Efeitos adversos relacionados ao uso de hormônio em pessoas transexuais: revisão integrativa / Adverse effects related to hormone use in transgender people: integrative review

As pessoas Transexuais são aquelas que apresentam identidade de gênero diferente do sexo biológico e gênero atribuído ao nascer. Há um sentimento de não relação entre o sexo e gênero e, assim, sentem a necessidade de adquirir certas características corporais do gênero com o qual se identificam. Por vezes, essa transição ocorre por meio da utilização de hormônios e/ou procedimentos estéticos. Durante o processo da hormonização, certos efeitos adversos ocorrem e podem apresentar vários riscos e problemas à saúde. Para tanto, indaga-se: Quais são as evidências científicas sobre efeitos adversos em pessoas transexuais que utilizam hormônio de sexo cruzado? Assim, o presente trabalho objetivou identificar e analisar os efeitos adversos descritos na literatura relacionados ao uso de hormônios em pessoas transexuais. Trata-se de uma revisão integrativa cuja busca dos artigos foi realizado em dezembro de 2021 até o mês de janeiro de 2022, nas seguintes bases de dados: Embase, PubMed, MEDLINE, Scopus e Lilacs. Foram incluídos 18 artigos para integrar o presente estudo. A análise de dados dos artigos incluídos partiu da ordenação e categorização do problema de pesquisa e com auxílio de estatística descritiva, com emprego da frequência e porcentagem. A partir da análise crítica dos artigos permitiu a identificação dos efeitos adversos. Foram identificados 75 efeitos adversos, os mais identificados foram a diminuição significativa de HDL e o aumento considerável de IMC ambos apresentaram o mesmo porcentual 6,7% (n = 5), seguidos do surgimento de acne com 5,3%(n=4), hiperuricemia e hiperprolactinemia ambos apresentam 4% (n = 3). Portanto, os resultados alcançados neste estudo, fornecem maior compreensão dos eventuais problemas que os efeitos adversos podem causar no organismo. Diante disso, constata-se a necessidade da realização de estudo direcionado especificamente aos efeitos adversos dos hormônios em pessoas transexuais que optam por usar hormônios para a realização de transição de gênero. Outro ponto importante a ser estudado é qual seria o hormônio ideal ou a combinação ideal de hormônio que produz resultados mais satisfatórios ou menos efeitos adversos. Também, há necessidade da realização do monitoramento desses indivíduos durante todo o processo.

Transgender people are those who have a gender identity different from the biological sex and gender assigned at birth. There is a feeling of unrelatedness between sex and gender, and thus they feel the need to acquire certain body characteristics of the gender with which they identify. Sometimes this transition occurs through the use of hormones and/or aesthetic procedures. During the process of hormonization, certain adverse effects occur and can present several risks and problems to health. Therefore, the following questions are posed: What is the scientific evidence on adverse effects in transsexual people who use cross-sex hormone? Thus, the present work aimed to identify and analyze the adverse effects described in the literature related to the use of hormones in transsexual people. This is an integrative review whose search for articles was carried out from December 2021 to January 2022, in the following databases: Embase, PubMed, MEDLINE, Scopus, and Lilacs. Eighteen articles were included in this study. The data analysis of the included articles started with the ordering and categorization of the research problem and with the help of descriptive statistics, using frequency and percentage. The critical analysis of the articles allowed the identification of adverse effects. Seventy-five adverse effects were identified, the most identified were a significant decrease in HDL and a considerable increase in BMI, both with the same percentage of 6.7% (n = 5), followed by the appearance of acne with 5.3% (n = 4), hyperuricemia and hyperprolactinemia, both with 4% (n = 3). Therefore, the results achieved in this study, provide greater understanding of the possible problems that adverse effects can cause in the body. In view of this, there is a need for a study directed specifically at the adverse effects of hormones on transsexuals who choose to use hormones for their gender transition. Another important point to be studied is what would be the ideal hormone or the ideal combination of hormones that produces more satisfactory results or fewer adverse effects. Also, there is a need for monitoring these individuals during the entire process.

Sports metabolism in improving national fitness / O metabolismo esportivo e a melhora no preparo físico nacional / El metabolismo deportivo y la mejoría en el preparo físico nacional

