Increased ROS production and DNA damage in monocytes are biomarkers of aging and atherosclerosis

BACKGROUND: New evidence demonstrates that aging and dyslipidemia are closely associated with oxidative stress, DNA damage and apoptosis in some cells and extravascular tissues. However, in monocytes, which are naturally involved in progression and/or resolution of plaque in atherosclerosis, this concurrence has not yet been fully investigated. In this study, we evaluated the influence of aging and hypercholesterolemia on serum pro-inflammatory cytokines, oxidative stress, DNA damage and apoptosis in monocytes from apolipoprotein E-deficient (apoE-/-) mice compared with age-matched wild-type C57BL/6 (WT) mice. Experiments were performed in young (2-months) and in old (18-months) male wild-type (WT) and apoE-/- mice. RESULTS: Besides the expected differences in serum lipid profile and plaque formation, we observed that atherosclerotic mice exhibited a significant increase in monocytosis and in serum levels of pro-inflammatory cytokines compared to WT mice. Moreover, it was observed that the overproduction of ROS, led to an increased DNA fragmentation and, consequently, apoptosis in monocytes from normocholesterolemic old mice, which was aggravated in age-matched atherosclerotic mice. CONCLUSIONS: In this study, we demonstrate that a pro-inflammatory systemic status is associated with an impairment of functionality of monocytes during aging and that these parameters are fundamental extra-arterial contributors to the aggravation of atherosclerosis. The present data open new avenues for the development of future strategies with the purpose of treating atherosclerosis.

Does low serum TSH within the normal range have negative impact on physical exercise capacity and quality of life of healthy elderly people?

Objective Investigate the differences in cardiopulmonary (CP) capacity and Quality of Life (QOL) between healthy elderly (≥ 65 years) with different TSH levels (< 1.0 and ≥ 1.0 μIU/mL) both within the normal range. Also, evaluate the effects of TSH elevation on CP test and QOL, by administering methimazole to subjects with initial lower-normal TSH, in order to elevate it to superior-normal limit. Materials and methods Initially, a cross-sectional study was performed to compare CP capacity at peak exercise and QOL (using WHOQOL-OLD questionnaire) between healthy seniors (age ≥ 65 years) with TSH < 1.0 μIU/mL vs. TSH ≥1.0 μIU/mL. In the second phase, participants with TSH < 1.0 μIU/mL were included in a non-controlled-prospective-interventional study to investigate the effect of TSH elevation, using methimazole, on QOL and CP capacity at peak exercise. Results From 89 elderly evaluated, 75 had TSH ≥ 1 μIU/mL and 14 TSH < 1 μIU/mL. The two groups had similar basal clinical characteristics. No difference in WHOQOL-OLD scores was observed between groups and they did not differ in terms of CP function at peak exercise. QOL and CP variables were not correlated with TSH levels. Twelve of 14 participants with TSH < 1.0 μIU/mL entered in the prospective study. After one year, no significant differences in clinical caracteristics, QOL, and CP variables were detected in paired analysis before and after methimazole intervention. Conclusions We found no differences in CP capacity and QOL between health elderly with different TSH levels within normal range and no impact after one year of methimazole treatment. More prospective-controlled-randomized studies are necessary to confirm or not the possible harm effect in normal low TSH.

Association between increased serum thyrotropin concentration and the oldest old: what do we know? / Associação entre aumento da concentração de tirotropina e longevos: o que sabemos?

To assess studies that evaluate the relation between serum thyrotropin concentration, very old subjects, and their events. We searched the PubMed, SciELO, and LILACS databases for articles published between 2004 and 2012. Our search was restricted to studies involving humans aged 65 years or older, and written in English, Spanish, or Portuguese. Studies that evaluated the association between elevated serum thyrotropin concentration among elderly subjects with subclinical hypothyroidism were chosen since at least in part they included a subpopulation of individuals aged 80 years and above. Thirteen studies were selected. No significant increase in risk of cardiovascular events, coronary heart disease, or total mortality was observed. Elevated thyrotropin concentration was associated with longevity. More randomized controlled trials are required to better define the potential benefits of elevated thyrotropin concentration in this oldest old population, hormone replacement, and longevity.

