Vegan diet bests Mediterranean diet for weight loss and cutting harmful inflammatory dietary compounds, finds new research

Eating a low-fat vegan diet reduces harmful inflammatory dietary compounds called advanced glycation end-products (AGEs) by 73%, compared to no reduction on a Mediterranean diet, according to new research by the Physicians Committee for Responsible Medicine published in Frontiers in Nutrition.

The decrease in AGEs on the vegan diet was associated with an average weight loss of 13 pounds, compared with no change on the Mediterranean diet.

The reduction of dietary AGEs on the low-fat vegan diet came mainly from excluding the consumption of meat (41%), minimizing the consumption of added fats (27%), and avoiding dairy products (14%).

“The study helps bust the myth that a Mediterranean diet is best for weight loss,” says lead study author Hana Kahleova, MD, PhD, director of clinical research at the Physicians Committee for Responsible Medicine. “Choosing a low-fat vegan diet that avoids the dairy and oil so common in the Mediterranean diet helps reduce intake of harmful advanced glycation end-products leading to significant weight loss.”

AGEs may be ingested through the diet, and animal products are generally higher in AGEs than plant foods. Cooking with high heat under dry conditions, such as grilling, leads to significant formation of AGEs, especially in animal-derived foods, which are also rich in fats. High amounts of AGEs circulating in the body can contribute to insulin resistance, which can lead to weight gain. AGEs are also linked to inflammation and oxidative stress, which contribute to chronic diseases like heart disease and type 2 diabetes.

The new research is a secondary analysis of a previous Physicians Committee study comparing a low-fat vegan diet to a Mediterranean diet. The study randomly assigned participants to either a low-fat vegan diet, which consisted of fruits, vegetables, grains, and beans, or a Mediterranean diet, which focused on fruits, vegetables, legumes, fish, low-fat dairy, and extra virgin olive oil, for 16 weeks. Neither group had a calorie limit.

Participants then went back to their baseline diets for a four-week washout period before switching to the opposite group for an additional 16 weeks. Dietary AGEs were calculated based on self-reported dietary intake records. AGE scores were assigned to each food item, using a published database of AGE content.

“Our research shows that you can use the power of your plate to lose weight with a low-fat vegan diet that’s rich in fruits, vegetables, grains, and beans and low in AGEs,” adds Dr. Kahleova. “It’s a simple and delicious way to maintain a healthy weight and fight chronic disease.”

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Beyond Wellness: New Method Proposes Objective Assessment of Positive Health

India: A recent review published in the Indian Journal of Community Medicine has identified key objectively measurable biomarkers of positive health that can help implement this concept at the individual level. 

The researchers revealed the development of a novel proposal to assess the positive health of individuals with five domains and nearly 50 items. They suggested that although preliminary, this communication likely addresses the key measurable biomarkers and may serve as a solid foundation for advancing the operationalization of positive health and its assessment. The framework could also highlight data gaps essential for developing policies to enhance public health.

The study conveys two key messages:

  1. Defining Positive Health: Positive health is characterized as the ability to live a long life with minimal or no ailments.

  2. Objective Measurement of Positive Health: Positive health can be objectively measured through a specific set of biomarkers.

According to Dr. Abhaya Indrayan, the lead author from the Department of Clinical Research at Max Healthcare, Saket, New Delhi, India, the study has identified major biomarkers for this purpose. These biomarkers are categorized into five domains: neurological, endocrinological, nutritional, immunological, and physiological. This information was shared with Medical Dialogues. 

He added that, “We have identified nearly 50 biomarkers. Among these, promising biomarkers are bone density, P3 amplitude, endorphins, FEV1/FVC ratio, hand grip strength, and semen quality in men.”

This exercise shows that evaluating an individual’s positive health is feasible. A scale incorporating these and other relevant parameters could be developed in the future to quantitatively measure the precise level of positive health. Since the exact combination of parameters that provides protection from ailments is not yet fully understood, this framework may help identify data gaps that need further investigation.

“With this work, now there is no need to depend on psychological and social factors such as family, interactions, happiness, laughter, and sleep for assessing positive health. These factors can not be exactly measured. We emphasize that these factors are only mediators for improving the biomarkers, and those biomarkers can be directly measured to assess positive health.” said Dr. Indrayan.

Positive health can be defined as the capacity to live a long life in optimal health, potentially without any activity limitations. Currently, there is no method for objectively assessing this in individuals. In this communication, Dr. Indrayan and colleagues propose a framework designed to operationalize and assess this concept effectively.

Rather than focusing on distal factors like diet and lifestyle, which are subjective and challenging to measure, we concentrate on objectively measurable biomarkers such as immunity levels, endorphins, and handgrip strength. The researchers’ focus is on key parameters that may offer protection against diseases and infirmity and can be evaluated using noninvasive methods. A combination of these parameters may indicate positive health. According to them, this may be a novel way to measure positive health at the individual level.