ABSTRACT Introduction: Exercise can invigorate the body's metabolism. There are very few people who know how sports promote people's physical and mental health. How to lead people to participate in physical exercise through sports is a question worth considering. Objective: We explore the effects of sports on human metabolism. Methods: The article analyzes athletes' physical and chemical indicators before and after exercise and during the recovery period. The indicators cover blood routine, urine routine, and blood testosterone content. Results: The blood and urine routines of athletes before and after training are different (P<0.05). After an expressive number of exercises, the urine testosterone content will be different due to the difference in genders (P<0.05). Conclusions: Physical exercise has a very significant impact on human metabolism. The body's hormone levels and metabolism are related to the amount of exercise. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução: o exercício pode fortalecer o metabolismo corporal. Poucas pessoas sabem o quanto o esporte promove a saúde física e mental de indivíduos. Como levar as pessoas a participar em exercícios físicos através dos esportes é uma questão que vale a pena considerar. Objetivo: Explorar os efeitos do esporte no metabolismo humano. Métodos: O artigo analisa indicadores físicos e químicos de atletas antes e depois do exercício e durante o período de recuperação. Os indicadores cobrem testes de sangue, de urina e conteúdo de testosterona no sangue. Resultados: Os resultados dos testes de sangue e urina dos atletas antes e depois de treinar são diferentes (P<0.05). Após muito exercício, o conteúdo de testosterona na urina será diferente devido a diferença entre os sexos (P<0.05). Conclusões: O exercício físico tem um impacto significativo no metabolismo humano. O nível hormonal e o metabolismo do corpo estão relacionados a quantidade de exercício. Nível de evidência II; Estudos terapêuticos - investigação de resultados de tratamento.

RESUMEN Introducción: El ejercicio puede fortalecer el metabolismo corporal. Pocas personas saben cuánto el deporte promueve la salud física y mental de individuos. Cómo llevar a las personas a participar en ejercicios físicos a través de los deportes es una cuestión que vale la pena considerar. Objetivo: Explorar los efectos del deporte en el metabolismo humano. Métodos: El artículo analiza indicadores físicos y químicos de atletas antes y después del ejercicio y durante el periodo de recuperación. Los indicadores abarcan análisis de sangre, urina y contenido de testosterona en la sangre. Resultados: Los resultados de los análisis de sangre antes y después de entrenar son distintos (P<0.05). Tras mucho ejercicio, el contenido de testosterona en la urina será diferente debido a la diferencia entre los sexos (P<0,05). Conclusiones: El ejercicio físico tiene un impacto significativo en el metabolismo humano. El nivel hormonal y el metabolismo del cuerpo están relacionados a la cantidad de ejercicio. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.

Tumor ovárico de células esteroideas sin otra especificación, durante el embarazo

Los tumores de células esteroides de ovario se clasifican en luteoma estromal, tumor de células de Leydig y tumor de células esteroideas sin otra especificación, según su origen embrionario. El tumor ovárico de células esteroideas sin otra especificación es un tumor benigno raro, pero con potencial maligno; representa menos del 0,1% de todos los tumores de ovario. Deben ser considerados como causa de virilización en mujeres adultas por la producción de testosterona. Solo un feto femenino corre riesgo de virilización. Al igual que otros tumores del estroma ovárico, los tumores deben ser tratados quirúrgicamente. La cirugía está indicada en casos de agrandamiento ovárico unilateral sólido, debido a un 50% de probabilidad de malignidad. En el embarazo, los tumores ováricos de células esteroideas sin otra especificación son excepcionalmente raros y deben ser diferenciados del luteoma del embarazo y otras neoplasias malignas del ovario. Con mayor frecuencia pueden complicarse con rotura y/o torsión. Se presenta un caso de tumor ovárico de células esteroideas sin otra especificación durante el embarazo.

Ovarian steroid cell tumors are classified into stromal luteoma, Leydig cell tumor and steroid cell tumor not otherwise specified, according to their embryonal origin. Ovarian steroid cell tumor not otherwise specified is a rare benign tumor, but with malignant potential; it accounts for less than 0.1% of all ovarian tumors. They should be considered as a cause of virilization in adult women due to testosterone production. Only a female fetus is at risk of virilization. Like other ovarian stromal tumors, the tumors must be treated surgically. Surgery is indicated in cases of solid unilateral ovarian enlargement, due to a 50% chance of malignancy. In pregnancy, ovarian steroid cell tumors not otherwise specified are exceptionally rare and should be differentiated from luteoma of pregnancy and other malignant ovarian neoplasms. More frequently they may be complicated by rupture and/or torsion. A case of nonspecific ovarian steroid cell tumor during pregnancy is presented.

Action of hormonal therapy in amyotrophic lateral sclerosis: a systematic review

SUMMARY Amyotrophic Lateral Sclerosis (ALS) is a fatal disease characterized by muscle weakness, atrophy, fasciculations, and decreased reflexes due to upper and lower motor neurons death. It can be present in both sexes (55-65 years), but with predominance in males. However, in female patients, ALS presents its first symptoms when they are already postmenopausal, when then the incidence ratio of the disease is practically equal between the sexes, which leads to a probable involvement of sex hormones in the development and protection against ALS. The aim of this systematic review, which used the PRISMA consensus and NOS (New Castle-Ottawa Scale) score, was to evaluate the evidence of the action of hormone therapy in women with ALS. The Medline and Cochrane databases were accessed from March 2019 to June 2019, and only full-text articles in Spanish, English, and Portuguese were included. Only four articles matched our inclusion criteria. Postmenopausal women who used exogenous estrogen did not have the same protective factor as women still under the action of endogenous estrogen in the same age group. There was also no increase in the survival of these women.