Avaliar os artigos que consideram a relação entre a concentração da tirotropina sérica, indivíduos muito idosos e seus eventos. Foram selecionados artigos do PubMed, SciELO e LILACS publicados entre 2004 e 2012, que consideraram uma população ≥65 anos, escritos em inglês, espanhol ou português. Os estudos que avaliaram a associação entre níveis séricos elevados de tirotropina sérica e idosos com hipotireoidismo subclínico foram escolhidos, desde que incluíssem uma subpopulação com 80 anos ou mais. Treze estudos foram selecionados. Não houve associação significante entre maior risco de eventos cardiovasculares, doença coronariana ou mortalidade. A concentração elevada de tirotropina sérica foi associada à longevidade. Mais estudos randomizados controlados são necessários para o melhor entendimento do potencial benefício da elevação de concentração da tirotropina sérica nos longevos, reposição hormonal e longevidade.

Degeneración quística de la arteria poplítea: Presentación de caso clínico / Cystic degeneration of the popliteal artery: Report of one case

Cystic degeneration of the popliteal artery is an uncommon cause of intermittent claudication. We report a 52 years old male consulting for intermittent claudication referred to the calf. The angiography showed a 93% stenosis in segment of 45 mm length of the left popliteal artery with a smooth surface, suggesting an extrinsic compression. A CT angiography of the lower limb suggested the presence of a cystic degeneration. The patient was operated and the middle third of the popliteal artery was excised. The pathological study of the surgical piece was informed as artery media cystic degeneration.

Control of diabetes and fibrinogen levels as well as improvement in health care might delay low cognitive performance in societies aging progressively / Controle do diabetes e dos níveis de fibrinogênio, bem como melhora no cuidado com a saúde, podem retardar o baixo desempenho cognitivo em sociedades que apresentam envelhecimento progressivo

Objective To know the prevalence and factors associated to low cognitive performance in a representative sample of the adult population in a society aging progressively. Method Cross-sectional population-based study carried out in a three-stage sampling: 81 census tracts (primary sampling unity) were randomly selected, followed by 1,672 households and 2,471 participants (weighted sample) corresponding to the second and third stages, respectively. The outcome prevalence was calculated according sociodemographic, behavioral and health related variables. Crude and adjusted prevalence ratios were estimated using Poisson regression. Results The prevalence of low cognitive performance was high, mainly among females, and indicated linear trends into categories of age, schooling, income, plasma fibrinogen and self-reported health status. In multivariate models, gender, diabetes, fibrinogen and self-reported health status presented positive associations, while schooling, employment and sitting time presented negative associations with the outcome. Conclusion Interventions related to diabetes and fibrinogen levels control as well as improvement in health care might delay low cognitive performance in societies aging progressively as such the study population. .

Objetivo Estimar a prevalência e os fatores associados ao baixo desempenho cognitivo em amostra representativa de adultos pertencentes a uma população com envelhecimento progressivo. Método Estudo transversal, de base populacional, conduzido em amostra selecionada em três estágios: 81 setores censitários (unidade primária de amostragem) foram selecionados aleatoriamente, seguidos por 1.672 domicílios e 2.471 participantes (amostra ponderada), correspondendo ao segundo e terceiro estágios, respectivamente. A prevalência do desfecho foi calculada segundo fatores sociodemográficos, comportamentais e relacionados à saúde. Razões de prevalência brutas e ajustadas foram estimadas pela regressão de Poisson. Resultados A prevalência de baixo desempenho cognitivo foi elevada, principalmente nas mulheres, indicando gradiente linear em relação à idade, à escolaridade, à renda, aos níveis de fibrinogênio e à saúde autorreferida. Nos modelos multivariados, sexo, diabetes, fibrinogênio e saúde autorreferida apresentaram associações positivas, enquanto escolaridade, trabalho e tempo sentado apresentaram associações negativas com o desfecho. Conclusão ...

