For the past 100 years, insulin supplementation has been the mainstay of treatment for type 1 diabetes (T1D), which is characterized by progressive autoimmune-mediated loss of insulin-producing β cells in the islets of Langerhans over the last decades, technological advances in glucose monitoring and therapeutics have greatly improved the care and management of these patients. However, morbidity, mortality, and quality of life remain challenges for patients with T1D. Islet transplantation has been successfully performed, but there are several limiting factors, such as the lack of cadaveric donors and the need for lifelong immunosuppressive therapy. Therefore, there is a great medical need for alternative therapeutic approaches. In the current review, the current knowledge on novel approaches for the treatment of T1D with a focus on the potential of using chimeric antigen receptor (CAR)-T cells and natural killer (NK) cells is summarized.
[Names] => Charlotte Steenblock ... Stefan R. Bornstein [CName] => CharlotteSteenblock, [Doi] => 10.37349/eemd.2023.00002 [Published] => April 01, 2024 [Viewed] => 841 [Downloaded] => 21 [Subject] => Review [Year] => 2024 [CiteUrl] => https://api.crossref.org/works/10.37349/eemd.2023.00002 [Inline] => 1 [Type] => 1 [Issue] => 1 [Topic] => 0 [TitleAbbr] => Explor Endocr Metab Dis. [Pages] => 2024;1:4–11 [Recommend] => 0 [Keywords] => Chimeric antigen receptor, natural killer cells, autoimmunity, type 1 diabetes [DetailTitle] => [DetailUrl] => [Id] => 10142 [ris] => https://www.explorationpub.com/uploads/Article/A10142/59a0d12fba453c387509d0b8dee05eac.ris [bib] => https://www.explorationpub.com/uploads/Article/A10142/79e33ed4a79bfcde8d13978fa52c13ff.bib [ens] => [Cited] => 1 [Cited_Time] => 2024-07-03 [CitethisArticle] => Steenblock C, Eitler J, Oikonomakos IT, Arriens M, Künzel SR, Tonn T, et al. Application of chimeric antigen receptor-natural killer cells for the treatment of type 1 diabetes. Explor Endocr Metab Dis. 2024;1:4–11. https://doi.org/10.37349/eemd.2023.00002 [Jindex] => 0 [CEmail] => charlotte.steenblock@uniklinikum-dresden.de, [Ris_Time] => 2024-04-30 05:01:15 [Bib_Time] => 2024-04-30 03:04:12 [KeysWordContens] => Application of chimeric antigen receptor-natural killer cells for the treatment of type 1 diabetes, Chimeric antigen receptor, natural killer cells, autoimmunity, type 1 diabetes, For the past 100 years, insulin supplementation has been the mainstay of treatment for type 1 diabetes (T1D), which is characterized by progressive autoimmune-mediated loss of insulin-producing β cells in the islets of Langerhans over the last decades, technological advances in glucose monitoring and therapeutics have greatly improved the care and management of these patients. However, morbidity, mortality, and quality of life remain challenges for patients with T1D. Islet transplantation has been successfully performed, but there are several limiting factors, such as the lack of cadaveric donors and the need for lifelong immunosuppressive therapy. Therefore, there is a great medical need for alternative therapeutic approaches. In the current review, the current knowledge on novel approaches for the treatment of T1D with a focus on the potential of using chimeric antigen receptor (CAR)-T cells and natural killer (NK) cells is summarized. ,Charlotte Steenblock ... Stefan R. Bornstein [PublishedText] => Published [IsEdit] => 0 [AccountId] => 88 [Zh] => 1 [AuthorsName] => Charlotte Steenblock, Jiri Eitler, Ioannis T. Oikonomakos, Marieke Arriens, Stephan R. Künzel, Torsten Tonn, Stefan R. Bornstein ) [2] => Array ( [ArticleId] => 946 [Create_Time] => 2023-11-23 [zipUrl] => https://www.explorationpub.com/uploads/zip/202406/20240624052240.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A10144/10144.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A10144/10144.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A10144/10144_cover.png [JournalsId] => 16 [Title] => Recent advances in artificial intelligence-assisted endocrinology and diabetes [Abstract] => Artificial intelligence (AI) has gained attention for various reasons in recent years, surrounded by speculation, concerns, and expectations. Despite being developed since 1960, its widespread appli [AbstractComplete] =>Artificial intelligence (AI) has gained attention for various reasons in recent years, surrounded by speculation, concerns, and expectations. Despite being developed since 1960, its widespread application took several decades due to limited computing power. Today, engineers continually improve system capabilities, enabling AI to handle more complex tasks. Fields like diagnostics and biology benefit from AI’s expansion, as the data they deal with requires sophisticated analysis beyond human capacity. This review showcases AI’s integration in endocrinology, covering molecular to phenotypic patient data. These examples demonstrate AI’s potential and power in research and medicine.
