Marek Mędraś

Bone mineral density and turnover in patients with acromegaly in relation to sex, disease activity, and gonadal function

Acromegaly is a rare disease caused by growth hormone (GH) hypersecretion. GH and insulin-like growth factor-I (IGF-I) exert anabolic activity in bones. Nevertheless, bone mineral density (BMD) loss is not uncommon in patients with acromegaly. It is assumed to be due to hypogonadism associated with the acromegaly. The aim of the study was to examine BMD at various skeletal sites and bone turnover and to assess the influence of impaired gonadal function and disease activity on BMD and turnover changes in acromegaly. A total of 62 patients were studied (40 women, 22 men). Among the women, 22 had active disease and 18 were cured; 16 women had normal gonadal function, and 24 were hypogonadal. Altogether, 12 men presented with active acromegaly, and 10 were cured; normal gonadal function was found in 10 men, and hypogonadism was diagnosed in 12 men. Controls were 30 healthy subjects. Densitometry using dual-energy X-ray absorptiometry of the lumbar spine, proximal femur, forearm, and total body was carried out. Bone turnover was studied based on serum osteocalcin, C-terminal collagen type 1 crosslinks, and bone alkaline phosphatase concentration. A disadvantageous effect of acromegaly on bone density was associated with hypogonadism in the distal radius (in women), the proximal femur (in men), and the total body (both sexes). An anabolic effect of GH during active acromegaly was present in the proximal femur only in men. We confirmed increased bone turnover in the presence of acromegaly, and these changes were similar regarding the activity of the disease and the gonadal status.

An Evaluation of the Levels of Vitamin D and Bone Turnover Markers After the Summer and Winter Periods in Polish Professional Soccer Players

Abstract Vitamin D is synthesised in the skin during exposure to sunlight. The fundamental roles of vitamin D are the regulation of calcium and phosphate metabolism and bone mineralisation. Low vitamin D levels in athletes may adversely affect their exercise capabilities. The aim of our study was to investigate changes in serum levels of 25(OH)D3, calcium and bone turnover markers in football players in two training periods differing in the exposure to sunlight (after the summer period and after the winter period). We investigated 24 Polish professional soccer players. Serum levels of the following parameters were determined: 25(OH)D3, calcium, osteocalcin (OC), parathormone (PTH), procollagen type I N - terminal peptide (P1NP), and beta - CrossLaps (beta - CTx). We showed significantly higher levels of 25(OH)D3 and calcium and lower levels of PTH after the summer period versus the winter period. No significant differences in the levels of bone turnover markers were found. Furthermore, we did not observe any significant correlations between the levels of 25(OH)D3 and other parameters. Normal levels of 25(OH)D3 were observed in 50% of the players after the summer period and only in 16.7% of the players after the winter period. It is justified to measure the levels of 25(OH)D3, calcium and PTH in soccer players, especially after the winter period, when the exposure to sunlight is limited.

Occupational Exposure to Impulse Noise Associated With Shooting

Shooting training is associated with exposure to a considerable amount of unique noise. We wanted to evaluate noise exposure during such training. Our observations especially apply to professional sport shooters, but they are also valid for shooting coaches/instructors. We collected acoustic signals in 10-, 25- and 50-m as well as open-air shooting ranges. The recorded material was analysed with orthogonal, adaptive parameterization by Shur. The mean duration of a single acoustic signal was 250–800 ms with the C-weighted sound peak pressure level of 138.2–165.2 dB. Shooters may be exposed to as many as 600–1350 acoustic impulses during a training unit. The actual load for the hearing organ of a professional shooter or a shooting coach is ~200 000 acoustic stimuli in a year-long training macrocycle. Orthogonal, adaptive parameterization by Shur makes safe scheduling of shooters’ training possible.

Hormonal markers of aging in men with laryngeal carcinoma

Cancer of the larynx, a frequent neoplasm in older people, occurs several times more often in men than in women. Surprisingly, the highest incidence of the disease is observed in the period in which concentrations of a number of hormones (eg, androgens, growth hormone) decrease. Our objective was to look for differences in hormonal markers of aging between men with laryngeal carcinoma and healthy control subjects.

Treatment with statins and testosterone levels in men

INTRODUCTION Statins belong to the most commonly used medicines worldwide. They affect cholesterol synthesis and thus they may suppress steroidogenesis. Our aim was to evaluate whether the use of statins is associated with the concentration of sex hormones.Material and methods/Results: In a population sample of men (n = 237) we found that subjects receiving statins had significantly lower concentrations of: total testosterone (14.9 vs. 16.35 nmol/L, p = 0.008 after correction for body mass), free testosterone (32 vs. 39 pmol/L, p = 0.004), calculated free testosterone (0.32 vs. 0.36 nmol/L, p < 0.001) and bioavailable testosterone (6.10 vs. 7.56 nmol/L, p < 0.001) than age-matched controls. CONCLUSIONS We conclude that the use of statins may have an impact on the diagnosis of age-related testosterone deficiency in men.

Vitamin D and Semen Quality in Urban, Young, Healthy Men (AndroLS)

Background and Objective Our aim was to evaluate whether the blood concentration of 25(OH)D3 is associated with semen quality and sperm morphology parameters in young men. Material and methods Healthy, urban volunteers aged 20-35 were recruited from universities, clubs and societies in the macroregion of Lower Silesia (Poland). We evaluated medical history, lifestyle factors and environmental threats, collected semen samples, and evaluated vitamin D levels. We acquired data for 177 subjects. Results The mean concentration of 25(OH)D3was 13.7 ± 8.9 ng/ml. Only a minority of the included subjects (18%) had a serum 25(OH)D3 concentration above the lower limit (20 ng/ml). In total, 39% had severe vitamin D deficiency (<10 ng/ml). None of the studied semen parameters was correlated with the serum concentration of 25(OH)D3; we also found no correlations after adjusting for alcohol consumption, cigarette smoking, carrying a mobile phone in pant pockets, body mass index, caffeine consumption and physical activity. Conclusion Our data indicate that the serum concentration of 25(OH)D3 was not correlated with semen quality in a healthy, young urban population with prevalent vitamin D insufficiency.