Correlation between the Serum Luteinizing Hormone to Folliclestimulating Hormone Ratio and the Anti-Mullerian Hormone Levels in Normo-ovulatory Women

Serum anti-Mullerian hormone (AMH) levels are regarded as an age-specific marker for predicting the ovarian reserve in women of reproductive age. Some studies have shown that the luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio can be used as a predictor of ovarian reserve. The purpose of this study was to assess the variation of LH/FSH ratio with aging and to evaluate the correlation between serum LH/FSH ratio and AMH levels as a predictor of the ovarian reserve in normo-ovulatory women. We retrospectively analyzed the day 3 serum hormone levels in 1,251 patients (age range: 20-50 yr) between January 2010 and January 2011. We divided the patients into 6 groups according to their age. Relation between serum AMH level and LH/FSH ratio was analyzed statistically. The serum AMH level was inversely correlated with age (r = -0.400, P < 0.001). A significant negative correlation was found between serum LH/FSH ratio and age (r = -0.213, P < 0.001). There was a significant partial correlation between serum LH/FSH ratio and AMH level when adjusted by age (r = 0.348, P < 0.001). The LH/FSH ratio could be considered as a useful marker for the ovarian reserve and could be applied to the clinical evaluation with AMH.

Correlation between the Serum Luteinizing Hormone to Folliclestimulating Hormone Ratio and the Anti-Mullerian Hormone Levels in Normo-ovulatory Women

Serum anti-Mullerian hormone (AMH) levels are regarded as an age-specific marker for predicting the ovarian reserve in women of reproductive age. Some studies have shown that the luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio can be used as a predictor of ovarian reserve. The purpose of this study was to assess the variation of LH/FSH ratio with aging and to evaluate the correlation between serum LH/FSH ratio and AMH levels as a predictor of the ovarian reserve in normo-ovulatory women. We retrospectively analyzed the day 3 serum hormone levels in 1,251 patients (age range: 20-50 yr) between January 2010 and January 2011. We divided the patients into 6 groups according to their age. Relation between serum AMH level and LH/FSH ratio was analyzed statistically. The serum AMH level was inversely correlated with age (r = -0.400, P < 0.001). A significant negative correlation was found between serum LH/FSH ratio and age (r = -0.213, P < 0.001). There was a significant partial correlation between serum LH/FSH ratio and AMH level when adjusted by age (r = 0.348, P < 0.001). The LH/FSH ratio could be considered as a useful marker for the ovarian reserve and could be applied to the clinical evaluation with AMH.

Is There an Association Between Serum Prostate-Specific Antigen Values and Serum Testosterone Levels in Healthy Men?

PURPOSE: To evaluate the relationship between levels of total testosterone and total prostate-specific antigen (PSA) in healthy men with PSA or =50 years. RESULTS: In all patients, the mean values for serum PSA and total testosterone were 1.27+/-0.88 ng/mL and 404.04+/-158.86 ng/mL, respectively. No correlation was detected between serum PSA and testosterone levels in either subgroup (group I, r=0.072, p=0.363; group II, r=0.031, p=0.900) or in patients aged or =50 years and in patients aged <50 years were 417.01+/-163.35 and 344.16+/-120.21 ng/dL, respectively (p=0.02). CONCLUSIONS: No impact of testosterone was found on the PSA level in healthy men with PSA <4 ng/mL. Therefore, a high serum testosterone level may not mandate adjustment of PSA values. This serum sex hormone showed a significant increment after the age of 50 years. Further studies including a larger number of patients should be carried out to confirm these findings.