[Names] => Ioannis T. Oikonomakos ... Stefan R. Bornstein [CName] => CharlotteSteenblock, [Doi] => 10.37349/eemd.2023.00004 [Published] => April 01, 2024 [Viewed] => 1350 [Downloaded] => 44 [Subject] => Review [Year] => 2024 [CiteUrl] => https://api.crossref.org/works/10.37349/eemd.2023.00004 [Inline] => 1 [Type] => 1 [Issue] => 1 [Topic] => 0 [TitleAbbr] => Explor Endocr Metab Dis. [Pages] => 2024;1:16–26 [Recommend] => 0 [Keywords] => Endocrinology, diabetes, artificial intelligence, machine learning, personalized medicine [DetailTitle] => [DetailUrl] => [Id] => 10144 [ris] => https://www.explorationpub.com/uploads/Article/A10144/b951ae8a3d45e679090fb140be9e59ce.ris [bib] => https://www.explorationpub.com/uploads/Article/A10144/70082f3f6a4f026376a76cd030585e1d.bib [ens] => [Cited] => 2 [Cited_Time] => 2024-07-02 [CitethisArticle] => Oikonomakos IT, Anjana RM, Mohan V, Steenblock C, Bornstein SR. Recent advances in artificial intelligence-assisted endocrinology and diabetes. Explor Endocr Metab Dis. 2024;1:16–26. https://doi.org/10.37349/emed.2023.00004 [Jindex] => 0 [CEmail] => charlotte.steenblock@uniklinikum-dresden.de, [Ris_Time] => 2024-04-30 06:32:07 [Bib_Time] => 2024-04-30 06:32:07 [KeysWordContens] => Recent advances in artificial intelligence-assisted endocrinology and diabetes, Endocrinology, diabetes, artificial intelligence, machine learning, personalized medicine, Artificial intelligence (AI) has gained attention for various reasons in recent years, surrounded by speculation, concerns, and expectations. Despite being developed since 1960, its widespread application took several decades due to limited computing power. Today, engineers continually improve system capabilities, enabling AI to handle more complex tasks. Fields like diagnostics and biology benefit from AI’s expansion, as the data they deal with requires sophisticated analysis beyond human capacity. This review showcases AI’s integration in endocrinology, covering molecular to phenotypic patient data. These examples demonstrate AI’s potential and power in research and medicine. ,Ioannis T. Oikonomakos ... Stefan R. Bornstein [PublishedText] => Published [IsEdit] => 0 [AccountId] => 88 [Zh] => 1 [AuthorsName] => Ioannis T. Oikonomakos, Ranjit M. Anjana, Viswanathan Mohan, Charlotte Steenblock, Stefan R. Bornstein ) [3] => Array ( [ArticleId] => 945 [Create_Time] => 2023-11-21 [zipUrl] => https://www.explorationpub.com/uploads/zip/202406/20240625014256.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A10143/10143.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A10143/10143.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A10143/10143_cover.png [JournalsId] => 16 [Title] => Unique original endocrine findings: the endoplasmic reticulum-mitochondrial unit in steroid producing cells [Abstract] => [AbstractComplete] => [Names] => Stefan R. Bornstein ... Waldemar Kanczkowski [CName] => Stefan R.Bornstein, [Doi] => 10.37349/eemd.2023.00003 [Published] => April 01, 2024 [Viewed] => 665 [Downloaded] => 17 [Subject] => Commentary [Year] => 2024 [CiteUrl] => https://api.crossref.org/works/10.37349/eemd.2023.00003 [Inline] => 1 [Type] => 1 [Issue] => 1 [Topic] => 203 [TitleAbbr] => Explor Endocr Metab Dis. [Pages] => 2024;1:12–15 [Recommend] => 0 [Keywords] => Endoplasmic reticulum, mitochondria, steroid-producing cell, mitochondrial-associated endoplasmic reticulum membranes [DetailTitle] => The HPA