Sex Differences in Gut Microbiota

Intelectin-1 and Endocrinological Parameters in Women with Polycystic Ovary Syndrome: Effect of Insulin Resistance / 이화의대지

OBJECTIVES: We aimed to evaluate the effect of insulin resistance (IR) on serum Intelectin-1 and endocrinological hormones levels in obese and non-obese women with and without polycystic ovary syndrome (PCOS) in Basrah, Iraq.METHODS: From 124 women volunteers, 60 patients with primary and 64 patients with secondary, while 56 normal ovulatory women were taken as controls. Their fasting insulin hormone, intelectin-1, anti-Mullerian hormone, luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL), estradiol (E2) and testosterones (T) were determined by ELISA methods. BMI, glucose and quantitative insulin sensitivity check index as well as IR was determined by the homeostasis model assessment.RESULTS: A significant changes (P<0.05) were seen in the level of homeostasis model assessment-IR, E2 and T. Levels of anti-Mullerian hormone, LH, LH/FSH ratio and prolactin were significantly (P<0.01) increased and level of intelectin-1 and E2/T ratio were significantly (P<0.01) decreased, while quantitative insulin sensitivity check index level was not significantly different (P>0.05) between the patients (1°PCOS and 2°PCOS) and control groups. On the other hand, our data reported that FSH level was significantly (P<0.05) lower in obese and higher in non-obese patients with PCOS as compared to control group.CONCLUSION: Levels of intelectin-1 and endocrinological hormones have significantly associated with body mass index, IR and physical activity in patients and normal groups and the strategies that can modulate levels of these parameters would improve metabolic disarrangements in women with PCOS.

Diagnóstico de pubertad precoz / Diagnosis of precocious puberty: clinical guideline for the diagnosis and treatment of precocious puberty

Resumen La Sociedad Mexicana de Endocrinología Pediátrica elaboró una guía de práctica clínica para el diagnóstico y el tratamiento de la pubertad precoz. Este documento presenta recomendaciones relacionadas con el diagnóstico de pubertad precoz. La descripción detallada de la metodología para el desarrollo de esta guía y del sistema de gradación, así como la síntesis de la evidencia en la que se basa, pueden consultarse en este suplemento.

Abstract The Mexican Society of Pediatric Endocrinology developed a clinical practice guide for the diagnosis and treatment of precocious puberty. This document presents recommendations related to the diagnosis of precocious puberty. The detailed description of the methodology for the development of this guide and the grading system, as well as the synthesis of the evidence on which it is based can be accessed in this same supplement.

Therapeutic efficacy of moxibustion plus medicine in the treatment of infertility due to polycystic ovary syndrome and its effect on serum immune inflammatory factors / 针灸推拿医学（英文版）

Objective: To explore the effects and related mechanism of heat-sensitive moxibustion plus clomifene citrate capsules for infertility due to polycystic ovary syndrome (PCOS). Methods: A total of 70 patients were randomized into a control group and an observation group by the random number table method, with 35 cases in each group. The control group was treated with clomifene citrate capsules, while the observation group was treated with heat-sensitive moxibustion on the basis of the medications in the control group. The treatment course lasted for 6 menstrual cycles. The endometrial thickness and ovarian volume of the patients were measured before and after treatment. The levels of serum sex hormones, tumor necrosis factor-α (TNF-α) and nuclear factor-κB (NF-κB) were detected. Follow-up was performed for 1 year after treatment, and the pregnancy rate was recorded. Results: After treatment, the endometrium of the patients in both groups was significantly thickened, the ovarian volume was significantly reduced, and the intra-group differences were statistically significant (all P<0.05). The endometrium thickness and ovarian volume in the observation group were significantly different from those in the control group (both P<0.05). After treatment, the levels of serum testostrn (T) and luteinizing hormone (LH) in both groups decreased significantly, the level of estradiol (E2) increased obviously, and the intra-group differences were statistically significant (all P<0.05). The levels of serum T and LH in the observation group were lower than those in the control group, and the E2 level in the observation group was higher than that in the control group, and the between-group differences were statistically significant (all P<0.05). After treatment, the levels of serum TNF-α and NF-κB of the patients in both groups decreased, and the intra-group differences were statistically significant (all P<0.05). The levels of serum TNF-α and NF-κB in the observation group were significantly lower than those in the control group (both P<0.05). After 1-year follow-up, the pregnancy rate was 20.0％ in the control group, versus 51.5％ in the observation group. The pregnancy rate in the observation group was higher than that in the control group, and the difference was statistically significant (P<0.05). Conclusion: The treatment of heat-sensitive moxibustion plus clomifene citrate capsules can increase the endometrium thickness, reduce the ovarian volume, improve the status of serum sex hormone disorders, and increase the conception rate in patients with infertility due to PCOS, which may be related to the adjustment of the levels of immune inflammatory factors such as serum TNF-α and NF-κB.

