Prostatic disorders in acromegalic patients experience of a Brazilian center

Introduction Published data suggest that patients with acromegaly have an increased prevalence of prostate disorders. Objective To evaluate prostatic disorders in acromegalic patients comparing these results after one year of treatment of acromegaly and with a group of healthy men. Materials and Methods This study was composed of two parts: sectional study comparing patients with healthy controls (baseline) and prospective, longitudinal study (at baseline and after one year of treatment). Forty acromegalic patients were enrolled and evaluated at baseline and after one year with the application of international prostatic symptoms score (IPSS), digital rectal examination, measurements of growth hormone (GH), insulin-like growth factor-I (IGF-I), insulin-like growth factor-binding protein-3 (IGFBP-3), sex hormone-binding globulin (SHBG), prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone, total and free prostate-specific antigen (PSA) levels and prostate ultrasonography (US). Thirty healthy men were selected as control group. Results We stratified patients and controls according to age, considering 40 years-old as cut off. Healthy controls under 40 had IPSS values lower than acromegalic patients. When considering only older patients and controls prostate hyperplasia and structural abnormalities were more frequent in acromegalics. After one year of treatment there was significant decrease in GH, IGF-I and prostate volume in acromegalics over 40 years-old. Conclusions Acromegalics under 40 have more urinary symptoms according to IPSS and above 40 years-old higher frequency of structural changes and increased prostate volume than healthy men. Significant reduction of GH and IGF-I levels during treatment of acromegaly leads to decrease in the prostate volume. .

Serum levels of hypothalamic-pituitary-testicular axis hormones in men with or without prostate cancer or atypical small acinar proliferation

INTRODUCTION: Substantial controversy exists regarding the association between testosterone serum levels and prostate cancer. OBJECTIVE: To evaluate the levels of hypothalamic-pituitary-testicular axis hormones in the sera of men with prostate cancer and atypical small acinar proliferation as well as those with normal biopsies. METHODS: A study cohort of 186 men with suspected prostate cancer who had undergone transrectal prostate biopsies was used in this study. The patients were divided into the following three groups based on the histology of the biopsy samples: no neoplasia, atypical small acinar proliferation or prostate cancer. Demographic data were also collected. Levels of total testosterone, follicle-stimulating hormone, luteinizing hormone, prolactin, estradiol, and serum prostate-specific antigen were measured in blood samples. RESULTS: Initially, 123 men were found to be without neoplasia, 26 with atypical small acinar proliferation and 37 with prostate cancer. After a second biopsy was taken from the men diagnosed with atypical small acinar proliferation, the diagnoses were revised: 18 were diagnosed with atypical small acinar proliferation and 45 with prostate cancer. No significant differences between the groups were identified regarding age, smoking history, chronic diseases, body mass index or PSA levels (P >.0.05). The mean serum levels of testosterone, follicle-stimulating hormone, luteinizing hormone, prolactin and estradiol were similar in all of the groups (P >.0.05). Furthermore, in individuals with prostate cancer, the Gleason scores and prevalence of hypogonadism were not significantly different (P.> 0.05). CONCLUSION: The present study revealed no difference in the serum levels of testosterone, follicle-stimulating hormone, luteinizing hormone, prolactin or estradiol in men without neoplasia compared with those with atypical small acinar proliferation or prostate cancer.

Avaliação tardia do eixo hipofisário-gonadal em pacientes adultos que sofreram traumatismo cranioencefálico grave / Late evaluation of the pituitary-gonadal axis in survivors of severe traumatic brain injury

OBJETIVO: Avaliar a função hipofisária-gonadal nos pacientes vítimas de TCE graves ocorridos na Grande Florianópolis, entre 2000 e 2004. MÉTODOS: Foram estudados 30 pacientes, sendo 22 homens e 8 mulheres, submetidos à avaliação clínica e laboratorial em seguimento médio de 4 anos após a data do traumatismo. RESULTADOS: Os homens possuíam em média 38 anos no ano da avaliação, enquanto as mulheres, 42 anos. A maioria dos traumatismos está relacionada aos acidentes de trânsito (63,3 por cento). Três pacientes (10 por cento) estavam com valores de FSH abaixo do normal e apenas 1 paciente (3,3 por cento) apresentou LH alterado. Nas mulheres avaliadas, os níveis de estradiol foram normais. Na população masculina, foi evidenciado nível de testosterona baixo em 2 pacientes (9,1 por cento). Todos os pacientes apresentavam normoprolactinemia. CONCLUSÃO: Dois casos de hipogonadismo masculino (9,1 por cento) foram diagnosticados neste estudo. Isso indica a necessidade de atenção aos pacientes sobreviventes de TCE grave para realizar diagnóstico precoce de hipogonadismo.