Axis in Health and Disease [DetailUrl] => https://www.explorationpub.com/Journals/eemd/Special_Issues/203 [Id] => 10143 [ris] => https://www.explorationpub.com/uploads/Article/A10143/68ab6c269a7958fb26ce140227d03a3a.ris [bib] => https://www.explorationpub.com/uploads/Article/A10143/2ed5f4b381d3b526fa328286aee73aa7.bib [ens] => [Cited] => 1 [Cited_Time] => 2024-07-03 [CitethisArticle] => Bornstein SR, Chen LS, Kanczkowski W. Unique original endocrine findings: the endoplasmic reticulum-mitochondrial unit in steroid producing cells. Explor Endocr Metab Dis. 2024;1:12–5. https://doi.org/10.37349/eemd.2023.00003 [Jindex] => 0 [CEmail] => Stefan.bornstein@uniklinikum-dresden.de, [Ris_Time] => 2024-04-30 03:10:02 [Bib_Time] => 2024-04-30 03:10:02 [KeysWordContens] => Unique original endocrine findings: the endoplasmic reticulum-mitochondrial unit in steroid producing cells, Endoplasmic reticulum, mitochondria, steroid-producing cell, mitochondrial-associated endoplasmic reticulum membranes,,Stefan R. Bornstein ... Waldemar Kanczkowski [PublishedText] => Published [IsEdit] => 0 [AccountId] => 80 [Zh] => 1 [AuthorsName] => Stefan R. Bornstein, Lan-Sun Chen, Waldemar Kanczkowski ) [4] => Array ( [ArticleId] => 954 [Create_Time] => 2023-11-28 [zipUrl] => https://www.explorationpub.com/uploads/zip/202406/20240624034722.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A10145/10145.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A10145/10145.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A10145/10145_cover.png [JournalsId] => 16 [Title] => Development of adrenal 3-dimensional spheroid cultures: potential for the treatment of adrenal insufficiency and neurodegenerative diseases [Abstract] => Aim: Regenerative and curative strategies would be desirable for neurodegenerative and adrenal diseases, and multipotent adrenal stem cells are considered as promising biological tools for this p [AbstractComplete] =>Regenerative and curative strategies would be desirable for neurodegenerative and adrenal diseases, and multipotent adrenal stem cells are considered as promising biological tools for this purpose. Stem-like cells with the potential to proliferate and differentiate in vivo and in vitro were discovered in both cortex and medulla of the adrenal gland. Previously, it was demonstrated that nestin-positive progenitors in the cortex and medulla, play an important role under stress. In the present study, the cultivation of these cells was optimized and their growth in vitro was characterized.
Primary cells from the adrenal cortex and medulla from Nes-GFP mice were isolated and the in vitro culture conditions promoting the growth of stem and progenitor cells using different 3-dimensional (3D) spheroid culture models were optimized.
Both cortical and medullary cells could be cultured for at least one month under several different low-adherence conditions maintaining their viability and potential to differentiate. Medullary cells grew faster than cortical cells. Endothelin did not affect the cultures.
Adrenomedullary and adrenocortical nestin-positive progenitor cells can be cultured long-term in 3D cultures maintaining their proliferation and differentiation capabilities. Such multidimensional models can potentially be used for drug screening to develop personalized medicines or for transplantation to treat neurodegenerative disorders or adrenal diseases, such as adrenal insufficiency.
