Influence of therapy on early development of osteoporosis in male smoker subjects with hypoandrogenism influenced by life style and schistosomal hepatic fibrosis

ABSTRACT

The study aims to evaluate the multifact outcome of hypoandrogenemia colinked with the impact of oxidative stress induced by glucose intolerance, Schistosomal hepatic fibrosis [SHF] and cumulative smoking influence on bone remodeling and early development of osteoporotic manifestations. The effect on vascular endothelium immune mediated mechanisms and antioxidant capacity were monitored in cases of 30 middle aged selected male cases involving 20 subjects with hypoandrogenemia who were either smokers and subjected to sedentary life style, glucose intolerance and SHF [GI] or without [GII] as well as cases of GI after following 6 months therapy [GIII] compared to controls [GIV]. Monitoring of clinical picture and biochemical assessments of osteoporotic indices [osteocalcin, bone alkaline phosphatase, parathyroid hormone, urinary cyclic AMP], hypoandrogenism [dehydroepiandrosterane sulphate "DHEAS" and testosterone] glycemic determinant [insulin] immunoinflammatory response [interleukein-6 "IL-6", tumor necrosis factor a "TNF-alpha", E-selectin, ceruloplasmin] smoking index [serum cotinine], tolal antioxidant capacity [AOC] and lipid peroxidation product [malonedialdehyde] were done before and after 6 months therapeutic program involving supplement of DHEAS, chromium picolinate, and megavit zinc alongside smoking cessation and physical exercise daily for at least 30 minutes. It was evident that the adjustment of hormonal status and antioxidant potential should be dealt with smoking cessation to maintain physical fitness and to retard the early onset of osteoporosis. the recognition of the profound impact of life style choices on bone health, risk factors of which the most frequent include smoking, hypoandrogenemia and glucose intolerance besides metabolic and immunoinflammatory derangement posed by SHF all of which induce oxidative stress and potentiate the early development of osteoporosis in middle aged male smokers. Cessation of smoking and adopting active life style with at least half hour daily sportive exercise besides supplements with DHEAS, chromium, zinc and multivitamin-mineral supplement for six months had retarded and readjusted osteoprotic manifestations in studied group