OBJECTIVE: The purpose of this study is to evaluate pituitary function impairment in order to verify the prevalence of sex hormone deficiency and to analyze the profile of TBI population. METHODS: Thirty patients were studied, 22 were male and 8 were female. All patients had their gonadal function assessed and they were evaluated at a median of 4 years post-trauma. RESULTS: The average age of the men was 38 years at the time of the evaluation, while the mean age of women was 42 years. The majority of TBI was related to traffic accidents (63.3 percent). Three patients (10 percent) had low FSH and only 1 patient (3.3 percent) had low LH. There was no biochemical evidence of hypogonadism in women. Two male patients presented low testosterone (9.1 percent) and were diagnosed with hypogonadism. Prolactin levels were normal in all patients. CONCLUSION: Two cases of hypogonadism (9.1 percent) were diagnosed among men in this study. It is therefore necessary that medical professionals involved in the management of TBI patients are aware of hypogonadism as a complication of TBI, in order to diagnose it early.

Gonadotropins and sex hormones in healthy Chinese infants.

This study was conducted to investigate the infantile changing regularity of gonadotropins and sex hormones. Serum samples were obtained from 416 healthy infants (male: 215; females: 201). In male infants, peaks in serum gonadotropins and testosterone concentrations were observed at 2-4 months. In female infants, serum FSH concentrations reached peak at 2-3 months. Before 6 months, serum testosterone and LH concentrations were higher in male, while FSH was on the contrary. Peaks in serum gonadotropins and sex hormones concentrations are reached and sexual dimorphism appears in the early infancy. Defining the range of mean values and the trends for infantile gonadotropins and sex hormones could be helpful for clinical evaluation.

Male gonadal function, prolactin secretion and lactotroph population in an experimental model of cirrhosis

Liver cirrhosis, a highly prevalent chronic disease, is frequently associated with endocrine dysfunctions, notably in the gonadal axis. We evaluated lactotroph population by immunohistochemistry, gonadotropins and prolactin by immunoradiometric assay and testosterone and estradiol by radioimmunoassay in adult male Wistar rats with cirrhosis induced by carbon tetrachloride. No significant difference in mean ± SEM percentages of lactotrophs was found between cirrhotic animals and controls (N = 12, mean 18.95 ± 1.29 percent). Although there was no significant difference between groups in mean serum levels of prolactin (control: 19.2 ± 4 ng/mL), luteinizing hormone (control: 1.58 ± 0.43 ng/mL), follicle-stimulating hormone (control: 19.11 ± 2.28 ng/mL), estradiol (control: 14.65 ± 3.22 pg/mL), and total testosterone (control: 138.41 ± 20.07 ng/dL), 5 of the cirrhotic animals presented a hormonal profile consistent with hypogonadism, all of them pointing to a central origin of this dysfunction. Four of these animals presented high levels of estradiol and/or prolactin, with a significant correlation between these two hormones in both groups (r = 0.54; P = 0.013). It was possible to detect the presence of central hypogonadism in this model of cirrhotic animals. The hyperestrogenemia and hyperprolactinemia found in some hypogonadal animals suggest a role in the genesis of hypogonadism, and in the present study they were not associated with lactotroph hyperplasia.

Assessment of hormonal and metabolic effects of dietary fiber in young Thai women.

OBJECTIVE: To investigate whether daily dietary fiber intake at the reference level has any impact on studied hormones in a population of Thai women. MATERIAL AND METHOD: Twenty-eight healthy Thai women (aged 18-20 years, BMI 18.5-25 kg/m2) with a history of regular menstrual cycles committed themselves to prepared food without changing the usual ratio of three major macronutrients. Dietary fiber from natural source at the amount of 8-10 g/day equal to their regular consumption was added to their daily diet for one menstrual cycle, then, increased to be 25-30 g/day for another 2 successive cycles. A single blood sample on midluteal day (day 18-23) was obtained in all three cycles. Plasma luteinizing hormone, follicle stimulating hormone, prolactin, estradiol, progesterone, cortisol, and insulin together with total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides were analyzed. RESULTS: The measured hormones and lipids did not change significantly when compared between a control and two experimental cycles (p > 0.05). CONCLUSION: Short-term consumption of 25-30 g/day fiber diet as recommended by the Reference Daily Intake (RDI) in a Thai population did not alter the studied hormones and lipids thus did not create any health problems.

Dose-dependent effect of copper chloride on male reproductive function in immature rats.