Epigenetic alterations have been reported in patients with pituitary tumors and those on antipsychotic drugs, which are also responsible for hyperprolactinemia. This suggests a possible role of epigenetics in the etiopathology of hyperprolactinemia.
The study recruited 83 hyperprolactinemia cases with prolactin > 100 ng/mL and 65 controls. Global DNA methylation status was studied by MethylFlash Methylated DNA Quantification Kit and genome-wide methylation analysis (GWMA) by Infinium Methylation EPIC BeadChip 850K array.
Hyperprolactinemia cases showed significant global DNA hypermethylation compared to controls. Around 66.67% of hypomethylated and 12.9% of hypermethylated cases were on antipsychotics. Gene enrichment analysis of 5-cytosine-phosphate-guanine-3 (CpG) site-associated genes demonstrated significantly enriched major histocompatibility complex (MHC)-related protein classes and cellular components.
The study suggested the role of epigenetics in the etiopathology of hyperprolactinemia.
Diabetes and cancer are two chronic metabolic diseases with ever-increasing incidence rates worldwide. These disorders can often occur together, as diabetes presents an important risk factor for cancer and some cancers could in turn lead to diabetes. In this perspective article, many more commonalities between diabetes and cancer are highlighted, including the role of lifestyle and environmental factors in the pathogenesis, the presence of a rather long latency period before clinical diagnosis of invasive disease, as well as the ultimate progression to diabetic complications or malignant metastases. Moreover, both of these devastating disorders still lack curative treatment options, whereas several currently approved antidiabetic and anticancer drugs have been originally derived from different natural sources. However, while in the case of diabetes, the main therapeutic goal is to maintain the pancreatic islet mass by preserving β-cells survival, the major purpose of cancer therapy is to kill malignant cells and reduce the neoplastic mass of solid tumors. It is expected that both diabetes and cancer, two systemic diseases with epidemic proportions, would be managed more effectively through an integral approach, considering many different aspects related to their pathogenesis, including also lifestyle changes and dietary modifications.
[Names] => Katrin Sak [CName] => [Doi] => 10.37349/eemd.2024.00007 [Published] => May 23, 2024 [Viewed] => 475 [Downloaded] => 12 [Subject] => Perspective [Year] => 2024 [CiteUrl] => https://api.crossref.org/works/10.37349/eemd.2024.00007 [Inline] => 1 [Type] => 1 [Issue] => 2 [Topic] => 0 [TitleAbbr] => Explor Endocr Metab Dis. [Pages] => 2024;1:56–61 [Recommend] => 0 [Keywords] => Diabetes, cancer, prevalence, pathogenesis, therapy, dietary modifications [DetailTitle] => [DetailUrl] => [Id] => 10147 [ris] => https://www.explorationpub.com/uploads/Article/A10147/6ac2164c218cfe53018fd82004834101.ris [bib] => https://www.explorationpub.com/uploads/Article/A10147/652c66109c1691398d00ca82fefcee2f.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Sak K. Diabetes and cancer: two epidemic diseases requiring an opposite therapeutic approach to target cells. Explor Endocr Metab Dis. 2024;1:56–61. https://doi.org/10.37349/eemd.2024.00007 [Jindex] => 0 [CEmail] => [Ris_Time] => 2024-05-22 01:32:44 [Bib_Time] => 2024-05-22 01:32:44 [KeysWordContens] => Diabetes and cancer: two epidemic diseases requiring an opposite therapeutic approach to target cells, Diabetes, cancer, prevalence, pathogenesis, therapy, dietary modifications, Diabetes and cancer are two chronic metabolic diseases with ever-increasing incidence rates worldwide. These disorders can often occur together, as diabetes presents an important risk factor for cancer and some cancers could in turn lead to diabetes. In this perspective article, many more commonalities between diabetes and cancer are highlighted, including the role of lifestyle and environmental