In addition to testosterone (T), the emerging role of sex hormone-binding
globulin (SHBG) in pathogenesis of metabolic syndrome (MetS) has been noted
recently. However, reports of associations with serum adipocytokine levels are
still limited. Therefore, we conducted this study to evaluate whether serum T and
SHBG levels are independent predictors for the risk of MetS that are associated
with adiponectin and leptin levels in 614 Taiwanese men over 40 years old
collected from a free health screening. Subjects in the lowest quartile of TT and
SHBG levels are exposed to a 1.58 and 3.22 times risk of developing MetS, as
compared to those in the highest quartile of TT and SHBG levels. However,
SHBG retains its significance independent of TT as a MetS risk predictor, but not
vice versa. In addition, SHBG was significantly correlated with both adiponectin
and leptin levels even after adjusting for TT levels. In conclusion, SHBG served as
a major predictor for the risk of MetS and was correlated with serum adiponectin
and leptin levels that are independent of T. Further studies are needed to
elucidate the true role of SHBG in the pathogenesis of MetS and possible
mechanisms associated with serum adiponectin and leptin levels.
男性學論文獎臨床組第二名
Serum Lipid Profiles are Associated with Semen Quality
Chin-Yu Liu1
, Yu-Ching Chou2
, Shyh-Hsiang Lin3
, Sheng-Tang Wu4
,
Tai-Lung Cha4
, Hong-I Chen4,5 and Chih-Wei Tsao4
1
Department of Nutritional Science, Fu Jen Catholic University,
New Taipei City, Taiwan, China. 2
School of Public Health, National Defense Medical Center, Taipei, Taiwan, China
3
School of Nutrition and Health Sciences, College of Nutrition,
Taipei Medical University, Taipei, Taiwan, China 4
Division of Urology, Department of Surgery, Tri-Service General Hospital,
National Defense Medical Center, Taipei, Taiwan, China 5
Graduate Institute of Medical Sciences, Chang Jung Christian University, Tainan, Taiwan, China
Abstract
We aimed to explore the associations between different lipid profiles and semen
quality in a large-scale general male population. Sperm concentration, total
sperm motility, progressive motility, and normal sperm morphology were
recorded of total 7601 participants were recorded. The association of these
semen parameters with the triglyceride, total cholesterol, high density lipoprotein,
low density lipoprotein, and very low density lipoprotein of serum lipid profiles
were analyzed. Sperm concentration was statistically positively correlated with
triglyceride and very low density lipoprotein (adjusted P= 0.001, and P = 0.005,
respectively). Total sperm motility and progressive motility were statistically
increased with increasing low density lipoprotein and cholesterol levels (both
adjusted P = 0.008, and P <0.001, respectively). The similar J-shaped
associations (high-low-low-high) were noted between individual lipid profile and
normal sperm morphology, especially low density lipoprotein and cholesterol
with statistical significance (adjusted P = 0.017 and P = 0.021, respectively). The
prevalence of abnormal total sperm motility and progressive motility were
decreased in participants with high levels of cholesterol (P = 0.008, and P =
0.019, respectively), and the reverse J-shaped associations (low-high-high-low)
were noted between high density lipoprotein, triglyceride, very low density
lipoprotein and the prevalence of abnormal normal sperm morphology (P =
0.010, P = 0.037, and P = 0.025, respectively). A high cholesterol level was
associated with better sperm motility. Similar J-shaped associations were noted
between all lipid profiles and normal sperm morphology, meanwhile, the reverse
J-shaped trends were identified between them and abnormal normal sperm
morphology prevalence.
男性學論文獎基礎組第一名 財團法人鳳凰泌尿科學文教基金會論文獎
Loss of SLC9A3 Decreases CFTR Protein and Causes Obstructed Azoospermia in Mice
Ya-Yun Wang1,2☯, Ying-Hung Lin2☯, Yi-No Wu2☯, Yen-Lin Chen1,2,3,
Yung-Chih Lin2
, Chiao-Yin Cheng2
, Han-Sun Chiang2,4*
1
Department of Chemistry, Fu Jen Catholic University, New Taipei City, Taiwan, 2 Graduate Institute of Biomedical and Pharmaceutical Science,
Fu Jen Catholic University, New Taipei City, Taiwan, 3
Department of Pathology, Cardinal Tien Hospital, New Taipei City, Taiwan,
4
Department of Urology, Taipei Medical University Hospital, Taipei, Taiwan
Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR)
gene cause cystic fibrosis (CF) and are associated with congenital bilateral
absence of the vas deferens (CBAVD), which is the major cause of infertility in
male patients with CF. However, most Taiwanese patients with CBAVD do not
carry major CFTR mutations. Some patients have a single copy deletion of the
solute carrier family 9 isoform 3 (SLC9A3) gene. SLC9A3 is a Na+/H+ exchanger,
and depleted Slc9a3 in male mice causes infertility due to the abnormal dilated
lumen of the rete testis and efferent ductules. Furthermore, SLC9A3 interacts
with CFTR in the pancreatic duct and functions as a genetic modifier of CF.
