Latviešu valodas institūta žurnāls

Objective. To prospectively evaluate the effects of resistance training combined with increased energy intake or protein-supplementation on lean body-mass, resting metabolic-rate (RMR) and cardiovascular risk factors. Methods. Twenty-four healthy males (aged 19-32 years) performed resistance exercise for 12 weeks aiming for at least 1 hour training-sessions 3 times a week. The participants were randomized to consume extra protein (33 g whey protein/day) or a meal of fast-food/day (1350 kcal, 41 g protein). Body-composition was measured with Dual-Energy X-ray Absorptiometry (DEXA) and RMR by indirect calorimetry. Fasting blood samples were drawn before and after the 3-month training period and after 12 months. Results. The body weight increased from 75.1 +/- 6.9 kg to 78.7 +/- 7.2 kg (p andlt; 0.0001), without differences between the groups. RMR increased from 1787 +/- 143 kcal/24 h to 1954 +/- 187 kcal/24 h (p andlt; 0.0001, N = 24), which was more than expected from the increase in lean body-mass (increase from 59.7 +/- 4.3 kg to 61.8 +/- 4.1 kg p = 0.004). Fasting serum-insulin levels increased in the fast-food group compared with the extra-protein group (p = 0.03). ApoB increased from 0.691 +/- 0.14 g/L to 0.768 +/- 0.17 g/L, p = 0.004, in the fast-food group only. Long-term follow up after 12 months showed that RMR, body weight, total fat and lean body-masses did not differ from baseline (n = 19). Conclusions. Resistance training for 12 weeks increased RMR and lean body-mass similarly when based on either an increased energy-intake or protein supplement. However, the increase in RMR was higher than expected from the increase in lean body-mass. Thus resistance training could potentially decrease the risk of obesity by induction of increased RMR.Funding Agencies|University Hospital of Linkoping Research Funds||Linkoping University||Gamla Tjanarinnor||Medical Research Council of Southeast Sweden||Diabetes Research Centre of Linkoping University||</p

Testosterone Use and Abuse : Methodological Aspects in Forensic Toxicology and Clinical Diagnostics

Abuse of anabolic androgenic steroids (AAS) is widespread in society and is today a major public health problem, associated with mental and somatic adverse effects and risk behavior, such as use of other illicit drugs and criminality. Testosterone, the most important endogenous male androgen, is therapeutically used in replacement therapy but is also extensively used as a doping agent. Traditionally, testosterone abuse is detected in urine in forensic cases and in serum in clinical diagnosis and monitoring, and free bioavailable serum testosterone is calculated by formulas. Salivary testosterone is however an attractive biomarker, as testosterone in saliva is supposed to reflect free testosterone in serum.  The aim of this thesis was to investigate the abuse of AAS from a forensic perspective, particularly focusing on testosterone and methodological problems and potential alternative matrices for measurements of testosterone in forensic and clinical assessments.  In the first study the toxicological findings in individuals suspected of doping offences, registered in the Swedish national forensic toxicology database were investigated (paper I). In paper II, testosterone levels in serum, saliva, and urine in clinical patients during replacement therapy with testosterone undecanoate (Nebido®) were studied. Further, the sensitivity of the current procedure for detection of testosterone abuse was investigated by method comparison using isotope ratio measurement (paper III) and a quantitative LC-MS/MS method for testosterone in serum and saliva was developed and presented (paper IV).  It was found that testosterone was most frequently detected in the forensic cases and co-abuse of narcotics was common among AAS abusers. Methodological problems in detection of testosterone abuse using the present procedures was identified, indicating a need for new analytical strategies. A sensitive and highly specific LC-MS/MS method was developed for determination of testosterone in serum and saliva, which was shown suitable for analysis of forensic and clinical samples. Salivary testosterone was shown to correlate well with free serum testosterone in both male and female, and a sensitive marker in testosterone therapy, especially in females. In conclusion, it was found that saliva might have a potential as an alternative matrix for detection of illicit administration of testosterone and for diagnosis and monitoring of androgenic status. Missbruket av anabola androgena steroider (AAS) är idag utbrett i samhället och är ett betydande folkhälsoproblem, associerat med fysisk och psykisk ohälsa och riskbeteende, såsom bruk av andra illegala droger och kriminalitet. Testosteron, det viktigaste manliga könshormonet används medicinskt vid klinisk substitutionsbehandling, men missbrukas även omfattande som dopningsmedel. Traditionellt detekteras missbruk av testosteron i urin i forensiska fall och i serum i klinisk diagnostik och monitorering och fritt biotillgängligt testosteron beräknas utifrån olika formler. Salivtestosteron är emellertid en attraktiv biomarkör, då testosteron i saliv anses spegla den fria fraktionen testosteron i serum.  Denna avhandling syftade till att studera missbruket av anabola androgena steroider utifrån ett forensiskt perspektiv, speciellt med fokus på testosteron och metodologiska problem och möjligheten att använda alternativa biomarkörer för detektion och mätning av testosteron i forensiska och kliniska frågeställningar.  I det första delarbetet studerades de toxikologiska fynden hos individer misstänkta för brott mot den svenska dopinglagen, registrerade i Sveriges nationella databas för forensisk toxikologi. I delarbete II studerades nivåerna av testosteron i serum, saliv och urin hos patienter vid substitutionsbehandling med testosteronundekanoat (Nebido®). Vidare studerades känsligheten för detektion av missbruk av testosteron med befintlig metod genom jämförelser med analyser med isotop ratio (delarbete III) och en kvantitativ LC-MS/MS metod för testosteron i serum och saliv utvecklades och presenterades (delarbete IV).  Testosteron detekterades frekvent i de forensiska fallen, och ett blandmissbruk av AAS och narkotiska preparat var vanligt förekommande. Metodologiska problem identifierades med den nuvarande proceduren för detektion av testosteronmissbruk, vilket indikerar ett behov av nya analytiska strategier. En känslig och högst specifik LC-MS/MS metod för bestämning av testosteron i serum och saliv utvecklades, vilken visade sig lämplig för analys av forensiska och kliniska prover. Salivtestosteron korrelerade med fritt testosteron i serum hos både män och kvinnor, och visade sig vara en känslig markör vid testosteronbehandling, speciellt hos kvinnor. Slutsatsen är att saliv kan ha potential som en alternativ matris för detektion av missbruk av testosteron och för diagnosticering och monitorering av androgent status.  Funding agencies: The National Board of Forensic Medicine,Department of Endocrinology, University Hospital, Linköping, Medical ResearchCouncil of Southeast Sweden and Strategic Research Area in Forensic Science,Linköping University.</p

