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OBJECTIVE--Low levels of androgens in men may play a role in the development of diabetes; however, few studies have examined the association between androgen concentration and diabetes in men in [...]

Abstract: Opiates and cocaine both have effects on adrenal and gonadal function. Opiates suppress the hypothalamic-pituitary adrenal (HPA) axis, whereas cocaine leads to HPA activation. Opiates also cause gonadal dysfunction [...]

Abstract: There are an estimated 200 million users of an illicit drug in the world today. In addition, an estimated 40 million people are infected with the human immunodeficiency virus [...]

This article discusses the advantages of replacing lost testosterone for HIV-infected men, in terms of psychological and physical benefits, especially increasing lean muscle mass to fight the effects of wasting syndrome. There is a question as to the best form of administration -- injection, patch, oral, etc.

Candidates for amiodarone therapy should undergo endocrine screening. This antiarrhythmic agent has been associated with hypothyroidism, hyperthyroidism, and, recently, testicular dysfunction. Hypothyroidism can usually be treated with thyroxine replacement; however, therapy for hyperthyroidism usually centers on withdrawing the drug and administering antithyroid agents. Testosterone supplementation should be considered for patients with testicular dysfunction.

OBJECTIVE--To assess associations of sex hormones with impaired fasting glucose (IFG) and type 2 diabetes in men. RESEARCH DESIGN AND METHODS--A total of 3,156 African American, Non-Hispanic white, Hispanic, and [...]

It has been widely reported that diets high in saturated fat and cholesterol increase the risk of developing heart disease, and that lowering blood cholesterol and fat levels can reduce the risk of heart disease. The first step in treating patients with hyperlipidemia (high blood levels of fats) involves a modified diet that restricts the intake of saturated fat and cholesterol. If this form of diet therapy fails, special drugs, lipid-lowering agents, may be required to reduce blood cholesterol levels. Studies have been performed to evaluate the effectiveness of modified diets used in combination with lipid-lowering drugs in treating patients with hyperlipidemia. However, none of these studies has examined the nutritional adequacy of this form of treatment. This is important because the modified diets restrict the consumption of red meat, which contains vitamins B-6, B-12, iron, and zinc. Therefore, a study was performed to evaluate the nutritional status of 272 men and women with hyperlipidemia who had been following a modified diet for one year and were receiving pravastatin (a drug that inhibits synthesis of cholesterol in the liver). When the subjects' daily records of dietary intake were evaluated for nutrient content, it was found that greater than 40 percent of the women were getting less than two thirds of the recommended dietary allowance (RDA) of vitamins B-6 and D, folic acid, zinc and calcium. The men had low dietary intakes of folic acid and zinc. It is concluded that patients with hyperlipidemia will comply with modified diets, even while they are taking lipid-lowering drugs, but that special attention should be paid to ensure proper daily intake of vitamins and minerals. (Consumer Summary produced by Reliance Medical Information, Inc.)

Adverse effects of androgens, such as hirsutism, are generally mild. Androgens are usually well tolerated. Additional studies are needed to understand tong-term effects on cardiovascular outcomes, mood and anger, and [...]

PURPOSE: Weight loss is a strong predictor of morbidity and mortality in human immunodeficiency virus (HIV)-infected patients. Men with acquired immunodeficiency syndrome (AIDS) lose body cell mass. Hypogonadism is also common. This study tested the efficacy of a testosterone transscrotal patch (6 mg/day) in improving body cell mass and treating hypogonadism in these patients. SUBJECTS AND METHODS: This multicenter, randomized, double-blinded, placebo-controlled trial was conducted from August 1995 to October 1996 in 133 men, 18 years of age and older, who had AIDS, 5% to 20% weight loss, and either a low morning serum total testosterone level ([is less than] 400 ng/dL) or a low free testosterone level ([is less than] 16 pg/mL). Outcomes included weight, body cell mass as measured using bioelectrical impedance analysis, quality of life, and morning measurements of serum testosterone and dihydrotestosterone levels, lymphocyte subsets, and HIV quantification. RESULTS: There were no significant differences in baseline weight, CD4 cell counts, or HIV serum viral quantification between treatment arms. Morning total and free testosterone levels increased in those treated with testosterone, but not with placebo. Following 12 weeks of treatment there were no differences (testosterone--placebo) in mean weight change (-0.3 kg [95% confidence interval (CI): -1.4 to 0.8]) or body cell mass (-0.2 kg [95% CI: -1.0 to 0.6]) in the two groups. There were also no changes in quality of life in either group. CONCLUSION: Hypogonadal men with AIDS and weight loss can achieve adequate morning serum sex hormone levels using a transscrotal testosterone patch. However, this system of replacement does not improve weight, body cell mass, or quality of life. Am J Med. 1999;107:126-132. [C] 1999 by Excerpta Medica, Inc.

Background: Abdominal obesity--an elevated level of visceral adipose tissue--has been linked to colorectal cancer. Furthermore, elevated levels of visceral adipose tissue have been associated with hyperinsulinemia, and insulin is a growth factor in the colon. We assessed whether waist circumference, a surrogate measure of visceral adipose tissue, and metabolic parameters associated with visceral adipose tissue were related to colorectal cancer. Methods: In the Cardiovascular Health Study cohort, we examined the relationship of baseline measurements of body size, glucose, insulin, and lipoproteins to incident colorectal cancer. All P values are two-sided. Results: Among 5849 participants, 102 incident cases of colorectal cancer were identified. Individuals in the highest quartile of fasting glucose had a nearly twofold increased risk of colorectal cancer (relative risk [RR] = 1.8; 95% confidence interval [CI] = 1.0-3.1), and the linear trend RR (LT RR - 1.2; 95% CI = 1.0-1.5) for fasting glucose level was statistically significant (P = .02). Glucose and insulin levels 2 hours after oral glucose challenge also exhibited statistically significant associations with colorectal cancer (2-hour glucose levels: RR = 2.4 [95% CI = 1.2-4.7]/LT RR = 1.3 [95% CI = 1.0-1.6; P = .02]; 2-hour insulin levels: RR = 2.0 [95% CI = 1.0-3.8]/LT RR = 1.2 [95% CI = 1.0-1.5; P = .041). Analysis of fasting insulin levels suggested a threshold effect, with values above the median associated with colorectal cancer (RR = 1.6; 95% CI = 1.1-2.4; P = .02). Higher levels of waist circumference were also statistically significantly associated with colorectal cancer (RR = 1.9; 95% CI = 1.1-3.3; P = .02). Conclusions: These data provide, to our knowledge, the first direct evidence of an association between elevated visceral adipose tissue level, its associated metabolic effects, and colorectal cancer. [J Natl Cancer Inst 1999; 91:1147-54]

One of the more puzzling issues in the treatment of postmenopausal women is how and when to prescribe androgen therapy Many myths surround the use of androgen therapy In addition, [...]

Study objectives: To determine the efficacy of the lung as an alternative route of delivery for insulin in controlling glucose below diabetic levels (11.2 mmol/L) 2 h after the ingestion [...]