However, SLC9A3 function and its relation to CFTR expression in the male
reproductive tract in vivo remain elusive. In the present study, we found that
CFTR expression was dramatically decreased in the epididymis and vas deferens
of Slc9a3 knockout mice. Adult Slc9a3-/- mice showed not only significantly
decreased epididymis and vas deferens weight but also increased testis weight.
Furthermore, Slc9a3-/- mice developed obstructive azoospermia because of
abnormal abundant secretions and calcification in the lumen of the reproductive
tract. Ultrastructural analysis of the epithelium in Slc9a3–/–epididymis and vas
deferens displayed disorganized and reduced number of stereocilia and
numerous secretory apparatuses. Our data revealed that interdependence
between SLC9A3 and CFTR is critical for maintaining a precise
microenvironment in the epithelial cytoarchitecture of the male reproductive
tract. The Slc9a3-deficient mice with impaired male excurrent ducts in this study
provide proof for our clinical findings that some Taiwanese of CBAVD
carry SLC9A3 deletion but without major CFTR mutations.
江萬煊教授傑出研究論文獎
Optimization of Platelet-rich Plasma and Its Effects on the Recovery of Erectile
Function after Bilateral Cavernous Nerve Injury in a Rat Model
Yi-No Wu1,2,3†, Chien-Chih Wu4,5†, Ming-Thau Sheu3
, Kuo-Chiang Chen1,2,6,
Hsiu-O Ho3 and Han-Sun Chiang2,4*
1
PhD Programme in Nutrition and Food Science,
Fu Jen Catholic University, New Taipei City, Taiwan 2
Graduate Institute of Basic Medicine, Fu Jen Catholic University, New Taipei City, Taiwan 3
School of Pharmacy, Taipei Medical University, Taiwan 4
Department of Urology, Taipei Medical University Hospital, Taiwan 5
School of Medicine, College of Medicine, Taipei Medical University, Taiwan 6
Department of Urology, Cathay General Hospital, Taipei, Taiwan
Abstract
Platelet-rich plasma (PRP) containing autologous growth factors is applied in
regenerative medicine, but the lack of an optimized PRP preparation protocol
causes unstable therapeutic effects. The aim of this study was to optimize the
PRP preparation method and compare the effects of PRP from different
preparation methods in restoration of erectile function in a rat model. The in vivo
experiments used Sprague–Dawley male rats (n=24), which were randomly
divided into four groups of equal numbers: group I underwent sham operation,
while the remaining three groups underwent bilateral CN crush. Crush injury
groups were treated at the time of injury with an application of general PRP,
optimized PRP [with the largest amount of platelet-derived growth factor
(PDGF)–AB] or normal saline-only injection in the corpus cavernosum,
respectively. Four weeks later, erectile function was assessed by CN
electrosimulation, and penile tissue was collected for histology. Results
demonstrated that in the PRP group prepared with the ACD-A anticoagulant,
chitosan and incubated at 20°C for 15 days had the largest amount of PDGF-AB
and showed a synergistic effect on release (p<0.05). Functional outcome
measurement and immunofluorescence staining for the dorsal nerve revealed
that improvement after bilateral CN injury occurred in the optimized PRP group
(p<0.05). It was concluded that optimized PRP with a high level of growth
factors was more stable, and its injection into the corpus cavernosum facilitated
recovery of erectile function.