In this communication, the researchers briefly review the literature and identify a few major biomarkers that provide a protective shield and could determine the status of positive health at the individual level. The proposed framework may spark a discussion on indicators of positive health and help define parameters for interventions aimed at enhancing overall well-being and longevity, the study stated. 

Speaking on the study’s limitations Dr. Indrayan commented, “Although the biomarkers have been identified based on a review of hundreds of studies, they need to be measured in a sample of individuals who should be followed up for their longevity and the incidence of ailments.” 

“Lifestyle and environmental factors affect changes in our body. Positive factors such as exercise, diet, family support, social interactions, and good sleep build a reserve in the body that helps in preventing ailments and living long in a healthy state,” he concluded. 

Reference:

Indrayan, A., Vishwakarma, G., Verma, S., Sarmukaddam, S., & Tyagi, A. (2023). Quest for Biomarkers of Positive Health: A Review. Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine, 48(3), 382-389. https://doi.org/10.4103/ijcm.ijcm_480_22

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Lower Risks of Stroke and Cardiovascular Death Associated with Home Hemodialysis Over Peritoneal Dialysis: Study

USA: In a large observational study of patients undergoing home kidney dialysis, home hemodialysis (HHD) showed better cardiovascular (CV) outcomes than peritoneal dialysis (PD). However, experts highlighted several important caveats to consider.

Relative to peritoneal dialysis, home hemodialysis is associated with a reduced risk of stroke, cardiovascular death, acute coronary syndrome, and all-cause death, the researchers reported in Kidney360 Journal. They stress the need for further studies to understand better the factors associated with differences in CV outcomes by type of home dialysis modality in patients with kidney failure.

Home hemodialysis involves using a machine to filter blood, which is performed several times a week in the comfort of the patient’s home. It contrasts with peritoneal dialysis, where the patient’s abdominal cavity is used to filter blood, typically done daily.

Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in patients with end-stage kidney disease (ESKD). Considering that there is limited knowledge on differences in CV outcomes between HHD and PD, Silvi Shah, University of Cincinnati, Cincinnati, OH, and colleagues aimed to compare the risks of CV events, CV death, and all-cause death in patients on daily HHD and PD.

For this purpose, the researchers evaluated 68,645 patients who initiated home dialysis between 2005 and 2018 using the United States Renal Data System with linked Medicare claims. They determined rates for incident cardiovascular events of acute coronary syndrome, stroke hospitalizations, and heart failure. Adjusted time-to-event models were utilized to investigate how different types of home dialysis modalities are associated with incident cardiovascular events, cardiovascular mortality, and all-cause mortality.

Based on the study, the researchers reported the following findings:

  • The mean age of patients in the study cohort was 64±15 years, and 42.3% were women. The mean time of follow-up was 1.8±1.6 years.
  • The unadjusted cardiovascular event rate was 95.1 per thousand person-years (PTPY), with a higher rate in patients on HHD than on PD (127.8 PTPY versus 93.3 PTPY).
  • HHD was associated with a slightly lower adjusted risk of cardiovascular events than PD (hazard ratio [HR], 0.92).
  • Compared with patients on PD, patients on HHD had 42% lower adjusted risk of stroke (HR, 0.58), 17% lower adjusted risk of acute coronary syndrome (HR, 0.83), and no difference in risk of heart failure (HR, 1.05).
  • HHD was associated with a 22% lower adjusted risk of cardiovascular death (HR, 0.78) and an 8% lower adjusted risk of all-cause death (HR, 0.92) as compared with PD.

“Home hemodialysis is linked to reduced adjusted risks for cardiovascular events, including stroke and acute coronary syndrome, as well as lower adjusted risks for cardiovascular mortality and all-cause mortality compared to peritoneal dialysis,” the researchers concluded.

Reference:

Shah, Silvi1; Weinhandl, Eric2,3; Gupta, Nupur4; Leonard, Anthony C.5; Christianson, Annette L.5; Thakar, Charuhas V.1,6,7. Cardiovascular Outcomes in Patients on Home Hemodialysis and Peritoneal Dialysis. Kidney360 5(2):p 205-215, February 2024. | DOI: 10.34067/KID.0000000000000360

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AI systems promising for diagnosis of dental caries on intraoral radiographs: Study

AI systems promising for diagnosis of dental caries on intraoral radiographs suggests a study published in the Journal of Dentistry. 

This study aimed to assess the reliability of an AI-based system that assists the healthcare processes in the diagnosis of caries on intraoral radiographs. The proximal surfaces of the 323 selected teeth on the intraoral radiographs were evaluated by two independent observers using an AI-based (Diagnocat) system. The presence or absence of carious lesions was recorded during Phase 1. After 4 months, the AI-aided human observers evaluated the same radiographs (Phase 2), and the advanced convolutional neural network (CNN) reassessed the radiographic data (Phase 3). Subsequently, data reflecting human disagreements were excluded (Phase 4).