factors in the pathogenesis, the presence of a rather long latency period before clinical diagnosis of invasive disease, as well as the ultimate progression to diabetic complications or malignant metastases. Moreover, both of these devastating disorders still lack curative treatment options, whereas several currently approved antidiabetic and anticancer drugs have been originally derived from different natural sources. However, while in the case of diabetes, the main therapeutic goal is to maintain the pancreatic islet mass by preserving β-cells survival, the major purpose of cancer therapy is to kill malignant cells and reduce the neoplastic mass of solid tumors. It is expected that both diabetes and cancer, two systemic diseases with epidemic proportions, would be managed more effectively through an integral approach, considering many different aspects related to their pathogenesis, including also lifestyle changes and dietary modifications. ,Katrin Sak [PublishedText] => Published [IsEdit] => 0 [AccountId] => 86 [Zh] => 0 [AuthorsName] => Katrin Sak ) [7] => Array ( [ArticleId] => 1304 [Create_Time] => 2024-05-23 [zipUrl] => https://www.explorationpub.com/uploads/zip/202406/20240625011728.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A10148/10148.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A10148/10148.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A10148/10148_cover.png [JournalsId] => 16 [Title] => Four hepatic steatosis indices in predicting quantitative computed tomography-based metabolic dysfunction-associated fatty liver disease [Abstract] => Aim: To evaluate the prediction ability for quantitative computed tomography (QCT)-based metabolic dysfunction-associated fatty liver disease (MAFLD) of four widely known hepatic steatosis algori [AbstractComplete] =>To evaluate the prediction ability for quantitative computed tomography (QCT)-based metabolic dysfunction-associated fatty liver disease (MAFLD) of four widely known hepatic steatosis algorithms, namely the fatty liver index (FLI), the hepatic steatosis index (HSI), the Framingham Steatosis index (FSI) and the Zhejiang University index (ZJU index).
From July 2020 to June 2022, health checkup subjects who accepted liver fat quantification with QCT at the Health Management Center of the Second Affiliated Hospital of Chongqing Medical University were recruited in this study. MAFLD was diagnosed by using QCT-based liver fat quantification. The prediction performance of FLI, HSI, FSI, and ZJU index on MAFLD was evaluated using the area under the receiver operating characteristic curve (AUC).
Of a total of 4,566 subjects enrolled in this study, 48.7% were diagnosed with MAFLD. The AUC values of FLI, HSI, FSI, and ZJU index were 0.819, 0.792, 0.822 and 0.826, respectively. FLI exhibited the highest sensitivity (SN) of 79.42%, while the ZJU index demonstrated the highest specificity (SP) of 75.35%.
All four indices (FLI, HSI, FSI, and ZJU index) have acceptable predictive performance for patients with QCT-based MAFLD. Our study suggests that the above indices have a stable ability for detecting MAFLD.
Hypoparathyroidism, deafness and renal dysplasia (HDR) syndrome is a rare genetic disorder caused by haploinsufficiency of the GATA3 gene. A very limited number of cases have been reported in the literature to date. Diagnosis is challenging as the phenotypic expression has wide heterogeneity due to variable penetrance of the underlying genetic mutation. Although the condition is inherited in an autosomal dominant pattern, sporadic cases do occur. This report presents a case of a 22-year-old female diagnosed with HDR syndrome, featuring bilateral cataract and bicornuate uterus. The GATA3 mutation detected in the patient was not identified in the family, suggesting it to be arising de novo. The present case report describes the rare phenotypic findings of bilateral cataract and bicornuate uterus associated with HDR, thus expanding the clinical spectrum of the syndrome.