Clinical observation on herb-partitioned spreading moxibustion at Baliao points plus climen for diminished ovarian reserve / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of herb-partitioned spreading moxibustion at Baliao points plus climen for diminished ovarian reserve (DOR). Methods: A total of 60 patients with DOR were randomized into a spreading moxibustion group and a Western medicine group by the random number table method, with 30 cases in each group. The Western medicine group was treated with climen, starting from the 5th day of the menstrual cycle for 21 d. The spreading moxibustion group was treated with herb-partitioned spreading moxibustion at Baliao points on the basis of the medication in the Western medicine group, 1 h per time, once a week. The treatment was performed for 1 month as one treatment course in both groups, for 3 courses in total. The serum follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) in the patients were measured before and after treatment. The peak systolic velocity (PSV) and resistance index (RI) were also detected. The traditional Chinese medicine (TCM) symptom score was evaluated. The clinical efficacy was evaluated after treatment. Results: The total effective rate in the spreading moxibustion group was 93.3％, which was significantly higher than 80.0％ in the Western medicine group, and the difference between the groups was statistically significant (P<0.05). After treatment, the TCM symptom scores, the serum FSH levels, FSH/LH ratios and RI in both groups decreased, and the intra-group differences were all statistically significant (all P<0.05). The serum E2 level and PSV increased compared with those in the same group before treatment, and the intra-group differences were statistically significant (all P<0.05). After treatment, the TCM symptom score, the serum FSH level, FSH/LH ratio and RI in the spreading moxibustion group were lower than those in the Western medicine group, while the serum E2 level and PSV were higher than those in the Western medicine group, and the differences between the groups were statistically significant (all P<0.05). Conclusion: Herb-partitioned spreading moxibustion at Baliao points plus climen can produce valid therapeutic efficacy for DOR. It can improve the clinical symptoms, regulate serum hormone levels and increase ovarian blood perfusion, thus improving ovarian reserve function, producing more significant efficacy than climen alone.

Influência das alterações hormonais advindas do climatério nos tecidos bucais / Influence of climacteric hormonal changes on buccal tissues

Durante o climatério, período em que as gônadas femininas cessam sua função, a deficiência de estrógenos, especialmente do estradiol, provoca alterações importantes na cavidade bucal, interferindo em mecanismos inflamatórios, secreção salivar, metabolismo do colágeno, entre outros. Por meio de uma revisão de literatura, esse estudo teve como objetivo, ver a influência das alterações hormonais advindas do período de climatério nos tecidos bucais, proporcionando ao cirurgião dentista informações em relação às consequências e cuidados relacionados a esta fase da vida da mulher. Nesse período, as mulheres tornam-se mais suscetíveis a alterações tais como: osteopenia e osteoporose dos maxilares, hipossalivação, doenças periodontais, entre outros. O tratamento preventivo por meio de remoção de placa, adequação do meio bucal e orientação antes e durante o climatério são os melhores meios de minimizar os problemas bucais advindos dessa fase da vida da mulher.

During the climacteric period, when female gonads cease their function, estrogen deficiency, especially estradiol, causes important changes in the oral cavity, interfering in inflammatory mechanisms, salivary secretion, collagen metabolism, among others. Through a literature review, this study aimed to see the influence of the hormonal changes from the climacteric period in the oral tissues, providing the dentist surgeon with information regarding the consequences and care related to this phase of the woman's life. In this period, women become more susceptible to changes such as: osteopenia and osteoporosis of the jaws, hyposalivation, periodontal diseases, among others. Preventive treatment through removal of plaque, adequacy of the buccal environment and orientation before and during climacteric are the best means of minimizing oral problems arising from this phase of a woman's life.

Hormônios sexuais, moralidades de gênero e contracepção de emergência no Brasil / Sex hormones, gender moralities and emergency contraception in Brazil / Hormonas sexuales, moralidades de género y contracepción de emergencia en Brasil

Propõe-se discutir juízos sociais distintos sobre o crescente uso de hormônios sexuais, para fins contraceptivos ou não, prática cada vez mais abrangente no contexto internacional e no Brasil. Há uma expansão vertiginosa de indicações clínicas para uso de hormônios sexuais em diferentes circunstâncias da vida (como envelhecimento, embelezamento, melhoria de performance sexual e física), sendo tais inovações tecnológicas propagadas com entusiasmo pela mídia. Paradoxalmente, convive-se com certa reserva ao uso da contracepção de emergência pelas jovens mulheres. A despeito da popularização do conhecimento científico sobre hormônios sexuais como fontes de aprimoramento humano, a difusão e uso da contracepção de emergência, aprovados há vinte anos no Brasil, com indicações clínicas precisas, continuam marginais e sofrendo restrições, em um país no qual o aborto segue interditado às mulheres. A hipótese considera uma perspectiva de gênero que subjuga o exercício da sexualidade feminina a determinados padrões morais vigentes.(AU)

