Amilia Aminuddin

Testosterone is associated with age-related changes in bone health status, muscle strength and body composition in men

Objective: Variations in testosterone levels are associated with several outcomes of aging. The present study aimed to examine the relationship between age-related decline of testosterone levels and changes in bone health status, handgrip strength, body fat percentage and fat-free mass. Materials and methods: A total of 335 Malaysian Chinese and Malay men aged 40 years and above were recruited for this study. Their body compositions, calcaneal speed of sound and handgrip strength were measured and their blood was collected. Linear regression analysis was done to examine the relationship among age, testosterone levels and outcomes of aging. Results: The results indicated significant changes in all testosterone measurements, sex hormone binding globulin level, calcaneal speed of sound, handgrip strength, body fat percentage and fat-free mass with age (p < 0.05). Age-dependent decline in bioavailable and free testosterone levels were significantly associated with reduction in calcaneal speed of sound, fat-free mass and handgrip strength (p < 0.05). Age-dependent decline in the total testosterone level was significantly associated with an increase in body fat percentage among the elderly men (p < 0.05). Conclusion: Testosterone levels are associated with changes in outcome of aging such as bone health status, muscle strength and body composition, and the relationships are age-dependent.

The Relationships between Thyroid Hormones and Thyroid-stimulating Hormone with Lipid Profile in Euthyroid Men

Background and Aim: Alteration in lipid profile is a common observation in patients with thyroid dysfunction, but the current knowledge on the relationship between lipids and thyroid hormone levels in euthyroid state is insufficient. The current study aimed to determine the association between thyroid hormones and thyroid-stimulating hormone (TSH) with lipid profile in a euthyroid male population. Methods: A total of 708 Chinese and Malay men aged 20 years and above were recruited in this cross-sectional study. Their blood was collected for the determination of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglyceride (TG), free thyroxine (FT4), free triiodothyronine (FT3) and TSH levels. The association was analyzed using multiple regression and logistic regression models with adjustment for age, ethnicity, body mass index and FT4/FT3/TSH levels. Results: In multiple regression models, TSH was positively and significantly associated with TG (p<0.05). Free T4 was positively and significantly associated with TC, LDL-C and HDL-C (p<0.05). Free T3 was negatively and significantly associated with HDL-C (p<0.05). In binary logistic models, an increase in TSH was significantly associated with higher prevalence of elevated TG in the subjects (p<0.05), while an increase in FT4 was significantly associated with higher prevalence of elevated TC but a lower prevalence of subnormal HDL in the subjects (p<0.05). Free T3 was not associated with any lipid variables in the logistic regression (p>0.05). Conclusions: In euthyroid Malaysian men, there are positive and significant relationships between TSH level and TG level, and between FT4 level and cholesterol levels.

Effects of Swedish Massage Therapy on Blood Pressure, Heart Rate, and Inflammatory Markers in Hypertensive Women

Swedish Massage Therapy (SMT) is known for its therapeutic relaxation effects. Hypertension is associated with stress and elevated endothelial inflammatory markers. This randomized control trial measured the effects of whole body SMT (massage group) or resting (control group) an hour weekly for four weeks on hypertensive women. Blood pressure (BP) and heart rate (HR) were measured before and after each intervention and endothelial inflammatory markers: vascular endothelial adhesion molecules 1 (VCAM-1) and intracellular adhesion molecules 1 (ICAM-1) were measured at baseline and after the last intervention. Massage group (n=8) showed significant systolic BP (SBP) reduction of 12 mmHg (P=0.01) and diastolic BP (DBP) reduction of 5 mmHg (P=0.01) after four sessions with no significant difference between groups. Reductions in HR were also seen in massage group after sessions 1, 3, and 4 with significant difference between groups. VCAM-1 showed significant reduction after four sessions: the massage group showed reduction of 998.05 ng/mL (P=0.03) and the control group of 375.70 ng/mL (P=0.01) with no significant differences between groups. There were no changes in ICAM-1. In conclusion, SMT or resting an hour weekly has effects on reducing BP, HR, and VCAM-1 in hypertensive women.

Thyroid-stimulating hormone is significantly associated with bone health status in men

Background and Aim: Recent studies revealed a novel association between thyroid-stimulating hormone (TSH) and bone health status in healthy male populations. The present study aimed to validate this association and provide new information on the relationship between TSH levels and calcaneal speed of sound (SOS) in men. Methods: This cross-sectional study recruited 681 men with complete data of calcaneal SOS, body anthropometry, serum TSH, free triiodothyronine (FT3) and free thyroxine (FT4) levels. Results: All subjects had FT3 and FT4 levels within the in-house reference range and 13 subjects had lower than normal TSH levels. The results revealed that the SOS value of subjects was significantly associated with TSH after multiple adjustments (p<0.05). When subjects were divided into quintiles according to their TSH levels, the difference of SOS between men with low-normal TSH and high-normal TSH contributed significantly to the association between TSH and bone health status (p<0.05). The significance of the association persisted with the inclusion and exclusion of subclinical hyperthyroid subjects. Conclusions: There was a significant association between TSH levels and bone health status in men as assessed by quantitative ultrasound. This age-independent association between TSH and SOS might explain some of the individual variation of bone health status in men.