Anemia e nível de hemoglobina como fatores prognósticos da mortalidade entre idosos residentes na comunidade: evidências da Coorte de Idosos de Bambuí, Minas Gerais, Brasil / Anemia and hemoglobin level as prognostic factors of mortality in community-dwelling elderly: evidence from the Bambuí Cohort Study on Aging, Minas Gerais State, Brazil / Anemia y nivel de hemoglobina como factores pronósticos de la mortalidad entre ancianos residentes en la comunidad: Cohorte de Ancianos de Bambuí, Minas Gerais, Brasil

O objetivo deste trabalho foi examinar a influência de baixos níveis de hemoglobina (Hb) e anemia na mortalidade entre idosos ao longo de dez anos de seguimento (1997 a 2007). Entre os 1.742 idosos participantes da linha de base da coorte de Bambuí, Minas Gerais, Brasil, 1.322 (82,3%) foram acompanhados pelo tempo médio de 8,9 anos. A probabilidade de sobrevida foi estimada pelo método de Kaplan-Meier e o modelo de riscos proporcionais de Cox foi utilizado, estimando-se os hazard ratios (HR) e intervalos de 95% de confiança (IC95%), considerando-se os potenciais fatores de confusão. Idosos anêmicos e com baixos níveis de Hb (primeiro tercil) apresentaram maior risco de óbito (HR = 2,63; IC95%: 1,83-3,76 e HR = 1,38; IC95%: 1,07-1,79, respectivamente) comparados aos não anêmicos e aos de maior nível de Hb. Os resultados demonstram que a ocorrência de anemia e/ou baixos níveis de Hb (independente do diagnóstico de anemia) devem ser interpretados e tratados como determinante independente da mortalidade nessa população idosa.

The aim of this study was to examine the influence of low hemoglobin (Hb) and anemia on mortality in the elderly in a ten-year follow-up (1997-2007). Among the 1,742 elderly participants in the baseline cohort from Bambuí, Minas Gerais State, Brazil, 1,322 (82.3%) were followed for an average of 8.9 years. Probability of survival was estimated by Kaplan-Meier and Cox's proportional hazard ratios (HR), and confidence intervals (95%CI) were used, considering potential confounders. Anemia and low Hb (lowest tertile) were associated with increased risk of death (HR = 2.63, 95%CI: 1.83-3.76 and HR = 1.38, 95%CI: 1.07-1.79, respectively). The results show that anemia or low Hb (regardless of a diagnosis of anemia) should be interpreted and managed as independent determinants of mortality in this elderly population.

El objetivo de este trabajo fue evaluar la influencia de los bajos niveles de hemoglobina (Hb) y anemia sobre la mortalidad de ancianos a lo largo de diez años (1997-2007). De los 1.742 ancianos participantes de la cohorte de Bambuí, Minas Gerais, Brasil, a 1.322 (82,3%) se les realizó un seguimiento promedio de 8,9 años. Se utilizó el método de Kaplan-Meier para estimar la probabilidad de supervivencia y el modelo de riesgos proporcionales de Cox para poder realizar una estimación del cociente de riesgo - hazard ratios (HR) - con intervalos de confianza de un 95%. Asimismo, fueron considerados factores potenciales de confusión. Ancianos anémicos y con niveles bajos de Hb (primer tercil) presentaron un riesgo superior de morir (HR = 2,63; IC95%: 1,83 a 3,76 y HR = 1,38; IC95%: 1,07 a 1,79, respectivamente), en comparación con los individuos no anémicos y con los que presentaron niveles superiores de Hb. Los resultados indican que la ocurrencia de anemia y/o bajos niveles de Hb (independiente del diagnóstico) se debe interpretar y manejar como factores determinantes independientes de la mortalidad entre una determinada población geriátrica..

Proteomic data show an increase in autoantibodies and alpha-fetoprotein and a decrease in apolipoprotein A-II with time in sera from senescence-accelerated mice