The aim of the present study is to discuss different social judgments about the growing use of sex hormones, a practice that is increasingly common in Brazil and worldwide. There has been a rapid expansion of clinical indications for the use of sex hormones in different circumstances, such as aging, beauty purposes and improvement of physical and sexual performance. These technological innovations are disseminated by the media enthusiastically. Paradoxically, there is some reserve regarding the use of emergency contraception by young women. Despite the popularization of scientific knowledge of sex hormones as a tool to improve some physical human aspects, the diffusion and use of emergency contraception, which was approved twenty years ago with precise clinical indications, remain marginal and restricted, in a country where abortion is still unavailable to women. The study hypothesis considers a gender perspective that subjugates the exercise of women's sexuality to specific prevailing standards.(AU)

Se propone discutir juicios sociales distintos sobre le creciente uso de hormonas sexuales, para fines contraceptivos o no, práctica cada vez más incluyente en el contexto internacional y en Brasil. Hay una expansión vertiginosa de indicaciones clínicas para la utilización de hormonas sexuales en diferentes circunstancias de la vida (tales como envejecimiento, embellecimiento, mejora del desempeño sexual y físico), siendo tales innovaciones tecnológicas propagadas con entusiasmo por los medios. Paradojalmente, se convive con cierta reserva al uso de la contracepción de emergencia por parte de las mujeres jóvenes. A pesar de popularización del conocimiento científico sobre hormonas sexuales como fuentes de perfeccionamiento humano, la difusión y el uso de la contracepción de emergencia, aprobados desde hace veinte años en Brasil, con indicaciones clínicas precisas, continúan marginalizados y sufriendo restricciones en un país en el cual el aborto sigue siendo prohibido para las mujeres. La hipótesis considera una perspectiva de género que subyuga el ejercicio de la sexualidad femenina a determinados estándares morales vigentes.(AU)

The role of sex hormones on ion channels of drug-induced long QT syndromes / 天津医药

Female gender is an independent risk factor for the development of torsade de pointes (TdP) arrhythmias not only in congenital long QT syndromes(LQTs)but also in acquired long QT syndromes. Clinical evidences imply that sex steroid hormones appear to play important roles in gender differences by affecting the cardiac repolarization process of action potential. This review summarizes the effects of sex hormones on cardiac ion channel currents and the effects of gender differences on drug-induced long QT syndromes, and reveals the mechanism of sex hormone induced arrhythmia by computer simulation

The value of serum anti-Müllerian hormone combined with sex hormones for polycystic ovary syndrome diagnosis / 中华检验医学杂志

Objective To investigate the diagnostic value of serum anti-Müllerian hormone combined with sex hormones for polycystic ovary syndrome ( PCOS).Methods The serum levels of anti-Müllerian hormone ( AMH), testosterone ( T), luteinizing hormone ( LH), follicle-stimulating hormone (FSH) and the estradiol ( E2) were measured by electrochemiluminescence method in 82 patients with PCOS and 60 controls. The sensitivities, specificities and the areas under the receiver operating characteristic curves ( ROC-AUC) of the indicators and their combination for diagnosis of PCOS were compared by chi-square test and Z test separately.The correlations of serum AMH levels with age and sex hormones levels were analyzed separately by Spearman correlation analysis .Results The levels of serum AMH, T, LH and LH/FSH ratio in patients with PCOS were obviously higher than those in controls (62.19 pmol/L vs 27.63 pmol/L, 1.39 nmol/L vs 0.88 nmol/L, 12.72 IU/L vs 6.44 IU/L, 2.17 vs 1.17, U＝592.00, 1 096.00, 1 233.50, 1 134.00, all P＜0.01).The sensitivity of AMH (80.5%, 66/82) for diagnosis of PCOS was higher than that of LH (62.2%, 51/82) and LH/FSH ratio (54.9%, 45/82, χ2＝5.6, 13.79, all P＜0.05), but no significant difference was found when comparing with T (72%, 59/82, χ2＝1.71, P＞0.05 ) .The sensitivity of AMH ( 80.5%, 66/82 ) increased when combined with T (89.0%, 73/82), LH (87.8%, 72/82) and T+LH (95.10%, 78/82, χ2＝5.14, 4.17, 10.08, all P＜0.05), but no significant change by the combination of AMH +LH/FSH (85.4%, 70/82, χ2＝2.25, P＞0.05) .The specificity of AMH (80%, 48/60) for diagnosis of PCOS was no significant difference compared with that of T (71.7%, 43/60), LH (85%, 51/60), and LH/FSH ratio (91.7%, 55/60) (χ2＝3.20, 0.36, 2.77, all P＞0.05) .Also no increase when combined with T (71.7%, 43/60), LH (73.3%, 44/60), LH/FSH (75%, 45/60) and T +LH (66.7%, 40/60, χ2＝3.20, 2.25, 1.33, 3.38, all P＞0.05).The ROC-AUC of multiple indicators for diagnosis of PCOS were compared , AMH (0.880) was higher than T, LH and LH/FSH ratio (0.778, 0.760, 0.778, Z＝2.12, 2.46, 2.12, all P＜0.05), but no significant differences were found comparing with AMH and the combination of AMH +T, AMH+LH, AMH+LH/FSH and AMH+T+LH (0.892, 0.897, 0.898, 0.902, Z＝0.31, 0.45, 0.48, 0.59, all P＞0.05).Serum AMH levels were positively correlated with T , LH levels and LH/FSH ratio (r＝0.258, 0.241, 0.290, all P＜0.05), but not correlated with age in PCOS group (r＝-0.178, P＞0.05).In the control group, AMH levels had no correlations with T, LH levels and LH/FSH ratio (r＝0.025, 0.104, 0.111, P＞0.05), while negatively correlated with age (r＝-0.307, P＜0.05).The cutoff value of AMH for diagnosis of PCOS decreased with age .Conclusions The sensitivity of AMH for diagnosis of PCOS was higher than that of LH and LH /FSH ratio, and the sensitivity could be further improved by the combination with T or /and LH without reducing the specificity .Age-stratified cut-off values of AMH were better for accurate diagnosis of PCOS.