Total testosterone and sex hormone-binding globulin are significantly associated with metabolic syndrome in middle-aged and elderly men.

Testosterone and sex hormone-binding globulin (SHBG) have been shown to be associated with metabolic syndrome (MS) in men. This study aimed at validating these relationships in a group of middle-aged and elderly men and assessing their strength of association to MS. A cross-sectional study of 332 Malaysian men aged 40 years and above was conducted. The blood of subject was collected under fasting condition for determination of testosterone, SHBG, glucose and lipid levels. Their medical history, smoking and alcohol consumption status, waist circumference (WC), body mass index (BMI) and blood pressure (BP) were recorded. All testosterone and SHBG levels were significantly reduced in MS subjects compared to non-MS subjects (p<0.05). Testosterone and SHBG were correlated significantly with most of the MS indicators without adjustments. In multiple regression analysis, the triglyceride level was the only MS indicator that was significantly, inversely and independently associated with all testosterone measurements and SHBG (p<0.05). Waist circumference was significantly and negatively associated with SHBG level (p<0.05) though not independent of BMI. Total testosterone and SHBG were significantly and inversely associated with the presence of MS. Testosterone and SHBG are potential intervention targets for the prevention of MS in men.

Sex hormones in Malay and Chinese men in Malaysia: are there age and race differences?

OBJECTIVES: Variations in the prevalence of sex-hormone-related diseases have been observed between Asian ethnic groups living in the same country; however, available data concerning their sex hormone levels are limited. The present study aimed to determine the influence of ethnicity and age on the sex hormone levels of Malay and Chinese men in Malaysia. METHODS: A total of 547 males of Malay and Chinese ethnicity residing in the Klang Valley Malaysia underwent a detailed screening, and their blood was collected for sex hormones analyses. RESULTS: Testosterone levels were normally distributed in the men (total, free and non-sex hormone-binding globulin (SHBG) bound fractions), and significant ethnic differences were observed (p<0.05); however, the effect size was small. In general, testosterone levels in males began to decline significantly after age 50. Significant ethnic differences in total, free and non-SHBG bound fraction estradiol levels were observed in the 20-29 and 50-59 age groups (p<0.05). The estradiol levels of Malay men decreased as they aged, but they increased for Chinese men starting at age 40. CONCLUSIONS: Small but significant differences in testosterone levels existed between Malay and Chinese males. Significant age and race differences existed in estradiol levels. These differences might contribute to the ethnic group differences in diseases related to sex hormones, which other studies have found in Malaysia.

Retinal Vasculature Fractal Dimension Measures Vessel Density

Abstract Purpose: The goal of this study was to provide the empirical evidence of fractal dimension as an indirect measure of retinal vasculature density. Materials and methods: Two hundred retinal samples of right eye [57.0% females (n = 114) and 43.0% males (n = 86)] were selected from baseline visit. A custom-written software was used for vessel segmentation. Vessel segmentation is the process of transforming two-dimensional color images into binary images (i.e. black and white pixels). The circular area of approximately 2.6 optic disc radii surrounding the center of optic disc was cropped. The non-vessels fragments were removed. FracLac was used to measure the fractal dimension and vessel density of retinal vessels. Results: This study suggested that 14.1% of the region of interest (i.e. approximately 2.6 optic disk radii) comprised retinal vessel structure. Using correlation analysis, vessel density measurement and fractal dimension estimation are linearly and strongly correlated (R = 0.942, R2 = 0.89, p < 0.001). Polynomial regression model suggests quadratic regression as the best fit for our data (linear: R2 = 0.1024, 198 d.f., p < 0.001, quadratic: R2 = 0.1236, 197 d.f., p < 0.001, cubic: R2 = 0.1236, 196 d.f., p < 0.001). Conclusions: This study demonstrated the ability of vessel density measurement to detect the changes in the morphology of retinal microvascular associated with increasing age. Thus, vessel density can be suggested to be another parameter in the quantification of retinal microvasculature.