BACKGROUND: Copper is essential as a trace element for metabolic processes. Exposure to copper in industries develops toxicity among the workers. Previous findings on adverse effects of copper on male reproductive function in adult albino rats led to investigate the effects of this metal on reproductive function of maturing male rats in the present experiment. METHODOLOGY: To study these effects, immature (30 to 35 days old) Wistar strain albino rats weighing about 50-60 g were treated intraperitoneally with copper chloride at doses of 1000, 2000 and 3000 microg/kg body weight/day for 26 days. RESULT: Significant fall in accessory sex organ weight and inhibition of testicular 17beta-hydroxysteroid dehydrogenase activity along with degeneration of testicular growing spermatogenic cells and reduction in serum testosterone, FSH and LH level were observed at the doses of 2000 and 3000microg/kg/day. On the other hand, at the dose of 1000 microg/kg/day significant increase in testicular steroidogenic enzyme activity and stimulation of testicular spermatogenesis along with rise in serum testosterone and LH level were observed, though no significant change was observed in serum FSH level. This suggests that copper has got a dose-dependent effect on testicular steroidogenesis and spermatogenesis and serum testosterone and LH level in maturing male rats.

Perfil hormonal sexual de mulheres em programa crônico de diálise em tratamento com eritropoetina humana recombinante / Sex hormones profile in women on dialysis program in treatment with erythropoietin

A IRC (insuficiência renal crônica) terminal é acompanhada por alterações sistêmicas, inclusive do eixo hipotálamo-hipofisário-gonadal. Após o aparecimento da EPO (eritropoetina humana recombinante), surgiram relatos de melhora da disfunção sexual em homens, havendo relativa escassez de dados sobre dosagens hormonais e função sexual das mulheres. No Brasil, há poucos dados sobre o perfil hormonal de mulheres em programa crônico de diálise. OBJETIVOS: Avaliação e comparação do perfil hormonal sexual, através das dosagens de FSH (hormônio folículo estimulante), LH (hormônio luteinizante), PRL (prolactina) e E2 (estradiol) de mulheres em programa crônico de diálise, sob terapêutica com EPO. MÉTODOS: Foram avaliadas 47 mulheres (uma em diálise peritoneal intermitente, quatro em diálise peritoneal ambulatorial contínua e 42 em hemodiálise), subdivididas em três grupos: (1) Grupo I, de mulheres com menos de 48 anos de idade e menstruando regularmente; (2) Grupo II, de mulheres com menos de 48 anos de idade e amenorreicas; (3) Grupo III, de mulheres com mais de 48 anos de idade e amenorreicas. Os grupos foram comparados entre si através do teste de Mann-Whitney para duas amostras independentes. RESULTADOS: Todos os grupos mostraram valores normais das dosagens séricas de FSH, LH e E2, e não houve diferença estatisticamente significante nos níveis desses hormônios entre as mulheres que menstruam e as amenorreicas com idade inferior a 48 anos. Os níveis de PRL encontravam-se acima da normalidade em todos os grupos, independentemente da idade e do padrão menstrual, não havendo diferenças estatísticas significantes entre os grupos. As pacientes do grupo III apresentaram perfis hormonais compatíveis com a menopausa, ou seja, níveis séricos de FSH e LH elevados e de E2 diminuídos

Infertilidade conjugal: histerossalpingografia, avaliaçäo hormonal e ultra-sonografia na mulher com ciclo menstrual regular / Conjugal infertility: hysterosalpingography, hormonal evaluation and ultrasonography in woman with regular menstrual cicle

Foi realizado estudo prospectivo de um ciclo menstrual, de 91 pacientes consecutivas, por meio de dosagens de FSH, LH e prolactina no terceiro dia do ciclo, monitorização ultra-sonográfica de crescimento folicular e endometrial até a ovulação, dosagem de progesterona plasmática entre o sexto e oitavo dias da fase lútea e histerossalpingografia. Dezessete (18,7 por cento) pacientes apresentaram alterações hormonais ou de ovulação. Na histerossalpingografia, foram evidenciadas lesões tubárias que podem estar associadas a moléstia inflamatória pélvica em 52 por cento das pacientes nulíparas e em 17 por cento das não-nulíparas. Nas não-nulíparas, 40 por cento das lesões foram devidas a laqueadura tubária. Os autores concluíram que, embora a monitorização do ciclo menstrual seja trabalhosa e consuma tempo, a freqüência das alterações encontradas justifica a realização do procedimento. Concluíram ainda que, nas pacientes nulíparas com queixa de infertilidade, deve ser realizado estudo das tubas uterinas, em vista do encontro freqüente de seqüelas de moléstia inflamatória pélvica nestas estruturas.