臺灣楓城泌尿學會男性學論文獎
Effects of TNF-α on Penile Structure Alteration in Rats with Hyperprolactinemia
Zhong-Lin Wang1
, Ling-Yu Yang2,3, Hong-Huan Chen1
, Hsiao-Hsin Lin1
,
Yi-Ting Tsai1
, William J. Huang1,4,5*
Department of Physiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan1
,
Department of Pediatrics, School of Medicine, National Yang-Ming University, Taipei, Taiwan2
,
Department of Medical Education, and Pediatrics,
Taipei Veterans General Hospital, Taipei, Taiwan3
,
Department of Urology, School of Medicine, Shu-Tien Urological Research Center,
National Yang-Ming University, Taipei, Taiwan4
,
Division of Male Reproductive Medicine, Department of Urology, Taipei5
Abstract
This study aimed to investigate the effects of anti-tumor necrosis factor (TNF)-α
antibody (Ab) on alteration of penile structure in the hyperprolactinemia
(hyperPRL) rat model. HyperPRL was induced in 8-week-old male
Sprague-Dawley rats by allografting anterior pituitary (AP) glands under the renal
capsule (+AP rats). Rats implanted with cerebral cortex(CX) were used as sham
control (+CX rats). At 6 weeks post implantation, rats received either a single
intra-testicular dose of TNF-α Ab (12.5 μg/kg) or testosterone replacement (2
doses of testosterone enanthate [TE], 3 mg/kg), and they were sacrificed 1 week
later. Blood and penile tissue was collected for analysis. Compared to +CX rats,
the +AP group had lower serum testosterone concentration and neuronal nitric
oxide synthase (nNOS) expression, but exhibited a higher ratio of collagen III/I in
the corpus cavernosum. Smooth muscle content exhibited no significant changes.
At 1 week post TNF-α Ab injection, the collagen III/I ratio in the +AP group was
decreased, and the smooth muscle content and nNOS expression increased
significantly. These findings were comparable to those observed in+AP rats
receiving TE. Testicular TNF-α suppresses testosterone release, which in turn
results in the erectile dysfunction (ED) seen in hyperPRL. Intra-testicular TNF-α
Ab treatment is as effective as testosterone supplementation on penile structure
normalization inthe hyperPRL model.
男性學論文獎住院醫師組
Preliminary Experience and Possible Predictors of Successful Mirabegron
Treatment for Overactive Bladder
Tsai-Feng Chena
, Hsu-Che Huanga
, Yu-Hua Lina
, Chun-Hou Liaoa,b, Bing-Juin Chianga,b
a
Division of Urology, Department of Surgery, Cardinal Tien Hospital, Taiwan
b
School of Medicine, Fu-Jen Catholic University, Taiwan
Abstract
Objective: The aim of this study was to report our preliminary experience of the
treatment with mirabegron and to identify the predictors of a successful
treatment with mirabegron in overactive bladder (OAB) patients.
Materials and Methods: Between October 2015 and February 2016, 234
consecutive patients (167 men and 67 women; mean age: 65.6 years; standard
deviation: 16.3) diagnosed with OAB and receiving mirabegron monotherapy
were enrolled retrospectively. Four weeks after mirabegron treatment, a global
response assessment (GRA) was performed for all patients and analyses were
performed to identify possible predictors of successful mirabegron treatment
(defined as GRA ≥ 1). Mirabegron was intended being given for at least 12 weeks.
Adverse events (AEs) and reasons for discontinuing mirabegron were recorded
between 4 to 12 weeks of following-up.
Results: The rate of successful mirabegron treatment (GRA ≥ 1) was 70.5%. The
proportion of patients with a successful response was significantly higher in men
than in women (75.3% vs. 60.5%, p = 0.022). The success rates as well as the
percentage of older patients between groups with or without diabetes,
hypertension, nocturia, urge incontinence, or prior anticholinergic treatment
were not significantly different. Multivariable analysis showed that male sex was a
significant independent predictor (p < 0.05) for successful treatment. The overall
rate of AEs was 3.8%, including five cases with hypertension (2.1%) and three
with severe voiding difficulty (1.3%). A total of 136 patients (58%) were
administered mirabegron for more than 12 weeks. The reasons for discontinuing
mirabegron included symptom improvement (17%), loss to follow-up (13%),
poor treatment efficacy (8%), and side effects (4%).
Conclusions: The success rate of mirabegron treatment for OAB patients was
high and the rate of overall AEs was low. Although only 58% patients continued
mirabegron at 12 weeks, most patients (17%) discontinued the treatment
because of reduction in symptoms. Male sex showed better response to
mirabegron treatment.