Carotid intima media thickness among young males with cardiovascular risk factors

Introduction: Atherosclerosis is a condition where there are fat, cells and connective tissue deposition in the arterial wall. This may lead to reduced blood flow to the vital organs such as heart (ischemic heart disease) and brain (stroke). There is increasing prevalence of ischemic heart disease (IHD) among the young population, especially males. Carotid intima media thickness (CIMT) of the common carotid artery is a novel marker of atherosclerosis. The aims of the current study were to compare these markers among young males with cardiovascular disease (CVD) risk factors with healthy subjects and to determine the associations between these markers with other CVD risk factors. Methods: One hundred and eighty one men aged 20 to 40 years old were recruited from areas around Klang Valley. These comprised those having one or more risk factors of CVD [hypertension, abdominal obesity, dyslipidemia, first degree family history (FH) of CVD and smoker, n=128] and without risk factors (n=53). Measurements included peripheral blood pressure (BP), heart rate (HR), body mass index (BMI), waist circumference (WC), total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL) and fasting blood sugar (FBS). Right and left CIMT were also measured via B mode ultrasound. Data were analyzed via SPSS version 15 and significance level was set at P<; 0.05. Results: The mean age of all the subjects was 26.47 ± 5.09 years old. Those with risk factors were older, had significantly higher BP, BMI, WC and lipid profiles. Nevertheless, most of these variables were within normal range. Other variables such as HR and FBS were comparable between the two groups. After adjustment for age, those with CV risk factors had significantly higher right CIMT (0.5600 ± 1417 vs 0.5267 ± 0733 mm, P<;0.05) but not left CIMT (0.5450 ± 0.1500 vs 0.5167 ± 1033 mm, P > 0.05) compared to healthy group. Both CIMTs correlate with other major CV risk factors. The predictors of CIMT were age, SBP and WC which contribute about 12% of the variance in CIMT. Conclusion: Young males with CV risk factors have increased RCIMT and this may be the early markers of CVD.

Piper sarmentosum attenuates TNF-α-induced VCAM-1 and ICAM-1 expression in human umbilical vein endothelial cells

Objectives Inflammation plays a key role in the pathogenesis of atherosclerosis. Piper sarmentosum is an herb with antioxidant and anti-atherosclerotic activities. The aim of this study was to evaluate the anti-inflammatory properties of an aqueous extract of P. sarmentosum (AEPS) in human umbilical vein endothelial cells (HUVECs). Methods HUVECs were divided into six groups: control, treatment with 10 ng/ml TNF-α, and co-treatment of 10 ng/ml TNF-α with four different concentrations of AEPS (100, 150, 250, and 300 μg/ml) for 24 h. Subsequently, vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) protein expression, U937 monocyte cells adhesion, and nuclear factor-kappaB (NF-κB) p65 expression in HUVECs were measured. Results Treatment of TNF-α-stimulated HUVECs with AEPS at different concentrations resulted in decreased VCAM-1 and ICAM-1 protein expression in a dose-dependent manner. Furthermore, AEPS also inhibited TNF-α-stimulated U937 monocyte cells adhesion to HUVECs. In addition, AEPS reduced TNF-α-induced NF-κB p65 expression in a dose-dependent manner. Conclusions The results indicated that AEPS suppressed TNF-α-induced VCAM-1 and ICAM-1 expression NF-κB signaling.

The Assessment of Finger Photoplethysmography Fitness Index (PPGF) among Young Men with Cardiovascular Disease Risk Factors: A Cross Sectional Study

Two new vascular health markers which are derived from finger photoplethysmography (PPG) waveform have been introduced based on Malaysian population, namely PPG fitness index (PPGF) and vascular risk prediction index (VRPI). The objectives of this study were to investigate the associations between PPGF and other cardiovascular disease (CVD) markers such as carotid femoral pulse wave velocity (PWVCF), to compare PPGF between those with and without CVD risk factors and to determine the sensitivity of VRPI in identifying young subjects with CVD risk factors. A total of 114 men age 20 to 40 yrs with and without CVD risk factors were recruited. Risk factors included hypertension, smoking, dyslipidemia, abdominal obesity and family history of premature CVD. Subjects were divided into healthy, those with one risk factor and those with at least two risk factors. Their weight, height, peripheral and central blood pressure (BP), PWVCF and PPGF were measured and the sensitivity of VRPI in predicting subjects with CVD risk factor was calculated. Data was analyzed via SPSS version 15 and p 0.05). The independent variables for PPGF were forward pressure (Beta = 0.35, p < 0.01), PWVCF (Beta = -0.26, p < 0.01), systolic BP (Beta = -0.26, p = 0.04) and height (Beta = 0.24, p < 0.01). The sensitivity of VRPI was 82.02%. In conclusion, PPGF was correlated to PWVCF and may be a potential marker of arterial stiffness. In addition, VRPI is sensitive to be used as an early screening of CVD risk factors.