Extraovarian endocrine abnormalities in north Indian women with premature ovarian failure.

BACKGROUND. Premature ovarian failure is a rare syndrome characterized by cessation of menstruation before 35 years of age associated with an elevated gonadotropin level (serum follicle stimulating hormone > 40 IU/L) and oestrogen deficiency. Premature ovarian failure is often the result of an autoimmune process and involvement of other endocrine glands has been reported but available studies are hampered by a lack of uniformity in diagnostic criteria. METHODS. The endocrine profile of 37 north Indian women with premature ovarian failure was studied. The investigations included measurement of serum follicle stimulating hormone, luteinizing hormone, oestradiol, prolactin, total thyroxine, total triiodothyronine and thyroid stimulating hormone. To assess adrenocortical reserve, adrenocorticotropic hormone stimulated plasma cortisol levels were estimated. RESULTS. Eighteen (49%) patients had extraovarian endocrine abnormalities. Eight (22%) had abnormal thyroid function tests and 12 of 29 (41%) patients tested for adrenocortical reserve showed impaired response of plasma cortisol to adrenocorticotropic hormone stimulation. CONCLUSION. Extraovarian endocrine (especially adrenocortical) involvement is frequent in patients with premature ovarian failure. Because none of the patients had overt clinical evidence of thyroid or adrenocortical disease, we suggest that tests for thyroid and adrenal function be performed routinely in females presenting with premature ovarian failure.

Comportamento dos níveis de gonadotrofinas hipofisárias na menopausa / Pituitary gonadotropins level behavior in menopause

Os autores estudaram os níveis de gonadrotrofinas hipofisárias de 337 mulheres na pós-menopausa no período de 1989 a 1990. Avaliaram os níveis gonadotrofinas hipofisárias, assim como sua relaçao, consoant o tempode pós-menopausa, pelos métodos de radiomunoensaio e imonofluorométrico. Observaram que existe aumento dos níveis de FSH e LH, havendo diferenças significantes dos valores de LH consoante o tempo de pós-menopausa. O LH torna-se progressivamente menor com o evoluir da menopausa, porém suas medidas permacem elevadas. Com relaçao ao FSH, nao se detectou variaçao similar, mantendo-se em níveis elevados e praticamente constantes, sem variaçoes significantes após a menopausa.

Hormonal and metabolic responses to acute exercise in Thai women.

Physiological and hormonal changes after acute exercise of moderate intensity (75% VO2 max) by pedalling bicycle ergometer were studied during follicular and/or luteal phase of menstrual cycle in sixteen healthy Thai women compared to the other sixteen non-exercised women. Physiological recordings and hormonal determinations were performed at corresponding times as follows: before, immediately after and 30 minutes after stopping exercise. Exercise significantly increased lactic acid, pulse rate, respiratory rate, systolic and mean arterial blood pressure and decreased plasma glucose while diastolic blood pressure, hemoglobin and hematocrit were not significantly changed. Plasma LH, FSH and estradiol were unaffected by exercise either in follicular or luteal phase. Plasma progesterone and cortisol rose in response to acute exercise during luteal and follicular phase respectively. Testosterone and prolactin concentrations in blood decreased significantly 30 minutes after exercise during the luteal phase. The effects of acute exercise on studied hormones related to reproductive function in women were discussed.

Hyperprolactinaemia and reproductive failure.

63 cases of hyperprolactinaemia (55 women and 8 men) were studied. Of the 55 women, 39 presented with infertility, while five were unmarried and had menstrual abnormalities. All eight men were partners of an infertile union. The principal modes of presentation of hyperprolactinaemia in women were infertility (74.6%) and menstrual disorders (27.6%). Galactorrhoea was evident in 28.6% and 10.7% had headache. There was no significant correlation between the level of prolactin and the duration of amenorrhoea. Changes in pituitary gonadotrophin levels were observed in 30.2% of cases, the common feature being an elevated LH level. Treatment with bromocriptine restored normal cycles, and the incidence of pregnancies was 38.5%. 14 normal infants were born and one patient miscarried.

Effect of sub-chronic endosulfan exposures on plasma gonadotrophins, testosterone, testicular testosterone and enzymes of androgen biosynthesis in rat.