We evaluated changes in levels by comparing serum proteins in senescence-accelerated mouse-prone 8 (SAMP8) mice at 2, 6, 12, and 15 months of age (SAMP8-2 m, -6 m, -12 m, -15 m) to age-matched SAM-resistant 1 (SAMR1) mice. Mice were sacrificed, and blood was analyzed by 2-dimensional electrophoresis combined with mass spectrometry. Five protein spots were present in all SAMP8 serum samples, but only appeared in SAMR1 samples at 15 months of age except for spot 3, which also showed a slight expression in SAMR1-12 m sera. Two proteins decreased in the sera from SAMP8-2 m, -6 m, and -12 m mice, and divided into 2 spots each in SAMP8-15 m sera. Thus, the total number of altered spots in SAMP8 sera was 7; of these, 4 were identified as Ig kappa chain V region (M-T413), chain A of an activity suppressing Fab fragment to cytochrome P450 aromatase (32C2_A), alpha-fetoprotein, and apolipoprotein A-II. M-T413 is a monoclonal CD4 antibody, which inhibits T cell proliferation. We found that M-T413 RNA level was significantly enhanced in splenocytes from SAMP8-2 m mice. This agreed with serum M-T413 protein alterations and a strikingly lower blood CD4+ T cell count in SAMP8 mice when compared to the age-matched SAMR1 mice, with the latter negatively correlating with serum M-T413 protein volume. Age-related changes in serum proteins favored an increase in autoantibodies and alpha-fetoprotein and a decrease of apolipoprotein A-II, which occurred in SAMP8 mice at 2 months of age and onwards. These proteins may serve as candidate biomarkers for early aging.

Age estimation using content of sjTREC in human peripheral blood / 法医学杂志

OBJECTIVE@#To determine and verify the correlation formula of age estimation using the content of signal joint T-cell receptor excision DNA circle (sjTREC) in human peripheral blood and to discuss its application value in forensic biological practice.@*METHODS@#The samples of peripheral blood stains were collected from 30 healthy unrelated individuals whose ages were known. The DNAs were extracted from the samples stored at room temperature after 4 weeks. The content of sjTREC was measured by real-time fluorescent quantitative PCR technique, and the TATA box binding protein (TBP) was selected as reference genes. The age of each sample was predicted with the formula which was Age = -7.181 5 Y-42.458 +/- 9.42 (Y = dCtTBP-sjTREC), and the result was compared with the real age of each individual to determine the accuracy of the formula.@*RESULTS@#sjTREC and TBP gene were detectable in all 30 samples of peripheral blood. The contents of sjTREC in human peripheral blood showed a decreasing tendency with aging. The accuracy rate for the age estimation by this method was 76.67%.@*CONCLUSION@#The method for the age estimation with the content of sjTREC was simple, fast, sensitive, and good species specific with important potential application prospect.

Age-related testosterone decline in a Brazilian cohort of healthy military men

INTRODUCTION: Androgen decline in the aging man has become a topic of increasing clinical relevance worldwide, as the reduction in testosterone levels has been reported to be accompanied by loss of muscle mass, accumulation of central adiposity, impaired mobility and increase risk of bone fractures. Although well-established in studies conducted in developed countries, progressive decline in serum testosterone levels with age has been poorly investigated in Brazil. AIM: To determine the pattern of blood testosterone concentrations decline with age in a cohort of Brazilian healthy military men. MATERIALS AND METHODS: We retrospectively reviewed data on serum testosterone measurements of healthy individuals that had undergone a routine check-up at the Military Biology Institute. Blood samples were obtained early in the morning, and total testosterone concentration was determined using a commercial chemoluminescent immunoassay. Mean values were analyzed in five age groups: < 40, 41 to 50, 51 to 60, 61 to 70, and > 70 years. MAIN OUTCOME MEASURE: Mean total testosterone levels. RESULTS: 1,623 subjects were included in the analysis; mean age was 57 years (24 to 87), and mean testosterone level was 575.5 ng/dL (25.0 to 1308.0 ng/dL). The evaluation of age-related changes in total testosterone levels revealed a progressive reduction in serum levels of this hormone with increasing age. Testosterone levels below 300 ng/dL were reported in 321 participants, a prevalence of nearly 20 percent in the study population. CONCLUSION: In agreement with other findings, a reduction of total testosterone levels with age was reported for healthy Brazilian men.