Association between asthma and female sex hormones / Associação entre asma e hormônios sexuais femininos

ABSTRACT CONTEXT AND OBJECTIVE: The relationship between sex hormones and asthma has been evaluated in several studies. The aim of this review article was to investigate the association between asthma and female sex hormones, under different conditions (premenstrual asthma, use of oral contraceptives, menopause, hormone replacement therapy and pregnancy). DESIGN AND SETTING: Narrative review of the medical literature, Universidade Federal do Tocantins (UFT) and Universidade Federal de São Paulo (Unifesp). METHODS: We searched the CAPES journal portal, a Brazilian platform that provides access to articles in the MEDLINE, PubMed, SciELO, and LILACS databases. The following keywords were used based on Medical Subject Headings: asthma, sex hormones, women and use of oral contraceptives. RESULTS: The associations between sex hormones and asthma remain obscure. In adults, asthma is more common in women than in men. In addition, mortality due to asthma is significantly higher among females. The immune system is influenced by sex hormones: either because progesterone stimulates progesterone-induced blocking factor and Th2 cytokines or because contraceptives derived from progesterone and estrogen stimulate the transcription factor GATA-3. CONCLUSIONS: The associations between asthma and female sex hormones remain obscure. We speculate that estrogen fluctuations are responsible for asthma exacerbations that occur in women. Because of the anti-inflammatory action of estrogen, it decreases TNF-α production, interferon-γ expression and NK cell activity. We suggest that further studies that highlight the underlying physiopathological mechanisms contributing towards these interactions should be conducted.

RESUMO CONTEXTO E OBJETIVO: A relação entre os hormônios sexuais e a asma tem sido investigada em diversos estudos. Esta revisão tem como objetivo descrever a relação entre hormônios sexuais (endógenos e exógenos) e a inflamação nas vias aéreas, especialmente na asma, em eventos diferentes (na asma pré-menstrual, durante o uso de anticoncepcionais, na menopausa, no uso de terapia hormonal e na gestação). TIPO DE ESTUDO E LOCAL: Revisão narrativa da literatura médica, Universidade Federal do Tocantins (UFT) e Universidade Federal de São Paulo (Unifesp). MÉTODO: Pesquisamos o Portal de Periódicos Capes, uma plataforma brasileira que fornece acesso a artigos nas bases de dados MEDLINE, PubMed, SciELO e LILACS. Os descritores utilizados foram asma, hormônios sexuais, mulheres e uso de anticoncepcionais, com base no "Medical Subject Headings". RESULTADOS: As associações entre hormônios sexuais e asma ainda permanecem obscuras. Em adultos, a asma é mais frequente em mulheres do que em homens. Além disso, a mortalidade por asma é significativamente maior no sexo feminino, destacando-se que o sistema imunológico sofre influência de hormônios sexuais, seja porque a progesterona estimula o fator bloqueador induzido pela progesterona e citocinas Th2 ou porque contraceptivos derivados de progesterona e estrógeno estimulam o fator de transcrição GATA-3. CONCLUSÕES: A associação entre asma e hormônios sexuais femininos permanece obscura. Nós especulamos que as flutuações do estrogênio são responsáveis pelas exacerbações da asma que ocorrem nas mulheres. Devido à ação anti-inflamatória do estrogênio há redução da produção de TNF-α, da expressão do interferon-γ e da atividade das células NK. Sugerimos que sejam realizados novos estudos para esclarecer os mecanismos fisiopatológicos dessas interações.

Clinical monitoring of serum sex hormones during normal menstrual follicle growth cycle / 中华检验医学杂志

