Serum lipocalin-2 and carotid artery intima-media thickness in relation to obesity in eugonadal males over forty with venogenic erectile dysfunction.

Obesity is a risk factor for erectile dysfunction and atherosclerosis. Lipocalin-2 is an adipocytokine with proinflammatory properties involved in several disorders with metabolic alterations. Our aim was to study the relation of serum lipocalin-2 and carotid artery intima-media thickness (CIMT) to obesity in erectile dysfunction. Serum lipocalin-2 and CIMT were measured in 25 obese and 25 nonobese eugonadal patients over forty with venogenic erectile dysfunction and 25 healthy controls. Their relation to different patient- and disease-related parameters was studied. Results revealed lipocalin-2 to be significantly higher in obese compared with nonobese patients and with controls, and in nonobese patients compared with controls. CIMT was lower in controls compared with both obese and nonobese patients. In obese and nonobese patients, lipocalin-2 was positively correlated with disease duration, body mass index, waist circumference and end-diastolic velocity. Lipocalin-2 was negatively correlated with the short form of the international index of erectile function scores in both groups. In conclusion, the elevated lipocalin-2 in obese and to a lesser extent in nonobese patients and its association with disease severity points to its potential value as a diagnostic marker and a possible therapeutic target that could ameliorate the metabolic derangement associated with erectile dysfunction.

Subclinical atherosclerosis in psoriatic disease: relation to endocan, TNF-α, age of onset, and body fat.

BACKGROUND: Psoriasis is a common multisystem inflammatory disease with several associated comorbidities. Serological markers to detect associated subclinical atherosclerosis in psoriatic patients are needed. We aimed to study serum endocan levels in psoriasis vulgaris and its relation to severity of psoriasis, systemic inflammation, associated atherosclerosis, obesity, and the possible factors affecting its level in psoriatic patients. METHODS: This study was conducted on 30 moderate-severe psoriasis vulgaris patients and 30 healthy controls. Body mass index, body fat percent, and PASI assessments were done. Serum endocan and tumor necrosis factor-α levels were measured by ELISA. Carotid artery intima-media thickness measurement by high-resolution ultrasound was performed. RESULTS: Psoriasis patients showed significantly higher serum tumor necrosis factor-α and endocan levels (P1 = 0.008, P2 = 0.003). Additionally, there was a statistically significant difference between mean carotid artery intima-media thickness of both groups (P = 0.005). Serum endocan levels positively correlated with PASI score (P = 0.002), tumor necrosis factor-α levels (P < 0.001), mean carotid artery intima-media thickness (P = 0.001), and body mass index (P < 0.001) in the patients group. Additionally, the age of onset of disease negatively correlated with serum endocan (P = 0.003). CONCLUSION: Serum endocan is a promising marker of severity of psoriasis and associated atherosclerosis. Early onset psoriasis is associated with higher serum endocan levels. Body mass index is positively correlated with serum endocan levels. The positive correlation of endocan and tumor necrosis factor-α supports the regulatory effect of the cytokine on endocan production and suggests the role of endocan as an inflammatory marker.

Serum endocan as a predictive biomarker of cardiovascular risk in erectile dysfunction patients.

Endothelial dysfunction is reported in erectile dysfunction (ED) and cardiovascular disease (CVD). Endocan is a serum marker in some endothelial-related disorders. Thirty patients with erectile dysfunction (Group A) and 15 controls (Group B) were enrolled in the study. Group A is subdivided into Group AI including 15 diabetic patients with ED and group AII including 15 nondiabetic patients with ED. The erectile function was assessed in all subjects using International Index of Erectile Function (IIEF-5) score. Fasting blood sugar (FBS), cholesterol and triglycerides (TG), serum endocan and carotid intima-media thickness (cIMT) were assessed in all subjects. Penile Doppler ultrasound was carried out for Group A. IIEF-5 score, serum endocan level and cIMT were significantly different between the groups. Serum endocan was positively correlated with cIMT (r = 0.342, p = 0.22) and negatively correlated with peak systolic velocity (r = -0.588, p = 0.001) and IIEF (r = -0.532, p < 0.001) although lack of correlation was detected with end-diastolic velocity, TG and cholesterol. ROC curve assessment yielded a serum endocan cut-off point of >2,392.7 ng/ml to predict the cIMT in ED patients with 83.33% sensitivity and 66.67% specificity (AUC 0.741, 95% CI 0.558-0.867). Serum endocan can correlate with ED severity and cIMT. In addition, it has a predictive value for cardiovascular risk in ED patients.

