Nelson Vergel
Founder, ExcelMale.com
Idiopathic Hypogonadotropic Hypogonadism (IHH) is a condition characterized by delayed or absent sexual development due to low levels of sex hormones. It is also known as isolated gonadotropin-releasing hormone (GnRH) deficiency. IHH can be congenital or acquired and is often associated with anosmia (lack of sense of smell), a condition known as Kallmann syndrome. The prevalence of idiopathic hypogonadotropic hypogonadism is approximately 1 in 10,000 men. It can manifest as small testes, a short penis, and delayed or absent puberty in males. The condition may be caused by gene mutations in KAL-1, FGFR1, GnRHR, GPR54, among others. Treatment options include hormone replacement therapy to induce and maintain secondary sexual characteristics and fertility. Early diagnosis and management are important to minimize patient morbidity.
STUDY:
The diagnostic criteria employed for isolated idiopathic hypogonadotropic hypogonadism in males included the following: (a) the absence of pubertal development by the age of 18, (b) serum testosterone level ≤ 100 ng/dl with low serum gonadotropin levels in the first visit; (c) other anterior pituitary hormone levels remaining normal; and (d) no abnormalities in hypothalamic-pituitary region magnetic resonance imaging. This cross-sectional study enrolled 26 male patients with a mean age (standard deviation) of 28.1 (8.4) with IHH and 22 healthy males with a mean age (standard deviation) of 31.5 (9.8) who visited the Endocrinology Outpatient Clinic of Erzurum Training and Research Hospital between May 2023 and December 2023. No genetic mutation was found in the genetic analysis performed on patients with isolated hypogonadotropic hypogonadism.
Abstract
Introduction: The toxic effects of heavy metals on biological systems are being investigated with increasing interest day by day. Our purpose was to investigate heavy metals such as aluminum (Al), cadmium (Cd), arsenic (As), lead (Pb), and nickel (Ni) in males with idiopathic hypogonadotropic hypogonadism (IHH) and to determine whether there is a relationship between heavy metals and testosterone levels.
Methods: Twenty-six male patients with IHH aged 18-50 and 22 healthy males aged 21-50 admitted to the Outpatient Department of Endocrinology for follow-up were enrolled. BMIs were calculated by measuring the height and weight of all participants. Al, Cd, As, Pb, and Ni levels were measured and compared between groups. Testosterone levels were measured to investigate whether there was a correlation with heavy metal levels.
Results: Al, Cd, As, Pb, and Ni levels were statistically higher in the patient group compared to the control group (p<0.001). A moderately strong significant negative correlation was detected between the patients' testosterone and As levels (p=0.001, r=-0.609, R2=0.371). Decreased As and Cd levels were observed as the patients’ ages increased (p=0.013, r=-0.471).
Conclusion: Heavy metals might play potential roles in IHH. We hope that investigating heavy metal levels in IHH and adding toxicity-preventive treatments to hormonal therapies will be beneficial in the multifaceted management of the disease in clinical practice.
STUDY:
The diagnostic criteria employed for isolated idiopathic hypogonadotropic hypogonadism in males included the following: (a) the absence of pubertal development by the age of 18, (b) serum testosterone level ≤ 100 ng/dl with low serum gonadotropin levels in the first visit; (c) other anterior pituitary hormone levels remaining normal; and (d) no abnormalities in hypothalamic-pituitary region magnetic resonance imaging. This cross-sectional study enrolled 26 male patients with a mean age (standard deviation) of 28.1 (8.4) with IHH and 22 healthy males with a mean age (standard deviation) of 31.5 (9.8) who visited the Endocrinology Outpatient Clinic of Erzurum Training and Research Hospital between May 2023 and December 2023. No genetic mutation was found in the genetic analysis performed on patients with isolated hypogonadotropic hypogonadism.
Abstract
Introduction: The toxic effects of heavy metals on biological systems are being investigated with increasing interest day by day. Our purpose was to investigate heavy metals such as aluminum (Al), cadmium (Cd), arsenic (As), lead (Pb), and nickel (Ni) in males with idiopathic hypogonadotropic hypogonadism (IHH) and to determine whether there is a relationship between heavy metals and testosterone levels.
Methods: Twenty-six male patients with IHH aged 18-50 and 22 healthy males aged 21-50 admitted to the Outpatient Department of Endocrinology for follow-up were enrolled. BMIs were calculated by measuring the height and weight of all participants. Al, Cd, As, Pb, and Ni levels were measured and compared between groups. Testosterone levels were measured to investigate whether there was a correlation with heavy metal levels.
Results: Al, Cd, As, Pb, and Ni levels were statistically higher in the patient group compared to the control group (p<0.001). A moderately strong significant negative correlation was detected between the patients' testosterone and As levels (p=0.001, r=-0.609, R2=0.371). Decreased As and Cd levels were observed as the patients’ ages increased (p=0.013, r=-0.471).
Conclusion: Heavy metals might play potential roles in IHH. We hope that investigating heavy metal levels in IHH and adding toxicity-preventive treatments to hormonal therapies will be beneficial in the multifaceted management of the disease in clinical practice.
