Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
5-Year Impact Factor – 2.2
Scopus CiteScore – 3.4 (CiteScore Tracker 3.4)
Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 6, June, p. 783–788

doi: 10.17219/acem/94153

Publication type: original article

Language: English

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Serum testosterone depression as a factor influencing the general condition in chronic obstructive pulmonary disease patients

Renata Rubinsztajn1,A,B,C,D,F, Tadeusz Przybyłowski1,B,C,E,F, Marta Maskey-Warzęchowska1,B,E,F, Krzysztof Karwat1,B,F, Ryszarda Chazan1,A,E,F

1 Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Poland

Abstract

Background. Testosterone has been recognized for its anabolic properties. It has been documented that in patients with chronic obstructive pulmonary disease (COPD), chronic hypoxia, disease severity, smoking, and corticosteroid treatment may contribute to low testosterone levels.
Objectives. The aim of the study was to evaluate the incidence of decreased serum testosterone concentration in male COPD patients and its influence on their condition.
Material and Methods. The study group consisted of 90 male patients, aged 67.2 ±8.8 years in all stages of airflow limitation severity (mild n = 6, moderate n = 43, severe n = 28 and very severe n = 13) Serum testosterone concentration was evaluated using ELISA method (Testosterone ELISE LDN). Decreased serum testosterone level was defined as a value of less than 3 ng/mL. Testosterone levels were related clinical features of COPD.
Results. Serum testosterone concentration did not differ in patients with different stages of airflow limitation severity (3.8 ±0.7 ng/mL for mild: 3.6 ±2.1 ng/mL for moderate; 3.4 ±1.2 ng/mL for severe and 3.7 ±1.7 ng/mL for very severe, respectively). Decreased serum testosterone was found in 30 patients (group A). There were no differences in age, the number of exacerbations or CRP concentration between patients with decreased and the normal serum testosterone group (group B). Group A was characterized by a lower FEV1, shorter 6-minute walking distance, longer smoking history and higher BMI, but no differences in body composition and densitometry results were found.
Conclusion. Serum testosterone depression may occur in as much as 30% of male COPD patients in all COPD stages of severity. The relationship between serum testosterone and negative COPD prognostic factors indicates its influence on the natural history of the disease.

Key words

quality of life, body composition, COPD, testosterone

References (36)

