has been perused and the definition; epidemiology; pathophysiology; clinical features; diagnosis and treatment are outlined

Fourteen days oral administration of therapeutic dosage of some antibiotics reduced serum testosterone in male rats

Fourteen days oral administration of therapeutic dose of Ampicillin (4mg/100g/day); Cloxacillin (6mg/100g/day) and Tetracycline (12mg/100g/day) separately to healthy adult male albino rats significantly reduced their serum testosterone level as assessed by enzyme immunoassay. The control group received equal volume of the vehicle (Normal saline) throughout the period of the treatment. A significant reduction (P0 .05) in testicular and epididymal weight was also produced by Cloxacillin; Cloxacillin and Tetracycline respectively. Ampicillin administration on the other hand significantly reduced (P0 .05) prostrate gland weight. After subjecting the treated animals to a recovery period ranging from 1-2 weeks; during which the drug administration was discontinued; all the animals recovered fully from the antifertility effect of these antibiotics on the serum testosterone level by the end of the second week. A significant recovery in the epididymal; testicular and prostrate gland weight was also recorded in the Cloxacillin and Tetracycline; Cloxacillin; and Ampicillin treated animals respectively. The result suggests that the reversible antifertility effects of these antibiotics were produced via the disruption of testosterone hormone production process. This was also accompanied by reduction in the weight of some of the male reproductive organs

Fourteen Days Oral Administration of Therapeutic Dosage of some Antibiotics Reduced Serum Testosterone in Male Rats

Fourteen days oral administration of therapeutic dose of Ampicillin (4mg/100g/day); Cloxacillin (6mg/100g/day) and Tetracycline (12mg/100g/day) separately to healthy adult male albino rats significantly reduced their serum testosterone level as assessed by enzyme immunoassay. The control group received equal volume of the vehicle (Normal saline) throughout the period of the treatment. A significant reduction (P0 .05) in testicular and epididymal weight was also produced by Cloxacillin; Cloxacillin and Tetracycline respectively. Ampicillin administration on the other hand significantly reduced (P0 .05) prostrate gland weight. After subjecting the treated animals to a recovery period ranging from 1-2 weeks; during which the drug administration was discontinued; all the animals recovered fully from the antifertility effect of these antibiotics on the serum testosterone level by the end of the second week. A significant recovery in the epididymal; testicular and prostrate gland weight was also recorded in the Cloxacillin and Tetracycline; Cloxacillin; and Ampicillin treated animals respectively. The result suggests that the reversible antifertility effects of these antibiotics were produced via the disruption of testosterone hormone production process. This was also accompanied by reduction in the weight of some of the male reproductive organs