Fat Necrosis of the Breast: Magnetic Resonance Imaging Characteristics and Pathologic Correlation.

RATIONALE AND OBJECTIVES: This study aims to describe the magnetic resonance imaging (MRI) features of fat necrosis on magnetic resonance mammography, which may downstage a suspicious lesion to a merely benign finding. MATERIALS AND METHODS: This prospective study included 82 female patients (mean age 50 years) who were diagnosed to have suspicious lesions by mammography, ultrasonography or both. All patients underwent MRI including diffusion-weighted imaging and spectroscopy. Image postprocessing and analysis included signal intensity, enhancement characteristics, diffusion restriction, and spectroscopic analysis. All patients underwent histopathological analysis for confirmation. Sensitivity, specificity, positive predictive value (PPV), and negative (NPV) predictive value were calculated. RESULTS: To label a lesion as fat necrosis on MRI analysis, presence of fat signal in a lesion revealed sensitivity of 98.04%, specificity of 100%, PPV of 100%, and NPP of 96.88%, whereas nonenhancement of the lesion itself revealed sensitivity of 96.08%, specificity of 100%, PPV of 100%, and NPP of 93.94%. However, adding both the nonrestriction on diffusion analysis and the lack of tCholine at 3.22 ppm increased the sensitivity and specificity to 100%, as well as PPV of 100% for fat necrosis and hence a NPV for malignancy of 100%. CONCLUSIONS: MRI proved to be of value in differentiating fat necrosis from malignancy based on the molecular composition of fat necrosis, clearly depicted by MRI without the need for invasive confirmation by biopsy.

Benign prostatic hyperplasia, metabolic syndrome and androgenic alopecia: Is there a possible relationship?

OBJECTIVE: To evaluate the incidence of benign prostatic hyperplasia (BPH) and metabolic syndrome in patients with androgenetic alopecia (AGA) in comparison with those with no AGA, as several previous studies have reported inconsistent results of an association between metabolic syndrome and BPH with AGA. PATIENTS SUBJECTS AND METHODS: This cross-sectional study included 400 participants, divided into 300 patients diagnosed with AGA, with different grades according to Norwood-Hamilton classification, and 100 control subjects with no AGA. Criteria for diagnosis of metabolic syndrome according to Adult Treatment Panel-III criteria (waist circumference, blood pressure, fasting blood sugar, high-density lipoprotein and triglycerides), as well as criteria for diagnosis of BPH (prostatic volume, urine flow, and prostate-specific antigen) were assessed in all patients and compared with the control subjects. RESULTS: There were significant differences between the AGA and no-AGA groups for the following variables: waist circumference, body mass index, fibrinogen level, fasting blood sugar, cholesterol, C-reactive protein, erythrocyte sedimentation rate, and glycosylated haemoglobin. There was a significant difference in number of patients with AGA manifesting criteria of metabolic syndrome (51% vs 28%), as well as BPH diagnostic criteria (36% vs 6.8%) compared with the control subjects. Both BPH and metabolic syndrome were shown to be significant independent variables associated with AGA. CONCLUSIONS: Dermatologists, urologists, and primary care physicians should monitor patients with early onset AGA for the development of urinary symptoms, to permit an earlier diagnosis of BPH; and for metabolic syndrome symptoms, to permit early diagnosis of cardiovascular risk factors.