Insecticide endosulfan significantly inhibited testicular androgen biosynthesis in adult rats, when fed (po) at 7.5 and 10 mg/kg body weight dose levels, consecutively for 15 and 30 days. No appreciable alterations were apparent in body weights, testicular wet weights, and cytosolic and microsomal protein contents of testis in treated rats. Profound decrease in the levels of plasma gonadotrophins (FSH and LH) along with plasma testosterone and testicular testosterone were observed at both the doses of endosulfan, particularly after the longer exposure of 30 days. Activities of steroidogenic enzymes studied (3 beta- and 17 beta-hydroxysteroid dehydrogenases) were considerably lowered on longer exposure of endosulfan. A significant decrease in the contents/activities of microsomal cytochrome P-450 and related mixed function oxidases (MFOs) in testis of treated rats was also observed, along with a marked inhibition in the activity of cytosolic conjugation enzyme, glutathione-S-transferase at both doses studied. These biochemical changes were reversed when the endosulfan treatment was withdrawn.

Evaluación hormonal hipofiso-gonadal en pacientes masculinos con cirrosis hepática alcoholica / Pituitary-gonadal hormonal evaluation in male patients with alcoholic liver cirrhosis

Se midieron los valores hormonales séricos hipofisogonadales en 26 cirróticos alcohólicos y 20 sujetos controles. Los valores medios de testosterona total y hormona luteinizante fueron más bajos en los cirróticos (p < 0.05); los valores de estradiol y prolactinemia fueron significativamente más altos (p < 0.05 y p < 0.001, respectivamente) en dicho grupo. El valor medio de la hormona folículo estimulante fue igual en ambos grupos. Los ejes hipofisogonadales hormona luteinizante-testosterona y hormona folículo estimulante estradiol estuvieron alterados en los cirróticos al no funcionar el mecanismo de retroalimentación en cada uno de ellos. Estos resultados muestran una variada alteración de la función hormonal sexual en nuestros pacientes, lo que contribuye a hacer más complejo el espectro clínico y el manejo de este tipo de enfermos

Treatment of endometriosis with gonadotropin releasing hormone agonist (buserelin).

The results of treatment of endometriosis with intranasal buserelin is convincing. The drug effectively suppresses serum estradiol to the menopausal level. Clinical improvement and regression of endometriotic lesions were observed during treatment. Thus, buserelin offers an alternative medical treatment of endometriosis. Further studies of the effects of GnRH agonist on bone mass are needed.

Alterations in testicular functions in patients of scrotal hydrocele.

Forty three randomly selected patients of scrotal hydrocele were investigated for alterations in functions of the testes. FSH and LH levels were raised in 50 and 75 per cent of patients respectively whereas testosterone level was found subnormal in 14 of the 28 patients in whom hormone profile was studied. LH and FSH levels also showed some relation with duration and size of the hydrocele. Similarly, sperm concentration and their motility was found affected by the duration of the disease.

Effects of Naloxone on pituitary gonadotropins throughout sexual maturation in male and female rats

Con el objeto de conocer los mecanismos por los cuales el sistema opioíde endógeno (SOE) modula la actividad de la unidad hipotálamo-hipofisiaria, se analizaron los efectos de la administración de clorhidrato de naloxona (NAL) sobre la dinámica gonadotrópica de la hipófisis anterior de la rata macho y hembra durante diferentes estadios de la maduración sexual. A ratas Wistar de ambos sexos (de 5 a 50 días de edad) se les administró NAL por vía subcutánea (10 mg/Kg peso) en 0.05 ml de solución salina. Se utilizaron de 5 a 10 animales por grupo de edad incluyéndose igual número de grupos control los cuales recibieron únicamente 0.05 ml de solución salina. Posterior a una hora de la administración de la NAL, los animales fueron sacrificado colectándose la sangre, así como el hipotálamo y las glándulas hipofisiarias. Las concentraciones en suero y contenido hipofisiario de LH y FSH se determinaron por radioinmunoanálisis específicos. El contenido de receptores hipofisiarios de la hormona liberadora de las gonadotropinas (GnRH) se determinó utilizando el análogo sintético del GnRH, D-Ser(TBu6) -des- Gli10 -GnRH-N- etilamida, el cual fue marcado radiactivamente con I-25 utilizando la técnica enzimática de Lactoperoxidasa. Los cambios producidos por la administración de NAL sobre el procesamiento (cambios post-traduccionales) de FSH hipofisiaria fueron estudiados por cromatografía en concanavalina-A obteniéndose la relación libre y unida de FSH a la lectina. Los resultados demostraron que la inhibición del SOE durante etapas prepuberales induce el incremento de las concentraciones en suero de LH y FSH. Este efecto fue estadísticamente significativo únicamente para el caso de las ratas hembras no observándose efectos importantes en ratas del sexo masculino. El incremento de ambas gonadotropinas estuvo acompañado de la depleción de receptores hipofisiarios para GnRh y del incremento de la fracción libre de la hormona folículo estumulante a nivel hipofisiario...