[Names] => Rajesh Chetiwal ... Priyank Rastogi [CName] => [Doi] => 10.37349/eemd.2024.00009 [Published] => May 27, 2024 [Viewed] => 292 [Downloaded] => 10 [Subject] => Case Report [Year] => 2024 [CiteUrl] => https://api.crossref.org/works/10.37349/eemd.2024.00009 [Inline] => 1 [Type] => 1 [Issue] => 2 [Topic] => 0 [TitleAbbr] => Explor Endocr Metab Dis. [Pages] => 2024;1:77–82 [Recommend] => 0 [Keywords] => Hypoparathyroidism, deafness, renal dysplasia, GATA3 [DetailTitle] => [DetailUrl] => [Id] => 10149 [ris] => https://www.explorationpub.com/uploads/Article/A10149/18d3b51f89d4c9fb533d00e483c180b2.ris [bib] => https://www.explorationpub.com/uploads/Article/A10149/2ce89d2216d6bf01cbe0fe95b830ff0d.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Chetiwal R, Kumar A, Tanwar S, Rastogi P. Hypoparathyroidism, deafness and renal dysplasia syndrome with bilateral cataract and bicornuate uterus caused by a de novo GATA3 mutation. Explor Endocr Metab Dis. 2024;1:77–82. https://doi.org/10.37349/eemd.2024.00009 [Jindex] => 0 [CEmail] => [Ris_Time] => 2024-05-27 03:07:16 [Bib_Time] => 2024-05-27 03:42:24 [KeysWordContens] => Hypoparathyroidism, deafness and renal dysplasia syndrome with bilateral cataract and bicornuate uterus caused by a de novo GATA3 mutation, Hypoparathyroidism, deafness, renal dysplasia, GATA3 , Hypoparathyroidism, deafness and renal dysplasia (HDR) syndrome is a rare genetic disorder caused by haploinsufficiency of the GATA3 gene. A very limited number of cases have been reported in the literature to date. Diagnosis is challenging as the phenotypic expression has wide heterogeneity due to variable penetrance of the underlying genetic mutation. Although the condition is inherited in an autosomal dominant pattern, sporadic cases do occur. This report presents a case of a 22-year-old female diagnosed with HDR syndrome, featuring bilateral cataract and bicornuate uterus. The GATA3 mutation detected in the patient was not identified in the family, suggesting it to be arising de novo. The present case report describes the rare phenotypic findings of bilateral cataract and bicornuate uterus associated with HDR, thus expanding the clinical spectrum of the syndrome. ,Rajesh Chetiwal ... Priyank Rastogi [PublishedText] => Published [IsEdit] => 0 [AccountId] => 80 [Zh] => 0 [AuthorsName] => Rajesh Chetiwal, Amit Kumar, Shweta Tanwar, Priyank Rastogi ) [9] => Array ( [ArticleId] => 1397 [Create_Time] => 2024-06-28 [zipUrl] => https://www.explorationpub.com/uploads/zip/202407/20240701073130.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A101410/101410.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A101410/101410.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A101410/101410_cover.png [JournalsId] => 16 [Title] => Adult-onset testosterone deficiency: the usefulness of hormone replacement in reducing mortality in men with this common age-related condition [Abstract] => Adult-onset testosterone deficiency (TD) in men is diagnosed by the finding of low serum testosterone levels and recognised, associated symptoms. The condition has high prevalence in men over 50 yea [AbstractComplete] =>Adult-onset testosterone deficiency (TD) in men is diagnosed by the finding of low serum testosterone levels and recognised, associated symptoms. The condition has high prevalence in men over 50 years of age, particularly those with type 2 diabetes (T2DM). Accumulating data show adult-onset TD is associated with increased mortality risk. We review the literature and consider the evidence suggesting testosterone therapy (TTh) reduces mortality, especially in men with T2DM. We previously reported that in the Burntwood Lichfield Atherstone Sutton Coldfield Tamworth (BLAST) study screened cohort of men with adult-onset TD and T2DM adult-onset TD was associated with increased mortality with TTh decreasing this higher mortality. The data hinted that the effect was greater in older men. We confirmed this observation with statistical analyses to study the effect of age on the association between adult-onset TD and mortality; Cox regression analysis demonstrated that the reduced risk (hazard ratio: 0.61, 95% CI: 0.38–0.96) following TTh was restricted to men above the median age of 65.89 years. Finally, we speculate on putative mechanisms that may mediate these associations. Heterogeneity in men with adult-onset TD is expected in view of its definition of low testosterone levels together with associated clinical phenotypes that are not always directly related. Many of these classifying phenotypes are associated with increased mortality. Thus, it is perhaps possible that mechanism(s) of all-cause mortality reduction following TTh is via the impact on these associated phenotypes such as the metabolic syndrome (MetS), hyperglycaemia, hypertension, dyslipidaemia, low haematocrit, sex hormone binding levels, erectile dysfunction, etc. We propose that further research studying the effect of TTh takes heterogeneity into account.