  1. Hassan J, Barkin J. Testosterone deficiency syndrome: Benefits, risks, and realities associated with testosterone replacement therapy. Can J Urol. 2016;23(Suppl 1):20–30.
  2. Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR; Baltimore Longitudinal Study of Aging. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging. J Clin Endocrinol Metab. 2001;86(2):724–731.
  3. Huhtaniemi I. Late-onset hypogonadism: Current concepts and controversies of pathogenesis, diagnosis and treatment. Asian J Androl. 2014;16(2):192–202.
  4. Wu FC, Tajar A, Beynon JM, et al; EMAS Group. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med. 2010;363(2):123–135.
  5. Mulligan T, Frick MF, Zuraw QC, Stemhagen A, McWhirter C. Prevalence of hypogonadism in males aged at least 45 years: The HIM study. Int J Clin Pract. 2006;60(7):762–769.
  6. Milewicz A, Krzyżanowska-Świniarska B, Miazgowski T, et al. The reference values of sex hormones and SHBG serum levels in subjects over 65 years old – The PolSenior Study. Endokrynol Pol. 2013;64(2):82–93.
  7. Zarotsky V, Huang MY, Carman W, et al. Systematic literature review of the risk factors, comorbidities, and consequences of hypogonadism in men. Andrology. 2014;2(6):819–834.
  8. Chock B, Lin TC, Li CS, Swislocki A. Plasma testosterone is associated with Framingham risk score. Aging Male. 2012;15(3):134–139.
  9. Balasubramanian V, Naing S. Hypogonadism in chronic obstructive pulmonary disease: Incidence and effects. Curr Opin Pulm Med. 2012;18(2):112–117.
  10. Leifke E, Gorenoi V, Wichers C, Von Zur Mühlen A, Von Büren E, Brabant G. Age-related changes of serum sex hormones, insulin-like growth factor-1 and sex-hormone binding globulin levels in men: Cross-sectional data from a healthy male cohort. Clin Endocrinol (Oxf). 2000;53(6):689–695.
  11. Karadag F, Ozcan H, Karul AB, Yilmaz M, Cildag O. Sex hormone alterations and systemic inflammation in chronic obstructive pulmonary disease. Int J Clin Pract. 2009;63(2):275–281.
  12. Creutzberg EC, Casaburi R. Endocrinological disturbances in chronic obstructive pulmonary disease. Eur Respir J Suppl. 2003;46:76–80.
  13. Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2010. www.goldcopd.org. Accessed March 31, 2017.
  14. Miller MR, Hankinson J, Brusasco V, et al; ATS/ERS Task Force. Standardisation of spirometry. Eur Respir J. 2005;26(2):319–338.
  15. Brooks D, Solway S, Gibbons WJ. ATS statement on six-minute walk test. Am J Respir Crit Care Med. 2003;167(9):1287.
  16. Mahler DA, Wells CK. Evaluation of clinical methods for rating dyspnea. Chest. 1988;93(3):580–586.
  17. Celli BR Cote C, Marin JM, et al. The body-mass index, airflow obstruction, dyspnoea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med.2004;350(10):1005–1012.
  18. Jones PW, Quirk FH, Baveystock CM. The St George’s Respiratory Questionnaire. Respir Med. 1991;85(Suppl B):25–31.
  19. Halmenschlager G, Rossetto S, Lara GM, Rhoden EL. Evaluation of the effects of cigarette smoking on testosterone levels in adult men. J Sex Med. 2009;6(6):1763–1772.
  20. Zhao J, Leung JY, Lin SL, Schooling CM. Cigarette smoking and testosterone in men and women: A systematic review and meta-analysis of observational studies. Prev Med. 2016;85:1–10.
  21. Svartberg J, Schirmer H, Medbø A, Melbye H, Aasebø U. Reduced pulmonary function is associated with lower levels of endogenous total and free testosterone. Eur J Epidemiol. 2007;22(2):107–112.
  22. Semple PD, Beastall GH, Watson WS, Hume R. Serum testosterone depression associated with hypoxia in respiratory failure. Clin Sci (Lond). 1980;58(1):105–106.
  23. Gosney JR. Atrophy of Leydig cells in the testes of men with longstanding chronic bronchitis and emphysema. Thorax. 1987;42(8):615–619.
  24. Akbaş T, Karakurt S, Unlügüzel G, Celikel T, Akalin S. The endocrinologic changes in critically ill chronic obstructive pulmonary disease patients. COPD. 2010;7(4):240–247.
  25. Van Vliet M, Spruit MA, Verleden G, et al. Hypogonadism, quadriceps weakness, and exercise intolerance in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2005;172(9):1105–1111.
  26. Kaparianos A, Argyropoulou E, Efremidis G, Spiropoulos K. Sex hormone alterations and systemic inflammation in a group of male COPD smokers and their correlation with the +138 insA/delA endothelin-1 gene polymorphism. A case-control study. Eur Rev Med Pharmacol Sci. 2011;15(10):1149–1157.
  27. Laghi F, Antonescu-Turcu A, Collins E, et al. Hypogonadism in men with chronic obstructive pulmonary disease: Prevalence and quality of life. Am J Respir Crit Care Med. 2005;171(7):728–733.
  28. Arver S, Lehtihet M. Current guidelines for the diagnosis of testosterone deficiency. Front Horm Res. 2009;37:5–20.
  29. Wacker ME, Jorres RA, Karch A, et al. Relative impact of COPD and comorbidities on generic health-related quality of life: A pooled analysis of the COSYCONET patient cohort and control subjects from the KORA and SHIP studies. Respir Res. 2016;17:81.
  30. Alonso J, Ferrer M, Gandek B, et al; IQOLA Project Group. Health-related quality of life associated with chronic conditions in eight countries: Results from the International Quality of Life Assessment (IQOLA) Project. Qual Life Res. 2004;13(2):283–298.
  31. Rubinsztajn R, Przybyłowski T, Maskey-Warzechowska, Karwat K, Chazan R. Exacerbations of chronic obstructive pulmonary disease and quality of life of patients. Adv Exp Med Biol. 2016;884:69–74.
  32. Köseoğlu N, Köseoğlu H, Ceylan E, Cimrin HA, Ozalevli S, Esen A. Erectile dysfunction prevalence and sexual function status in patients with chronic obstructive pulmonary disease. J Urol. 2005;174(1):249–252.
  33. Collins EG, Halabi S, Langston M, Schnell T, Tobin MJ, Laghi F. Sexual dysfunction in men with COPD: Impact on quality of life and survival. Lung. 2012;190(5):545–556.
  34. Halabi S, Collins EG, Thorevska N, Tobin MJ, Laghi F. Relationship between depressive symptoms and hypogonadism in men with COPD. COPD. 2011;8(5):346–353.
  35. Akbaş T, Deyneli O, Sönmez FT, Akalın S. The pituitary-gonadal-thyroid and lactotroph axes in critically ill patients. Endokrynol Pol. 2016;67(3):305–312.
  36. Atlantis E, Fahey P, Cochrane B, Wittert G, Smith S. Endogenous testosterone level and testosterone supplementation therapy in chronic obstructive pulmonary disease (COPD): A systematic review and meta-analysis. BMJ Open. 2013;3(8):e003127.