Simultaneous transfer of cholesterol, triglycerides, and phospholipids to high-density lipoprotein in aging subjects with or without coronary artery disease

OBJECTIVE: To verify whether the capacity of high-density lipoprotein (HDL) to simultaneously receive nonesterified cholesterol, triglycerides, cholesteryl esters, and phospholipids changes with aging and the presence of coronary artery disease. DESIGN: Cross-sectional study with biochemical analyses. SUBJECTS: Eleven elderly patients with coronary artery disease (74±5 years) were compared with the following groups of non-coronary artery disease subjects (referred to as "healthy"): 25 young (25±5 years), 25 middle-aged (42± years), and 25 elderly subjects (75±8 years). METHODS: Plasma samples were incubated with a nanoemulsion labeled with radioactive lipids; the transfer of the lipids from the nanoemulsion to the HDL was measured in chemically precipitated HDL. HDL size and paraoxonase-1 activity were also determined. RESULTS: The transfer of cholesteryl esters and phospholipids to high-density lipoprotein was significantly greater (p<0.001) in healthy elderly subjects than in the middle-aged and younger subjects. Non-esterified cholesterol and triglyceride transfer was not different among these three groups. The HDL size was significantly greater (p<0.001) in healthy elderly subjects than in the middle-aged and younger subjects. The paraoxonase-1 activity was similar among the groups. Compared with healthy elderly subjects, coronary artery disease elderly subjects had significantly less (p<0.05) transfer of non-esterified cholesterol, triglycerides, and cholesteryl esters to the HDL and a significantly smaller (p<0.05) HDL size. CONCLUSION: Because lipid transfer is enhanced in healthy elderly subjects but not in those with coronary artery disease, increasing lipid transfer to HDL may be a protective mechanism against the disease.

Effect of exercise training and vitamins e and c on antioxidant enzyme activities and lipid peroxidation in aging rats

There are many conditions that may affect the antioxidant enzyme activities, as aging and exercise. Moderate regular exercise up-regulate activities of antioxidant enzymes with depressant action on the lipid peroxidation processes, while strenuous exercise have a depressant effect on the activities of antioxidant enzymes with stimulatory action on the lipid peroxidation processes. Glutathione-S transferase [GST] and catalase are the major part of the specific antioxidant enzyme defence system response; malondialdehyde is the major indicator to lipid peroxidation processes which are affected by the exercise. To study the effect of moderate regular exercise and strenuous exercise with and without vitamin E or C supplementation on antioxidant defence system. Fifty six aging male albino rats were used in the present experiment. They were equally divided into seven groups. Group I: control group, Group II: moderate regular exercised group. Group III: strenuous exercised group. Group IV: moderate regular exercised group with vitamin E supplementation. Group V: strenuous exercised group with vitamin E supplementation, Group VI: moderate regular exercised group with vitamin C supplementation. Group VII: strenuous exercised group with vitamin C supplementation. The exercise was performed on a modified manual treadmill and the experiment continued for two months. Peripheral blood samples and muscular tissue samples were taken from all animal groups for estimation of glutathione-S transferase, catalase and malondialdehyde. The moderate regular exercise with or without vitamin E or C supplementation increased the antioxidant enzymes Glutathione-S transferase, catalase and decreased the malondialdehyde in serum and muscular tissue. The strenuous exercise decrease the antioxidant enzymes and increase the malondialdehyde production, while with vitamin E or C supplementation strenuous exercise enhanced the antioxidant enzymes and decreased the malondialdehyde production. The moderate regular exercise enhance the antioxidant defence system and so inhibit the lipid peroxidation production, while the strenuous exercise inhibit the antioxidant defence system activity and increase the lipid peroxidation production. Supplementation with vitamin E or C is essential to enhance the antioxidant defence system activities that decrease lipid peroxidation

Changes in erythrocyte glucose-6-phosphate dehydrogenase (G6PD) and reduced glutathione (GSH) activities in the development of senile and diabetic cataracts.