Diet and Semen Quality in Healthy Males from the Population of the Lower Silesia Region in Poland (The AndroLS Study)

Background Numerous studies have shown the associations between different dietary patterns and semen quality in a male population. There is no evidence on the relationship between dietary intake and markers of male fertility potential. The aim of this study was to investigate the relationship between dietary nutrients intake and semen quality parameters among healthy men from Lower Silesia (a region of Poland). Methods We enrolled 177 healthy young men aged 18-35 years from a genetically homogenous population of Lower Silesia (a region of Poland). Those who responded to the invitations were asked to complete the questionnaires covering: medical history and nutritional habits (last 5-day recall diary). The semen samples were analysed with use of the Sperm Class Analyser. Results The results showed a statistically significant positive correlation between the intake of saturated, monounsaturated fatty acids and immotility. The results also demostared a statistically significant positive correlation between energy derived from fat and immotility and rapid (a) and slow (b) progressive motility. As well a statistically negative correlation between the energy value of the diet and sperm concentration, energy derived from the consumption of carbohydrates and semen volume, consistency and the energy derived from the consumption of fat and sperm consistency and immotility was shown. Conclusion Based on our studies we concluded that further research is needed to confirm these findings and extend these results to other populations.

The Effect of Occasional Alcohol Drinking on Semen Quality and Sperm Morphology among Young and Healthy Polish Men

Background Ethanol (EtOH) is an agent that seems to exert an especially harmful effect on male fertility. The impact of high EtOH intake on fertility was demonstrated in numerous researches, with data suggesting that this effect may have been due to decreased semen quality; however, similar negative effects were not identified among occasional EtOH drinkers. There are currently no recommendations for alcohol consumption for men who plan to have a child other than avoiding high EtOH intake. Thus, studies on the effect of moderate and occasional EtOH drinking on semen quality are needed to develop appropriate recommendations for men planning to have a child in the future. The aim of this study was to determine whether changes in semen quality parameters and sperm morphology occur in healthy young men who occasionally exceed the WHO-recommended weekly dose of EtOH but are not alcohol dependent and do not frequently consume high amounts of EtOH. Methods The study sample consisted of 172 young men residing in urban areas. The semen quality and morphology of men who consumed more than 140 g of ethanol (high-risk group, HR, n=44) weekly was compared with that of low-risk group members (LR, n=128) who reported lower alcohol consumption. Results The only between-group difference in semen characteristics was the identification of a higher percentage of macrocephalic sperm in the HR group (P=0.011). Alcohol intake was the sole factor influencing the percentage of macrocephalic sperm (b =0.171, P=0.025, multiple linear regression). Conclusions We concluded that occasional alcohol consumption did not alter fertility but caused the accumulation of macrocephalic sperm potentially containing damaged DNA. Therefore, we recommend that men who plan to father children stop drinking alcohol at least 3 months before engaging in sexual intercourse that may lead to pregnancy.

Trends in the prevalence of autoimmune thyroiditis in the leading private health-care provider in Poland

BACKGROUND Autoimmune thyroiditis (AT) is one of the most common endocrine disorders affecting a significant percent of the population, especially women. It may have serious and long-lasting consequences. The etiology of AT is multifactorial and it arises from an interplas between environmental and genetic factors. Tendencies in AT prevalence and incidence are unclear. In Poland there are no national registers covering the data on AT prevalence. OBJECTIVES The aim of the investigation was to assess changes in diagnosing AT in the largest chain of outpatient medical centers in Poland. MATERIAL AND METHODS We compared freqnancy at which AT and hypothyroidism diagnoses were made during endocrinology consultations in the period 2006-2013. The data was extracted from the database of LUXMED (part of BUPA). RESULTS Within 8 years, the prevalence of newly diagnosed AT dropped from 10.4% to 4.8% (p < 0.001) alongside with a decrease in the prevalence of newly diagnosed hypothyroidism from 17.8% to 7.7% (p < 0.00001). AT was widespread in young women aged 20-39. There were relatively more cases in the southern areas of Poland. CONCLUSIONS The analyzed data does not support a hypothesis indicating a growing incidence of AT in the last years. Detailed epidemiological studies would be helpful in designing screening strategies for patients with this common disorder.

The quality of semen among a sample of young, healthy men from Lower Silesia (AndroLS)

INTRODUCTION Contrary to other parts of the continent, little information is available regarding semen quality among subjects from central and eastern Europe. MATERIAL AND METHODS We evaluated semen profiles among a sample of men from an industrialised region of Poland. We directly invited 5000 healthy inhabitants of the region (aged 18-35 years; with unchecked fecundity) to participate in the study. Among the 500 who were eligible and willing to participate, we acquired detailed information and semen and blood samples from 177 subjects. RESULTS Semen volume, sperm concentration, and total sperm count were, respectively, (mean ± SD): 3.1 ± 1.5 ml, 60 ± 44 x 106/ml and 170 ± 137 x 106/ml. Percentage of normal forms was 14.7 ± 6.5%. CONCLUSIONS Due to the relatively low sperm motility (mean ± SD: 54 ± 16%) and vitality (mean ± SD: 60 ± 15%) values, these variables require special attention during routine evaluations. The WHO 2010 criteria for these two parameters were met in only 60% and 66% of the samples, respectively. Further studies on men with different educational levels, social environments, or living conditions are needed to confirm our results.