Investigation, treatment and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA and ASA recommendations

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Reporting and ideal testosterone levels in men undergoing androgen deprivation for prostate cancer-time for a rethink?

Background: This study aims to review current laboratory reporting strategies across Australia and New Zealand with a view to propose a more useful template for reporting serum testosterone in the context of prostate cancer. Materials and methods: Registered pathology laboratories in Australia and New Zealand were enrolled into the current study. An electronic or a phone survey was utilized to collect data from each participating laboratory. Obtained information included assay utilized, units reported, reference intervals, lowest reported value, and lowest detectable value. To identify recommendations for testosterone testing, a systematic search was performed across Web of Science (including MEDLINE), EMBASE, and Cochrane libraries. Results: Assessment of national pathology laboratories identified significant heterogeneity in the reporting methods. Reports typically used a "normal healthy male of 35 years of age" as a comparator but did not refer to optimal castrate levels, the lowest level that their assay was able to detect, nor did they include appended clinical guidelines relating to the prostate cancer patient cohort. Conclusions: Across Australia and New Zealand, various methods for testing and reporting serum testosterone exist, while international guidelines remain vague. The fashion in which serum testosterone levels are displayed should be re-evaluated to address the relevant clinical population and reflect an agreed-upon castrate threshold in patients undergoing androgen deprivation therapy

Diagnosis of diabetes: HbA1c versus WHO criteria

The authors compared the diagnosis of type 2 diabetes using an HbA 1c cut-off point of ≥6.5% (≥48 mmol/mol) with current World Health Organization (WHO) criteria involving fasting plasma glucose and an oral glucose tolerance test. Diabetes was confirmed in 35% of Australian and 49% of UK participants using WHO criteria and a similar prevalence was obtained using HbA1c - 31% and 46%, respectively. Using HbA1c levels alone for diagnosis does not define the same people with diabetes as the WHO criteria. A considerable number of participants (38% of Australian and 49% of British) diagnosed with diabetes by WHO criteria would not have been diagnosed using a single HbA1c test. More consideration of the use of HbA 1c as a screening test for diabetes is required

HbA1c for screening and diagnosis of type 2 diabetes in routine clinical practice

Objective: To evaluate HbA1c for screening and diagnosis of undiagnosed Type 2 diabetes