Objective To study the changes of six sex hormones corresponding to the follicle growth during the normal menstrual cycle of Chinese women.Methods Thirty Chinese women with regular menstrual period and average age of (28.8±3.2) years were selected for the study by Peking Union Medical College Hospital in September,2010.Growth of follicles was monitored by using transvaginal sonography.Six sex hormones,including follicle-stimulating hormone (FSH),luteinizing hormone (LH),estradiol (E2),progesterone (P),testosterone (T),and prolactin (PRL) were measured by chemoluminescence immunoassay every day during a menstrual cycle.Nonparametric statistical analysis was used.ResultsMenstrual cycle of all the patients was in the range of 25 to 39 d,with mean of (29.5 ± 3.1) d.Length of follicular phase and luteal phase was 15.3 and 14.4 d,respectively.Number of days from antral follicle to emergence of dominant follicle,and from the latter to ovulation,was 6.2 and 8.9 d,respectively.Average diameter of preovulatory follicle was 19.33 mm.Both FSH and LH reached peak on the day before ovulation.P started to increase before ovulation and remained at a high plateau from 6th to 9th day after ovulation.Both PRL and T reached peak after ovulation,near the end of a menstrual cycle.Conclusions A small rise of LH and P emerges just 1 to 2 d before ovulation,indicating the maturing of follicle.PRL and T shows cyclic changes as follicle grows.Therefore,PRL and T levels should be measured in the early follicle phases in the clinical practice so that leading the impact of menstrual cycle minimal.

Impact of body mass index, age and varicocele on reproductive hormone profile from elderly men

ABSTRACT Objectives: To study the impact of obesity, age and varicocele on sexual hormones fof adult and elderly men. Materials and Methods: 875 men who were screened for prostate cancer were enrolled in this study. Data recorded comprised age, body mass index (BMI), serum levels of total testosterone (TT), free testosterone (FT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH) and follicular stimulating hormone (FSH). Patients were divided in groups according to their BMI in underweight, normal weight, overweight and obese grades 1, 2 or 3. First, it was studied the association between age, BMI, and hormone profile. Then, clinical varicocele was evaluated in 298 patients to assess its correlation to the others parameters. Results: Obese patients had lower levels of TT, FT and SHBG (p<0.001) compared to underweight or normal weight patients. There were no differences in age (p=0.113), FSH serum levels (p=0.863) and LH serum levels (p=0.218) between obese and non-obese patients. Obese grade 3 had lower levels of TT and FT compared to obese grade 1 and 2 (p<0.05). There was no difference in the SHBG levels (p=0.120) among obese patients. There was no association between varicocele and BMI; and varicocele did not impact on testosterone or SHBG levels. Conclusions: Men with higher BMI have a lower serum level of TT, FT and SHBG. The presence of clinical varicocele as well as its grade has no impact on hormone profile in elderly men.

Changes of sex hormone level in perinatal depression in different perinatal periods / 中华围产医学杂志

Objective To study the correlation between the changes of sex hormone level in different perinatal periods and perinatal depression (PND). Methods Between February 2014 and February 2015, 300 pregnant women from the Third Affiliated Hospital of Guangzhou Medical University were enrolled in this study. In the first trimester (12 weeks), the third trimester (34 weeks) and postpartum period (7 and 42 days), blood samples were collected and radioimmunoassay was performed to detect the levels of sex hormones, including estrogen, progesterone, prolactin, luteinizing hormone and follicle-stimulating hormone. Self Depression Scale and Edinburgh Postnatal Depression Scale were used for psychological assessment, and PND was diagnosed by psychiatrists as PND group, and non-PND cases served as control group. Two-sample t-test, variance analysis and Bonferroni test were used to compare the changes of sex hormones at different time points between the two groups. Results A total of 180 pregnant women completed the four stages of research. Fifity-four cases were diagnosed as PND, including 10 cases in the first trimester, 16 new cases in the third trimester, 14 new cases at postpartum 7 days, and 14 new cases at postpartum 42 days. (1) Comparison of the sex hormone levels between the two groups:The estrogen levels of the first trimester, the third trimester and postpartum 7 and 42 days in PND group were (4 107.30±344.68), (13 261.60±593.32), (1 281.70±151.54) and (161.40±12.21) pmol/L, and lower than in the control group [(8 619.60±514.92), (14 330.00±353.15), (3 585.90±150.83) and (270.50±11.86) pmol/L, respectively] (all P<0.05). The progesterone levels of the first trimester and postpartum 7 and 42 days in PND group were (105.49±20.40), (24.23±3.53) and (6.40±3.53) nmol/L, and higher than those in the control group [(85.80±19.06), (5.71±2.36) and (3.87±2.03) nmol/L] (t=-2.389, -2.660 and -2.103, all P<0.05). The prolactin and luteinizing hormone levels of the postpartum 42 days in PND group were lower than in the control group [(9.40±1.69) vs (17.50±1.64)μg/L, t=-4.059;(0.32±0.21) vs (2.21±0.17) mU/L, t=-12.302] (both P<0.05). The levels of follicle-stimulating hormone in the first trimester, the third trimester and postpartum 7 days were not detectable in both groups, but PND group had a lower level at postpartum 42 days than the control group [(2.22±0.58) vs (3.15±0.29) mU/L, t=-15.525, P=0.000]. (2) Sex hormone levels at different time points:There were significant differences in estrogen levels between the four time points in both groups. There was significant difference in progesterone in the PND group at four time points, while in the control group, significant differences were found between postpartum 42 days and the first and third trimester. Prolactin levels were lowest at postpartum 42 days in both groups among the four time points (Bonferroni test, all P<0.05). Conclusions Low estrogen levels and high progesterone levels and their changes in perinatal period may be correlated with PND.

