Obesity in the ageing man.

As the population is ageing globally, both ageing and obesity are recognized as major public health challenges. The aim of this narrative review is to present and discuss the current evidence on the changes in body composition, energy balance and endocrine environment that occur in the ageing man. Obesity in the ageing man is related to changes in both body weight and composition due to alterations in energy intake and total energy expenditure. In addition, somatopenia (decreased GH secretion), late-onset hypogonadism (LOH), changes in thyroid and adrenal function, as well as changes in appetite-related peptides (leptin, ghrelin) and, most importantly, insulin action are related to obesity, abnormal energy balance, redistribution of the adipose tissue and sarcopenia (decreased muscle mass). A better understanding of the complex relationship of ageing-related endocrine changes and obesity could lead to more effective interventions for elderly men.

Germinal epithelium changes in sexually immature rabbits treated with intratesticular testosterone implants.

The effect of testosterone (T) on germinal epithelium development and maturation was studied in prepubertal male rabbits. For this purpose, implants of free T (50 mg) or placebo (PL) were placed intratesticularly in 55-60-day-old animals. Each group was divided into sub-groups additionally treated with 0.9% NaCl, FSH/LH (3.0 IU) or cyproterone acetate (CA, 2.5 mg) over a 45-day period. Initial and final evaluations included measurements of testicular volume, testicular biopsy score count (TBSC) and plasma T, FSH and LH concentrations. At the end of the experiment, increment values (final-initial evaluation) of the parameters examined showed the following differences: (1) mean TBSC in T-implanted, irrespective of additional treatment, was higher than that of PL-implanted rabbits (P less than 0.01); (2) mean plasma T, FSH and LH values were significantly different in T- and PL-implanted rabbits, with higher T (P less than 0.05) but lower FSH and LH increments (P less than 0.01 for both) in the former group; (3) marked differences amongst types of additional treatment, irrespective of the implant used, were found for TBSC, T, FSH and LH (P less than 0.01 for all); animals treated with CA had markedly lower increments than other treatment groups. From these findings, it may be concluded, that in the prepubertal rabbit T plays an important role in development and maturation of the testis, but this effect probably requires the synergistic action of endogenous gonadotrophins.

Effects of antiandrogen-estrogen treatment on sexual and endocrine parameters in hirsute women.

Sexual activity was evaluated in 51 women with hirsutism associated with increased levels of circulating androgens before and while on combined treatment with the antiandrogen cyproterone acetate (CA) and ethinyl estradiol (EE2) and compared to a reference group of 52 subjects. The percentage of unbound testosterone (T) was higher (p less than 0.001), the coital frequency lower (p less than 0.05), and the masturbation frequency higher (p less than 0.04) in hirsute women. Mean frequency of total activity (coitus plus masturbation) was similar in the two groups. Treatment with combination of CA and EE2 resulted in a decline of unbound T (p less than 0.001). There was no change of total sexual activity, but coital frequency increased (p less than 0.05) and masturbation frequency declined (p less than 0.04). It is concluded that raised levels of circulating androgens, as judged by free T concentration, are not of crucial importance in the expression of sexual behavior in hirsute women.

Raised sodium, potassium, and urea concentrations in spermatic venous blood: an additional causative factor in the testicular dysfunction of varicocele?

The concentrations of Na, K, Cl, HCO3, LA, and urea, with calculation of the AG, as indirect indices of electrolyte balance and metabolic conditions prevailing in testicular environment, were determined in PB and SVB of 24 men with varicocele and 15 men with inguinal hernia. Significantly higher concentrations of Na, K, and urea were found in SVB as compared with PB values (P less than 0.001 for all) of patients with varicocele, but not in control subjects. The SVB concentrations of Na, K, and urea in varicocele patients were higher than SVB and PB concentrations of the control group (P less than 0.001 for all). It is concluded that urea, Na, and K concentrations are raised in SVB of patients with varicocele; this imbalance may be related, among other factors, to the pathogenesis of dyspermia in varicocele.