Effects of 12 Months' Treatment with Testosterone Undecanoate on Markers for Erythropoietic Activity and Safety Aspects in Transgender and Cisgender Hypogonadal Men

Background To investigate the erythropoietic activity and safety aspects of testosterone undecanoate (TU) injections in transgender men, assigned female at birth.Methods Twenty-three men (13 hypogonadal cisgender men and 10 transgender men) who initiated TU at the study start (naive) and 15 men (10 hypogonadal cisgender men and 5 transgender men) on steady-state treatment with TU (non-naive) were included in this prospective 1-year observational study. A control group of 32 eugonadal cisgender men was investigated once at baseline. Complete blood count, testosterone in serum and saliva, and plasma lipids, and liver enzymes were assessed.Results For naive transgender men, a significant increase in hemoglobin concentration was noted (mean (SD)), 141 (8) g/L to 151 (13) g/L, while no increase was seen in naive hypogonadal cisgender men. At the end of the study, naive transgender men exhibited comparable levels of hemoglobin, hematocrit, and testosterone levels in serum and saliva to hypogonadal cisgender men, as well as to the eugonadal cisgender men. During the study, HDL-cholesterol decreased significantly in naive transgender men, 1.4 (0.4) mmol/L to 1.2 (0.4) mmol/L, P = 0.03, whereas no significant change was noted in naive hypogonadal cisgender men. Liver enzymes remained unchanged in all groups.Conclusions After 12 months of treatment with TU in naive transgender men, hemoglobin and hematocrit increased to levels within the cisgender male reference range. A slight decrease in HDL-cholesterol was seen in naive transgender men but liver enzymes remained unchanged.Funding Agencies|Linkoping University, Sweden, ALF [ROE-129081]; Medical Research Council of Southeast Sweden [FORSS-37761]</p

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A randomized trial of protein supplementatio

A randomized trial of protein supplementation compared with extra fast food on the effects of resistance training to increase metabolism

Objective. To prospectively evaluate the effects of resistance training combined with increased energy intake or protein-supplementation on lean body-mass, resting metabolic-rate (RMR) and cardiovascular risk factors. Methods. Twenty-four healthy males (aged 19-32 years) performed resistance exercise for 12 weeks aiming for at least 1 hour training-sessions 3 times a week. The participants were randomized to consume extra protein (33 g whey protein/day) or a meal of fast-food/day (1350 kcal, 41 g protein). Body-composition was measured with Dual-Energy X-ray Absorptiometry (DEXA) and RMR by indirect calorimetry. Fasting blood samples were drawn before and after the 3-month training period and after 12 months. Results. The body weight increased from 75.1 +/- 6.9 kg to 78.7 +/- 7.2 kg (p andlt; 0.0001), without differences between the groups. RMR increased from 1787 +/- 143 kcal/24 h to 1954 +/- 187 kcal/24 h (p andlt; 0.0001, N = 24), which was more than expected from the increase in lean body-mass (increase from 59.7 +/- 4.3 kg to 61.8 +/- 4.1 kg p = 0.004). Fasting serum-insulin levels increased in the fast-food group compared with the extra-protein group (p = 0.03). ApoB increased from 0.691 +/- 0.14 g/L to 0.768 +/- 0.17 g/L, p = 0.004, in the fast-food group only. Long-term follow up after 12 months showed that RMR, body weight, total fat and lean body-masses did not differ from baseline (n = 19). Conclusions. Resistance training for 12 weeks increased RMR and lean body-mass similarly when based on either an increased energy-intake or protein supplement. However, the increase in RMR was higher than expected from the increase in lean body-mass. Thus resistance training could potentially decrease the risk of obesity by induction of increased RMR.Funding Agencies|University Hospital of Linkoping Research Funds||Linkoping University||Gamla Tjanarinnor||Medical Research Council of Southeast Sweden||Diabetes Research Centre of Linkoping University||</p