Salivary testosterone measurement in women with and without polycystic ovary syndrome

Clinical and/or biochemical hyperandrogenism is one of the diagnostic criteria for PCOS. An evaluation of the role of salivary testosterone (salT) and androstenedione (salA) for the diagnosis of PCOS was undertaken in a cross sectional study involving 65 women without PCOS and 110 women with PCOS fulfilling all 3 diagnostic Rotterdam criteria. Serum and salivary androgen measurements were determined by LC-MS/MS. salT and salA were significantly elevated in PCOS compared to controls (P<001). No androgen marker was more predictive than another using ROC curves, but multiple logistic regression suggested salT was more predictive than free androgen index (FAI)(p<0.01). The combination of salT or FAI identified 100% of PCOS women. PCOS women with both biochemical and clinical hyperandrogenism as opposed to clinical hyperandrogenism alone showed a metabolic phenotype (p<0.05) and insulin resistance(p<0.001). PCOS patients with an isolated elevated FAI showed increased insulin resistance compared to those with an isolated salT(P<0.05). salT appeared to be at least as predictive as FAI for the diagnosis of the classical PCOS phenotype, and the combination of salT or FAI identified 100% of PCOS patients. This suggests that salT measurement by LC-MS/MS holds the promise of complementing existing laboratory tests as a means of assessing hyperandrogenemia

الانتشار المصلى لفيروس الهربس البسيط (الدمط 1 والنمط 2) فى أوساط المجموعات السكانية ال هندية والفلبينية المهاجرة في قطر: مسح مقطعي