Oxidative and osmotic stress have been implicated in the pathogenesis of cataracts. Reactive oxygen intermediates (ROI) mediate peroxidation of membrane lipids and cause irreversible damage to lens proteins. The purpose of this study was to assess the changes in erythrocyte glucose- 6-phosphate dehydrogenase enzyme (G6PD) and reduced glutathione (GSH) levels in the development of senile and diabetic cataracts. The activity of erythrocyte G6PD and the concentration of GSH were measured to assess changes in oxidation-reduction status. The oxidation-reduction status of 26 non-diabetic non-cataract (control) subjects were compared with 24 diabetic non-cataract, 30 diabetic cataract and 28 non-diabetic cataract subjects. The results revealed that the GSH and G6PD levels of the subjects with senile cataracts were significantly lower than the subjects without cataracts. The present study reveals the risk of developing senile cataracts is associated with decreased levels of erythrocyte G6PD and GSH. In the formation of diabetic cataracts an adequate supply of NADPH (G6PD activity) is essential to produce osmotically active sorbitol in the lens.

Comparación de distintos métodos para evaluar la función androgénica en el adulto mayor / Assessment of androgenic decline in the elderly

Background:The gold standard to assess androgenic status is the measurement of free testosterone by equilibrium dialysis. However, the estimation of free testosterone using formulas based on the law of mass action can be an adequate standard. Aim: To assess androgenic decline in the elderly by different methods. Material and methods: Free testosterone by radioimmunoassay, total testosterone and steroid binding globulin (SHBG) by automated chemiluminiscence system and estradiol by automated electrochemiluminiscence system were measured in 30 male aged 64±5 years (range 60-70), and 25 males aged between 20 and 30 years, as control group; devoid of diseases or drugs that could cause hypogonadism. Free androgen index, free testosterone, biavailable testosterone, and free estradiol were calculated using a formula based on the law of mass action. Results: Fifty seven percent of elderly subjects had hypogonadism, according to calculated free testosterone values. Their total testosterone was on average, 152 nd/dl lower than in young adults, figure that represents a 3.8 ng/dl decline per year. According to total testosterone values, 27 percent of elderly males had gonadal incompetence. The correlations between calculated free testosterone and total testosterone was 0,95 and between calculated free testosterone and measured free testosterone was 0,67. The methods employed overestimated (76.7 percent of hypogonadism when using the free androgen index) or underestimated (27 and 3 percent of hypogonadism, considering total or free testosterone, respectively) the ondrogen decline of the elderly. Among the elderly, 16 or 30 percent of subjects had an absolute hypoestrogenism, based on estradiol or calculated free estradiol values, respectively. On average there was a 20 and 30 percent reduction of estradiol and calculated free estradiol values in the elderly. Conclusions: Calculated free or bioavailable testosterone values should be used to assess androgen decline in elderly men.

Prevalence of prostate cancer in aging males receiving PSA (prostate specific antigen) screening test (A campaign for celebration of Siriraj Established Day).

Prostate cancer is a potential men's health problem. The prevalence of prostate cancer continues to rise. Serum PSA (Prostate Specific Antigen) can be used as a screening tool for detection of early prostate cancer However, a screening program for prostate cancer has not yet been accepted as cost-effective and long term survival benefits have not been shown. Nevertheless, some doctors request PSA testing in men who present with lower urinary tract symptoms (LUTS) to detect prostate cancer OBJECTIVE: To study for prevalence of prostate cancer in healthy men seeking medical check-up for prostate cancer. MATERIAL AND METHOD: During the anniversary celebration of Siriraj established day (26/07/1888), a cohort study of Prevalence of prostate cancer in aging males using PSA Screening Test was carried out, 200 men over 45 years of age were invited to PSA testing and prostate glands check-up including, IPSS (international prostatic symptoms score), QOL (quality of life score) and DRE (digital rectal examination). Patients with elevated PSA were advised to undergo transrectal-ultrasound-guided-biopsy of the prostate (TRUS-biopsy). Cancer detection rate was calculated according to symptoms described by patients, IPSS and age groups. Data was compared using Chi-Square test. RESULTS: Median values from data of men's ages, IPSS, QOL and PSA were 63 years, 11, 2, and 1.23 ng/ml, respectively. 9 of 200 patients (4.5%) were found to have prostate adenocarcinoma on biopsy. Most of the cancer cases showed a localized lesion. Prostate cancer was found more common in patients who described themselves as having abnormal urination. There was no prostate cancer found in patients with a mild degree of LUTS (IPSS less than 8). Prostate cancer tended to be more common in men with high IPSS. CONCLUSION: Screening prostate cancer by PSA testing detected the cancer in 4.5%. Most cancers were found on symptomatic patients. Patients with LUTS should be made aware of prostate cancer and PSA testing may be offered in such patients. However screening of prostate cancer in all men regardless of symptoms must wait for a larger study looking at long term survival benefit, cost-effectiveness of screening, and lastly, quality of life of patients on a screening program.