[Names] => Amar Mann ... Sudarshan Ramachandran [CName] => [Doi] => 10.37349/eemd.2024.00010 [Published] => June 28, 2024 [Viewed] => 72 [Downloaded] => 6 [Subject] => Review [Year] => 2024 [CiteUrl] => https://api.crossref.org/works/10.37349/eemd.2024.00010 [Inline] => 1 [Type] => 0 [Issue] => [Topic] => 227 [TitleAbbr] => Explor Endocr Metab Dis. [Pages] => 2024;1:83–100 [Recommend] => 0 [Keywords] => Age, adult-onset hypogonadism, type 2 diabetes, testosterone therapy, all-cause mortality, haematocrit, phosphodiesterase type 5 inhibitors, sex hormone binding globulin [DetailTitle] => The Fountain of Youth: Decoding the Hormonal Regulation of Aging [DetailUrl] => https://www.explorationpub.com/Journals/eemd/Special_Issues/227 [Id] => 101410 [ris] => https://www.explorationpub.com/uploads/Article/A101410/cbc2680f4c9a777103ec50bb303f3182.ris [bib] => https://www.explorationpub.com/uploads/Article/A101410/a16abc709588947b798b8697bb93b661.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Mann A, Strange RC, Hackett G, König C, Ramachandran S. Adult-onset testosterone deficiency: the usefulness of hormone replacement in reducing mortality in men with this common age-related condition. Explor Endocr Metab Dis. 2024;1:83–100. https://doi.org/10.37349/eemd.2024.00010 [Jindex] => 0 [CEmail] => [Ris_Time] => 2024-06-27 08:28:02 [Bib_Time] => 2024-06-27 08:28:02 [KeysWordContens] => Adult-onset testosterone deficiency: the usefulness of hormone replacement in reducing mortality in men with this common age-related condition, Age, adult-onset hypogonadism, type 2 diabetes, testosterone therapy, all-cause mortality, haematocrit, phosphodiesterase type 5 inhibitors, sex hormone binding globulin, Adult-onset testosterone deficiency (TD) in men is diagnosed by the finding of low serum testosterone levels and recognised, associated symptoms. The condition has high prevalence in men over 50 years of age, particularly those with type 2 diabetes (T2DM). Accumulating data show adult-onset TD is associated with increased mortality risk. We review the literature and consider the evidence suggesting testosterone therapy (TTh) reduces mortality, especially in men with T2DM. We previously reported that in the Burntwood Lichfield Atherstone Sutton Coldfield Tamworth (BLAST) study screened cohort of men with adult-onset TD and T2DM adult-onset TD was associated with increased mortality with TTh decreasing this higher mortality. The data hinted that the effect was greater in older men. We confirmed this observation with statistical analyses to study the effect of age on the association between adult-onset TD and mortality; Cox regression analysis demonstrated that the reduced risk (hazard ratio: 0.61, 95% CI: 0.38–0.96) following TTh was restricted to men above the median age of 65.89 years. Finally, we speculate on putative mechanisms that may mediate these associations. Heterogeneity in men with adult-onset TD is expected in view of its definition of low testosterone levels together with associated clinical phenotypes that are not always directly related. Many of these classifying phenotypes are associated with increased mortality. Thus, it is perhaps possible that mechanism(s) of all-cause mortality reduction following TTh is via the impact on these associated phenotypes such as the metabolic syndrome (MetS), hyperglycaemia, hypertension, dyslipidaemia, low haematocrit, sex hormone binding levels, erectile dysfunction, etc. We propose that further research studying the effect of TTh takes heterogeneity into account. ,Amar Mann ... Sudarshan Ramachandran [PublishedText] => Published [IsEdit] => 0 [AccountId] => 78 [Zh] => 0 [AuthorsName] => ) )