Background: The epidemiology of herpes simplex virus infections is of growing interest but information on its seroprevalence in many countries is scarce. Aims: This study aimed to measure the seroprevalence of herpes simplex virus type 1 and type 2 in Filipino and Indian men living in Qatar. Methods: Blood serum specimens were collected from male blood donors aged ≥ 18 years in Qatar from 2013 to 2016. HerpeSelect® 1/2 and Euroline‐WB assays were used to measure antibodies to herpes simplex virus types 1 and 2 in 120 Filipino and 325 Indian men. Results: The seroprevalence of herpes simplex virus‐1 was 84.9% (95% confidence interval (CI): 78.4–90.0%) in Filipino men and 48.3% (95% CI: 43.6–53.0%) in Indian men. The seroprevalence of herpes simplex virus‐2 was 8.3% (95% CI: 4.6–13.7%) in Filipinos and 3.7% (95% CI: 2.2–5.9%) in Indians. The seroprevalence of herpes simplex virus types 1 and 2 increased with age, but this trend was only statistically significant in Indian men (P = 0.013 and P = 0.011 respectively). Conclusions: The seroprevalence rates of herpes simplex virus‐2 in Filipino and Indian men living in Qatar were similar to those found in the Philippines and India. However, the seroprevalence of herpes simplex virus‐1 in Indians, while similar to that found in India, was substantially lower than that of other countries in Asia and developing countries worldwide, which needs further investigation.Contexte : L'épidémiologie des infections par le virus de l'herpès suscite un intérêt croissant, mais les informationsrelatives à sa séroprévalence dans de nombreux pays sont rares.Objectifs : La présente étude visait à mesurer la séroprévalence du virus de l'herpès de types 1 et 2 parmi les hommesphilippins et indiens vivant au Qatar.Méthodes : Des échantillons de sérum sanguin ont été prélevés sur des donneurs de sang masculins âgés d'au moinsdix-huit ans au Qatar entre 2013 et 2016. Les tests HerpeSelect® 1/2 et Euroline-WB ont été utilisés pour mesurer lesanticorps dirigés contre le virus de l'herpès de types 1 et 2 chez 120 hommes philippins et 325 hommes indiens.Résultats : La séroprévalence du virus de l'herpès de type 1 était de 84,9 % (intervalle de confiance (IC) à 95 % : 78,4-90,0 %)chez les hommes philippins et de 48,3 % (IC à 95 % : 43,6-53,0 %) chez les hommes indiens. La séroprévalence du virus del'herpès de type 2 était de 8,3 % (IC à 95 % : 4,6-13,7 %) chez les hommes philippins et de 3,7 % (IC à 95 % : 2,2- 5,9 %) chezles hommes indiens. La séroprévalence du virus de l'herpès de types 1 et 2 augmentait avec l'âge, mais cette tendancen'était statistiquement importante que chez les homme indiens (p = 0,013 et p = 0,011 respectivement).Conclusions : Les taux de séroprévalence du virus de l'herpès de type 2 parmi les hommes philippins et indiens vivantau Qatar étaient similaires à ceux constatés aux Philippines et en Inde. Toutefois, le taux de séroprévalence du virus del'herpès de type 1 chez les Indiens, bien que comparable à celui relevé en Inde, était beaucoup moins élevé que celui desautres pays d'Asie et des pays en développement, ce qui mérite d'être étudié plus attentivement.الخلفية: يتزايد الاهتمام بدراسة السمات الوبائية لحالات العدوى بفيروس الهريس البسيط. غير أن المعلومات حول انتشاره مصليا في العديد من البُلدان شحيحة للغاية. الأهداف: هدفت هذه الدراسة إلى قياس الانتشار المصلي لفيروس الحربس البسيط (النمط 1 والنمط 2) بين الرجال الذين يعيشون في قطر وينتمون إلى الجنسيتين الهندية والفلبينية. طرق البحث: أخذت عينات من مصل الدم من متبرعين بالدم من الذكور يبلغون من العمر 18 عاما أو أكثر في قطر في الفترة من 2013 وحتى 2016. واستّخدمت مقايستئ Euroline–WB و ® HerpeSelect 1/2 لقياس الأجسام المضادة لفيروس المريس البسيط (النمط 1 والنمط 2) لدى 120 رجلا فليبينيا و 325 رجلا هنديا. النتائج: كانت نسبة الانتشار المصلي لفيروس الهربس البسيط (النمط -1)(84.9%; 95% CI=78.4-90%) في صفوف الرجال من الجنسية الفليبينية و (48.3%; 95% CI=43.6-53.0%) في صفوف الرجال من الجنسية الهندية. كانت نسبة الانتشار المصلي لفيروس الهريس البسيط النمط 2 (8.3%; 95% CI=4.6-13.7%) في صفوف الرجال من الجنسية الفليبينية و (3.7%; 95% CI=2.2-5.9%) في صفوف الرجال من الجنسية الهندية. وارتفع معدل الانتشار المصلي لفيروس الهربس البسيط (النمط 1 والنمط 2) مع تقدم العمرء غير أن هذا الاتجاه لم يُظهر أهمية إحصائية يُعتد بها إلا بين الرجال من الجنسية الهندية (P=0.013; P=0.011) على التوالي. الاستنتاجات: كانت معدلات الانتشار المصلي لفيروس الهربس البسيط النمط 2 في صفوف الرجال من الجنسيتين الفليبينية والهندية الذين يعيشون في قطر ممائلة لنفس المعدلات الموجودة في الفلبين والهند. ولكن بالنسبة لمعدل الانتشار المصلي لفيروس الهربس البسيط النمط 1 في صفوف الرجال من الجنسية الهندية، وبالرغم من مماثلته للمعدل الموجود في الهند. فقد كان أقل بصورة ملحوظة من بُلدان أخرى في قارة آسيا وفي بلدان نامية أخرى حول العالم، وهو الأمر الذي يتطلب مزيدا من الدراس

Negative epidemiological association between HSV-1 and HSV-2 infections

Objectives: Existing evidence on an epidemiological association between herpes simplex virus (HSV) type 1 and type 2 infections remains conflicting and inconclusive. Using a multi-national database of HSV-1/2 serological testing, we aimed to assess the existence of an association between both infections. Design, Setting, and Participants: An HSV-1/2 cross-sectional serological testing database was assembled by merging databases of seroprevalence studies on men blood donors residing currently in Qatar, but from different countries. Specimens were tested for anti-HSV-1 IgG antibodies using HerpeSelect® 1 ELISA, and for anti-HSV-2 IgG antibodies following a two-test algorithm: HerpeSelect® 2 ELISA to test the sera, and Euroline-WB to confirm positive and equivocal specimens. Logistic regressions were conducted to estimate unadjusted and adjusted infection odds ratios. Results: Serological testing for HSV-1/2 was performed on 2522 specimens. Sero-positivity for HSV-1 and HSV-2 was identified in 2053 (81.5%) and 87 (3.5%) specimens, respectively. Univariable analyses estimated higher odds of HSV-2 infection with increasing age and increasing country income level, and an unadjusted odds ratio with HSV-1 sero-positivity of 0.71 (95% CI 0.43–1.17; p-value 0.172). Adjusting for age and country income level, the adjusted odds ratio of HSV-2 infection with HSV-1 sero-positivity was 0.51 (95% CI 0.30–0.87; p-value 0.013). Sensitivity analyses confirmed this association. Conclusions: There is a negative association between HSV-1 and HSV-2 infections, suggestive of a protective effect for HSV-1 sero-positivity against HSV-2 acquisition. This finding supports earlier pooled but inconclusive evidence from prospective studies, yet contrasts with pooled findings of earlier cross-sectional studies