Effect of a comprehensive yoga-based lifestyle modification program on lipid peroxidation.

Oxidative stress contributes to the process of aging as well as a variety of chronic degenerative diseases. There are indications that psychological stress increases oxidative stress whereas relaxation decreases it. We have measured the concentration of thiobarbituric acid reactive substances (TBARS) in blood as an indicator of oxidative stress at the beginning and at the end of a comprehensive yoga-based lifestyle modification program (YLMP). The data was collected from 104 subjects (59 male, 45 female), 19-71 years of age (mean +/- SD, 41.2 +/- 14.6 years). The YLMP consisted of a nine-day educational out-patient course on the theory and practice of yoga and included, besides a daily one-hour practice of physical postures (asanas) and breathing exercises (pranayama), lecture and films on yoga, stress management and nutrition, practice of meditation and shavasana (a relaxation technique), and individual counseling. Venous blood samples were collected on the first and last day of the course. The serum concentration of TBARS decreased significantly from 1.72 +/- 0.72 nmoles/ml on day 1 to 1.57 +/- 0.72 nmoles/ml on day 10 (P<0.05). The study suggests that a brief low cost lifestyle intervention based on yoga reduces oxidative stress.

Age-related Contribution of Lp (a) with Coronary Artery Calcification in Patients with Acute Coronary Syndrome: a Potential Role of Metabolic Disorder in Calcified Plaque

Lp (a) and coronary artery calcification (CAC) have recently been reported as predictors of plaque instability, but this is surrounded by much controversy. We investigated the influence of Lp (a) and CAC compared other acute coronary syndrome (ACS) risk factors. 698 patients diagnosed with at least minimal coronary artery obstructive disease from a coronary angiography were randomly selected using SPSS. Lp (a), other lipid profiles and past histories were checked, and CAC semi quantitatively graded on stored fluoroscopic images. The prevalence of CAC was significantly higher in the ACS than the non-ACS group (38.0% vs. 29.9%, p=0.026). The serum level of Lp (a) (26.89 +/- 30.64 vs. 20.85 +/- 21.63, p 35 mg/dl) was higher in the ACS group (24% vs. 15.7%, p 35 mg/dl. In the younger patients ( 60 years), CAC, but not the Lp (a), was an independent risk factor (OR=1.775, p=0.021, 95% CI; 1.090 - 2.890). Both the Lp (a) and CAC were risk factors for ACS, and they had a synergistic effect on its development. In the younger Lp (a), and the older CAC, was the more potent risk factor for ACS, respectively.

Factors influencing blood viscosity: adult and newborn blood analysis.

Our finding of a decrease in blood viscosity in newborn infants compared with adults leads to analysis of this change by measuring blood viscosity, plasma fibrinogen concentration, plasma viscosity and mean corpuscular volume (MCV) of 24 adults and 16 newborn infants. Plasma proteins in newborn infants are synthesized to a lesser extent than in adults, therefore plasma fibrinogen concentration of newborn infants is less than that of adults. This causes decreased blood viscosity in newborn infants compared with adults. Secondly plasma viscosity of newborn infants is also less than that of adults. In the same situation this causes a decrease in blood viscosity in newborn. Thirdly. MCV of newborn infants is greater than that of adults because of young red cells. There is a negative correlation between blood viscosity and MCV. High MCV in newborns leads to low blood viscosity in newborn infants, compared with adults.