Study briefs, 9/5: Male mortality, exercise, acne

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By The Washington Post

When hormone levels decline, a man’s mortality risk may rise

THE QUESTION As men age, their testosterone levels gradually fall, contributing to such effects as loss of bone density and muscle, decreased sex drive, lack of energy, depression and insulin resistance. Might low levels of this hormone also add to a man’s risk of dying?

THIS STUDY analyzed medical data on 858 men, who averaged 62 years old and did not have prostate or testicular cancer. About 53 percent had normal testosterone levels, 19 percent had low levels and 28 percent had an equal number of tests showing low and normal levels. During about a four-year period, 20 percent of the men with normal amounts of testosterone died, compared with 25 percent of those with mixed readings and 35 percent of those with low levels.

WHO MAY BE AFFECTED BY THESE FINDINGS? Men older than 30, the age at which testosterone begins to decrease. Although testosterone supplementation is available, some experts question whether its benefits outweigh its risks. Men who suspect they have low testosterone may want to discuss options with a physician.

CAVEATS Some medications as well as surgery, trauma and critical illness can cause testosterone levels to drop. To account for this, the authors did a further analysis, eliminating data on the 50 men who died within the first year of the study; that lowered the risk of death for those with low testosterone levels from 88 percent higher than those with normal levels to 68 percent higher. Other unmeasured factors also may have affected the relationship between the hormone and death. Mortality rates in the study may have been affected by the fact that all participants were Veterans Affairs hospital patients, who have a higher mortality rate than the general population.

FIND THIS STUDY Aug. 14/28 issue of Archives of Internal Medicine; abstract available online at www.archinternmed.com.

LEARN MORE ABOUT low testosterone at www.mayoclinic.com and www.medem.com (search for “testosterone”).

Quick spurts of exercise appear to be as beneficial as longer workouts

THE QUESTION Despite their good intentions, many people have trouble finding time to exercise. Might short bursts of activity yield fitness results comparable to those achieved by a 30-minute regimen several days a week?

THIS STUDY randomly assigned 50 sedentary adults, who averaged about 50 years old, to do mild to moderate exercise at home, on their own, in one of two ways: either 30 minutes of continuous activity, three to four days a week, or six minutes of exercise five times a day, four to five days a week. Overall, the participants exercised for about the same amount of time. Two months later, both groups showed signs of improved fitness, with aerobic capacity increasing about 5 percent among those exercising in short bursts and about 7 percent for the others.

WHO MAY BE AFFECTED BY THESE FINDINGS? Any adult interested in and capable of exercising. Older adults are advised to consult a physician before starting any type of exercise program.

CAVEATS Participants were not monitored during their exercise. Several of those exercising in short spurts reported having difficulty scheduling five bouts of exercise a day. Long-term effects or adherence were not evaluated.

FIND THIS STUDY July 27 online issue of Preventive Medicine; abstract available at www.sciencedirect.com (click on “P” in “Browse” area, then “Articles in Press” under “Preventive Medicine”).

LEARN MORE ABOUT starting an exercise program at www.nhlbi.nih.gov/health (search for “Guide to Physical Activity”) and www.familydoctor.org (search for “exercise”).

Abnormal blood tests appear linked to drug treatment of acne

THE QUESTION Medications often carry warnings about potential side effects. In the case of the acne treatment isotretinoin (Accutane and other brands), cautions include the possibility of elevated blood fats and liver enzymes, which can affect the heart and may indicate liver disease, respectively. How often might such side effects occur?

THIS STUDY analyzed blood test results from 13,772 people, 13 to 50 years old, who took isotretinoin for an average of five months to treat severe acne. Triglyceride levels rose above the normal range in 44 percent of the participants while they took the drug, cholesterol levels became high in 31 percent and the liver enzyme transaminase rose to an abnormally high level in 11 percent. Nearly all levels returned to normal after participants stopped taking the drug. Changes in white blood cells (which fight infection), platelets (which promote clotting) and hemoglobin (a blood protein that aids in oxygen delivery) were rare.

WHO MAY BE AFFECTED BY THESE FINDINGS? Anyone taking isotretinoin, which often is prescribed when other treatments, including antibiotics, have not resolved severe acne.

CAVEATS What effect the findings, based solely on laboratory tests, might have on the participants’ condition — whether heart or liver disease, for instance, might develop — was not determined by the study. Other side effects — which can include headaches, dizziness, blurred vision and upset stomach — were not evaluated. Pregnant women are warned not to take isotretinoin because the drug may can cause miscarriage or birth defects.

FIND THIS STUDY August issue of Archives of Dermatology; abstract available online at www.archdermatol.com.

LEARN MORE ABOUT acne treatments at www.skincarephysicians.com and www.niams.nih.gov/hi.