Metabolic comparison of polycystic ovarian syndrome and control women in Middle Eastern and UK Caucasian populations

© 2020, The Author(s). To determine if metabolic characteristics differed in women with and without polycystic ovary syndrome (PCOS) between a Caucasian and Middle East population. Comparative cross-sectional analysis. Demographic and metabolic data from Middle Eastern women from Qatar Biobank (97 with PCOS, 622 controls) were compared to a Caucasian PCOS biobank in Hull UK (108 with PCOS, 69 controls). In both populations, PCOS women showed a worse cardiovascular risk profile of increased systolic and diastolic blood pressure, increased C-reactive protein (CRP), reduced HDL, insulin resistance as well as increased androgens compared to their respective controls without PCOS. UK women without PCOS had higher systolic and diastolic blood pressures, and increased testosterone results (p < 0.01) compared to Middle Eastern women without PCOS who had higher inflammatory markers (WBC and CRP), HDL and insulin resistance (p < 0.001). UK PCOS women had a higher body mass index, systolic and diastolic blood pressures, triglycerides (p < 0.01), whilst Middle Eastern PCOS women showed increased testosterone, free androgen index, HDL and CRP (P < 0.01). There was no difference in insulin or insulin resistance between the two PCOS cohorts. This study highlights ethnic population differences because, whilst cardiovascular risk indices were increased for both PCOS cohorts, this may be for different reasons: BMI, waist and hip measurements, systolic and diastolic blood pressure, and triglycerides were higher in the UK cohort whilst testosterone, HDL and CRP were higher in the Middle East population. Insulin resistance did not differ between the two PCOS populations despite differences in BMI

Estimating Seroprevalence of Herpes Simplex Virus Type 1 among Different Middle East and North African Male Populations Residing in Qatar

HSV-1 epidemiology in the Middle East and North Africa (MENA) remains poorly understood. Our study aimed to measure HSV-1 antibody prevalence (seroprevalence) and its age-distribution among select MENA populations residing in Qatar. Sera were collected from male blood donors attending Hamad Medical Corporation 2013-2015. A total of 2,077 sera were tested for anti-HSV-1 antibodies using HerpeSelect® 1 ELISA IgG kits (Focus Diagnostics, USA). Robust Poisson regression was conducted to estimate adjusted infection prevalence ratios. Country-specific HSV-1 seroprevalence was estimated for 10 national populations: 97.5% among Egyptians, 92.6% among Yemenis, 90.7% among Sudanese, 88.5% among Syrians, 86.5% among Jordanians, 82.3% among Qataris, 81.4% among Iranians, 81.4% among Lebanese, 80.5% among Palestinians, and 77.0% among Pakistanis. Age-specific HSV-1 seroprevalence was estimated for Egypt, the Fertile Crescent (Iraq, Jordan, Lebanon, Palestine, and Syria), and Qatar. Seroprevalence increased with age among Fertile Crescent and Qatari nationals. Seroprevalence increased from 70.0% among those aged ≤24 years up to 98.0% among those aged ≥55 years among Fertile Crescent nationals. Seroprevalence was consistently above 90% for all ages among Egyptians. HSV-1 seroprevalence is high in MENA, though with some variation across countries. The seroprevalence appears to have declined among current young age cohorts compared to its levels a few decades ago

Diabetes-related cardiovascular and economic burden in patients hospitalized for heart failure in the US: a recent temporal trend analysis from the National Inpatient Sample