Detection of sex hormone levels in children with hypospadias / 中国医师杂志

Objective To investigate the differences in sex hormone levels between hypospadias and circumcision groups.Methods Fifty cases of circumcision and 137 cases of hypospadias the dihydmtestosterone (DHT) value was tested with radioimmunoassay,and testosterone was tested with lightimmunoassay.Results DHT value was (64.51 ±32.10)pg/ml in circumcision group,and (46.72 ±28.94)pg/ml in hypospadias group (P ＜0.05).DHT value in hypospadias type Ⅰ,Ⅱ,Ⅲ,and Ⅳ were (50.20 ±32.90)pg/ml,(46.63 ±25.67)pg/rnl,(51.60 ±32.16)pg/ral,and (39.02 ±26.32)pg/ml,respectively (P =0.29).The differences between circumcision and hypospadias groups were statistically significant (P =0.00).Luteinizing hormone (LH) and testosterone (T) in children with hypospadias were significantly lower than those in children in the circumcision group (P ＜ 0.05).No statistically significant difference was found between two groups in follicle-stimulating hormone (FSH),estradiol (F2),and prolactin (PRL) (P ＞ 0.05).No statistically significant differences were found in FSH among all types of hypospadias (P ＞ 0.05).Conclusions Inadequate secretion of T or activity insufficiency and functional deficiency of 5 alpha reductase (SRD5A) are likely found in children with hypospadia.Inadequate secretion and low T value might be found in LH-T shaft in children with hypospadia.The normal T value in some children with hypospadia does not show that androgens produced during pregnancy are normal.

Analysis of the current status of the prevalence and its relative factors of non-alcoholic fatty liver disease in urban community in Ningxia province / 中华老年医学杂志

Objective To investigate the current status of prevalence and its relative factors of non-alcoholic fatty liver disease (NAFLD) in the elderly in urban community in Ningxia province and to compare the differences in prevalence of NAFLD between Han and Hui ethnicities.Methods 1046 residents aged 55 years and over from five communities were selected.Questionnaire survey and clinical examination were conducted in all subjects.Fasting vein blood samples were collected.The serum total cholesterol,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol were detected.Results There were 1043 subjects with average age of (66.41 6.65) years finishing the whole examination,including 696 (66.7％) Han and 347 (33.3％) Hui people.The total prevalence of NAFLD was 27.0％ (286/1043),and there was a significant difference in the prevalence [23.4％ (94 cases) vs.29.9％ (192 cases),x2 =5.18,P=0.023]between male and female,but no difference between Han and Hui ethnicities [28.2％ (98 cases) vs.27.0％ (188 cases) x2 =0.17,P=0.675].Logistic regression showed that age(OR=0.96,95％ CI:0.94-0.99),BMI(OR=1.31,95％ CI:1.24-1.38),TG(OR=1.71,95％ CI:1.47-1.98),central obesity (CO)(OR=5.20,95％CI:2.21-12.23) were the factors correlating with NAFLD.Conclusions The prevalence of NAFLD in Hui elderly people was is similar to that in Han elderly people.The elderly people with overweight,central obesity and high serum level of triglyceride and high level TG have higher risk for NAFLD.

Correlation between sex hormone level in serum and expressed prostatic secretion with erectile function in patients with type Ⅲ prostatitis / 重庆医学

Objective To explore the correlation between the levels of estradiol E2 and testosterone T in serum and expressed prostatic secretion(EPS) with the erectile function in the patients with type Ⅲ prostatitis(CP/CPPS) .Methods The E2 and T lev‐els in serum and EPS from 64 cases of CP/CPPS ,including 35 cases of type Ⅲ A and 29 cases of Ⅲ B ,and 20 individuals of physical examination were detected by using the radioimmunoassay .All cases were evaluated by the scores of NIH‐CPSI and the Internation‐al Index of Erectile Function 5(IIEF‐5) .64 patients were grouped according to the IIEF‐5 scores ,the erectile dysfunction(ED) group(32 cases) and the non‐ED group(32 cases) .Results The mean E2/T levels in serum and EPS of the Ⅲ A group and the Ⅲ B group were higher than those in the control group ,the difference had statistical significance(P0 .05 .There was a positive correlation between the IIEF‐5 score and the T level in serum and EPS in the CP/CPPS group(r=0 .218 ,r=0 .231 ,P0 .05) .The serum T level in the ED group was (6 .32 ± 1 .86)ng/mL ,which was lower than(7 .89 ± 2 .92)ng/mL in the non‐ED group and (8 .41 ± 2 .02)ng/mL in the control group ;the .E2/T level in EPS in the ED group was (55 .02 ± 29 .26) ,which was higher than (14 .06 ± 9 .36) in the non‐ED group and (16 .45 ± 13 .76) in the control group ,the differences among them were statistically significant (P<0 .05) .Con‐clusion The imbalance degree of hormone estradiol and testosterone in serum and EPS is related with erectile function in the pa‐tients with CP/CPPS .