We aimed to study the cardiovascular and economic burden of diabetes mellitus (DM) in patients hospitalized for heart failure (HF) in the US and to assess the recent temporal trend. Data from the National Inpatient Sample were analyzed between 2005 and 2014. The prevalence of DM increased from 40.4 to 46.5% in patients hospitalized for HF. In patients with HF and DM, mean (SD) age slightly decreased from 71 (13) to 70 (13) years, in which 47.5% were males in 2005 as compared with 52% in 2014 (p trend < 0.001 for both). Surprisingly, the presence of DM was associated with lower in-hospital mortality risk, even after adjustment for confounders (adjusted OR = 0.844 (95% CI [0.828–0.860]). Crude mortality gradually decreased from 2.7% in 2005 to 2.4% in 2014 but was still lower than that of non-diabetes patients’ mortality on a yearly comparison basis. Hospitalization for HF also decreased from 211 to 188/100,000 hospitalizations. However, median (IQR) LoS slightly increased from 4 (2–6) to 4 (3–7) days, so did total charges/stay that jumped from 15,704 to 26,858 USD (adjusted for inflation, p trend < 0.001 for both). In total, the prevalence of DM is gradually increasing in HF. However, the temporal trend shows that hospitalization and in-hospital mortality are on a descending slope at a cost of an increasing yearly expenditure and length of stay, even to a larger extent than in patient without DM

Herpes Simplex Virus Type 2 Seroprevalence among Different National Populations of Middle East and North African Men

© 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Sexually Transmitted Diseases Association. Background There are limited data on herpes simplex virus type 2 (HSV-2) seroprevalence in the Middle East and North Africa (MENA). We examined country- and age-specific HSV-2 seroprevalence among select MENA populations residing in Qatar. Methods Sera were collected from male blood donors attending Hamad Medical Corporation between June 2013 and June 2016. Specimens were screened for anti-HSV-2 IgG antibodies following a 2-test algorithm: HerpeSelect 2 ELISA was used to identify HSV-2-positive specimens, and Euroline-WB was used to confirm positive and equivocal specimens for final HSV-2 status. Trends and associations with HSV-2 seropositivity were assessed. Results Of the 2077 tested sera, 61 were found and confirmed positive. The proportion of those confirmed positive increased steadily with HerpeSelect 2 ELISA index value, ranging from 16.3% for index values of 1.101 to 1.999 to 92.9% for index values of 4 or greater. Nationality-specific seroprevalence was 6.0% (95% confidence interval [CI], 4.1%-8.8%) in Qataris, 5.3% (95% CI, 2.5%-11.1%) in Iranians, 4.2% (95% CI, 1.8%-9.5%) in Lebanese, 3.1% (95% CI, 1.2%-7.7%) in Sudanese, 3.0% (95% CI, 1.4%-6.4%) in Palestinians, 2.2% (95% CI, 1.1%-4.3%) in Egyptians, 2.0% (95% CI, 1.0%-5.0%) in Syrians, 1.0% (95% CI, 0.3%-3.6%) in Jordanians, 0.7% (95% CI, 0.1%-3.7%) in Yemenis, and 0.5% (95% CI, 0.1%-2.8%) in Pakistanis. There was evidence for higher seroprevalence in older age groups. Conclusions The seroprevalence of HSV-2 was in the range of few percentage points. There were no major differences in seroprevalence by nationality. These findings add to our understanding of HSV-2 epidemiology in MENA and indicate unmet needs for sexual health and control of sexually transmitted infections.Funding text #1 From the *Infectious Disease Epidemiology Group, Weill Cornell Medicine—Qatar, Cornell University, Qatar Foundation—Education City; †Department of Biomedical Science, College of Health Sciences, and ‡BioMedical Research Center, Qatar University, Doha, Qatar; and §Department of Healthcare Policy and Research, Weill Cornell Medi-cine, Cornell University, Ithaca, NY Acknowledgments: The authors gratefully acknowledge the administrative support of Ms Adona Canlas. They are also grateful to Dr Asmaa Al-Marwani, Ms Maria Samatti, and Ms Sana Abohasera for their work on blood specimen collection. The authors are further grateful for sup-port provided by the Biostatistics, Epidemiology, and Biomathematics Research Core at Weill Cornell Medicine—Qatar. Funding text #2 Funding: Testing kits were provided through pilot funding by the Biomedical Research Program at Weill Cornell Medicine—Qatar. Funding text #3 G.K.N. acknowledges support by Qatar University internal grant No. QUST-CHS-SPR-15/16-7. L.J.A. and S.R.D. acknowledge study conception and design support through NPRP grant number 9-040-3-008 from the Qatar National Research Fund (a member of Qatar Foundation), and G.K.N. acknowledges support from the Qatar National Research Fund UREP grant number UREP18-001-3-001. The findings achieved herein are solely the responsibility of the authors

Salivary and serum androgens with anti-Müllerian hormone measurement for the diagnosis of polycystic ovary syndrome

To determine the predictive value of a raised androgen level with an elevated anti-Müllerian hormone (AMH) for the diagnosis or exclusion of polycystic ovary syndrome (PCOS), a prospective cross-sectional study of 170 women (105 with PCOS type A and 65 normal) was undertaken. AMH was combined with one of, total serum testosterone (T); calculated free androgen index; salivary testosterone (salT); serum androstenedione (A); salivary androstenedione (salA). The diagnostic sensitivity and specificity of AMH (>35 pmol/l) alone for PCOS were 55% and 79% respectively. The diagnostic sensitivity and specificity of AMH (>35 pmol/l) with either an elevated T or raised FAI level for PCOS showed 100% specificity and a 100% positive predictive value. Conversely, diagnostic exclusion of PCOS was shown by an AM

The effect of high dose isoflavone supplementation on serum reverse T3 in euthyroid men with Type 2 Diabetes and post-menopausal women

Background: The health benefits of soy are widely reported but there are queries on the effect of soy isoflavones on thyroid function and the underlying mechanism of action.Materials and Methods: We examined the effect of soy isoflavones on reverse tri-iodothyronine (or 3,3′,5′-tri-iodothyronine; rT3) in two studies comprising 400 patients: 200 men (study 1; 3 months) and 200 post-menopausal women (study 2; 6 months) who were randomized to consume 15 g soy protein with 66 mg of isoflavones (SPI) daily, or 15 g soy protein alone without isoflavones (SP) daily.Results: SPI supplementation increased rT3 serum concentration in both men 0.41 (0.12) vs. 0.45 (0.14) nmol/L and women 0.33 (0.12) vs. 0.37 (0.09) nmol/L at 3 months compared to SP that was not seen at 6 months. Thyroid stimulating hormone (TSH) serum concentrations increased while free thyroxine (fT4) concentrations decreased with 3 months of SPI compared to SP supplementation for both men and women. rT3 correlated with TSH in both studies (p = 0.03) but not with either fT3 or fT4. fT3 levels did not differ between the SPI and SP preparations.Conclusion: Soy isoflavones transiently increased rT3 levels within 3 months though reverted to baseline at 6 months. The mechanism for this would be either rT3 degrading deiodinase 1 and/or deiodinase 2 activities are transiently inhibited at 3 months, or inhibition of deiodinase 3, which generates rT3 from T4 is induced at 6 months. These changes were mirrored in the TSH concentrations, suggesting that short-term high dose isoflavone transiently impairs thyroid function in the first 3 months and may impact on general health during this period

Soy isoflavones improve cardiovascular disease risk markers in women during 1 the early menopause 2 1

BackgroundHormone replacement therapy may be beneficial for cardiovascular disease risk (CVR) in post-menopausal women. Soy isoflavones may act as selective estrogen receptor modulators. The aim of this study was to evaluate whether soy isoflavones had an effect on CVR markers.MethodsThe expected 10-year risk of cardiovascular disease and mortality were calculated as a secondary endpoint from a double blind randomised parallel study involving 200 women (mean age 55 years, Caucasian, Hull, UK, 2012) in the early menopause who were randomised to 15 g soy protein with 66 mg isoflavone (SPI) or 15 g soy protein alone (depleted of all isoflavones; SP) given as a snack bar between meals daily for 6 months. Age, diabetes, smoking, blood pressure and lipid profiles were used to calculate CVR using the Framingham CVR engine.ResultsSPI treatment resulted in a significant reduction in the metabolic parameters and systolic blood pressure compared to SP (p < 0.01). There were no changes in fasting lipid profile and diastolic blood pressure with either treatment. At 6 months, changes in these parameters with SPI treatment were reflected in a calculated 27% (p < 0.01) reduction in 10 year coronary heart disease risk, a 37% (p < 0.01) reduction in myocardial infarction risk, a 24% (p < 0.04) reduction in cardiovascular disease and 42% (p < 0.02) reduction in cardiovascular disease death risk.ConclusionsSupplementation with soy protein with isoflavones for 6 months significantly improved CVR markers and calculated CVR at 6 months during early menopause compared to soy protein without isoflavones