For each phase, the Cohen and Fleiss kappa values, as well as the sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of Diagnocat were calculated. Results: During the four phases, the range of Cohen kappa values between the human observers and Diagnocat were κ=0.66–1, κ=0.58–0.7, and κ=0.49–0.7. The Fleiss kappa values were κ=0.57–0.8. The sensitivity, specificity and diagnostic accuracy values ranged between 0.51–0.76, 0.88–0.97 and 0.76–0.86, respectively. The Diagnocat CNN supports the evaluation of intraoral radiographs for caries diagnosis, as determined by consensus between human and AI system observers. The study may aid in the understanding of deep learning-based systems developed for dental imaging modalities for dentists and contribute to expanding the body of results in the field of AI-supported dental radiology..

Reference:

Viktor Szabó, Bence Tamás Szabó, Kaan Orhan, Dániel Sándor Veres, David Manulis, Matvey Ezhov, Alex Sanders. Validation of artificial intelligence application for dental caries diagnosis on intraoral bitewing and periapical radiographs, Journal of Dentistry, Volume 147, 2024, 105105, ISSN 0300-5712. https://doi.org/10.1016/j.jdent.2024.105105. (https://www.sciencedirect.com/science/article/pii/S0300571224002744)

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Oral Antibiotics Tied to Higher Risk of Serious Skin Reactions: Sulfonamides and Cephalosporins Pose Greatest Threat, Study Finds

Canada: Oral
antibiotics are linked to a higher risk of serious cutaneous adverse drug reactions
(cARDs), as suggested by a current study.

The study
published in the JAMA Network indicates
that many antibiotics have the safety issue of having serious cARDs leading to hospitalization or visits to the emergency
department. Compared to macrolides, sulfonamide antibiotics, and
cephalosporins are associated with the highest risk.

All commonly prescribed oral antibiotics are linked to a higher risk of severe cardiovascular adverse drug reactions compared to macrolides, with sulfonamides and cephalosporins presenting the greatest risk, the researchers reported. 

Antibiotics are antibacterial agents for fighting
bacterial infections, but they also pose risks of having adverse reactions.
These reactions range from mild side effects like diarrhoea, and nausea to more
serious conditions, including anaphylaxis and serious cutaneous adverse drug reactions (cARDs).

Serious cARDs is a life-threatening adverse drug
reaction that involves skin and internal organs. However, due to a scarcity of
studies comparing the risks of serious cADRs across different antibiotic
classes, researchers came together to investigate the risks associated with
commonly prescribed oral antibiotics and to assess the outcomes of patients
hospitalized due to these reactions.

Erika Y. Lee, Division of Clinical Immunology and
Allergy, Department of Medicine, University of Toronto, Toronto, Ontario,
Canada, and colleagues designed a population-based, nested case-control study
where they enrolled 21 758 older adults with having median age, 75 years,
64.1% female who received at least 1 oral antibiotic between 2002 and 2022 in
Ontario, Canada.

They include cases who had an emergency department
(ED) visit or hospitalization for serious cADRs within 60 days of the
prescription, and each case was matched with up to 4 controls who did not.

conditional logistic regression were used to
understand how different types of oral antibiotics might be linked to serious
skin reactions. In this analysis, they compared each antibiotic class to a specific
group called macrolides.

Study findings reveal:

  • In primary analysis, sulfonamide antibiotics (adjusted odds
    ratio [aOR], 2.9) and cephalosporins (aOR, 2.6) were most strongly associated
    with serious cADRs relative to macrolides.
  • Further
    associations were observed with nitrofurantoin (adjusted odds ratio [aOR],
    2.2), penicillins (aOR, 1.4) and fluoroquinolones (aOR, 1.3).
  • The
    crude rate of ED visits or hospitalization for cADRs was highest for cephalosporins,
    with 4.92 incidents per 1,000 prescriptions, followed by sulfonamide
    antibiotics, with 3.22 incidents per 1,000 prescriptions.
  • Of
    the 2,852 patients hospitalized for serious cutaneous adverse drug reactions
    (cADRs), the median hospital stay was 6 days (with an interquartile range of 3
    to 13 days). Additionally, 9.6% of these patients needed transfer to a critical
    care unit, and 5.3% died in the hospital.

“When clinically appropriate, prescribers should opt
for antibiotics with a lower risk of adverse reactions,” researchers concluded.

Reference: Lee
EY, Gomes T, Drucker
AM, et al. Oral Antibiotics and Risk of Serious Cutaneous Adverse Drug
Reactions. JAMA. Published online August 08, 2024.
doi:10.1001/jama.2024.11437

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Chronic and New Anxiety Linked to Higher Dementia Risk in Under-70s, but Timely Treatment Can Mitigate Risk: Study

Australia: The
study published in the Journal of the American Geriatrics Society on
24 July 2024, revealed that chronic and newly developed anxiety is linked to a higher risk of all-cause dementia, with the association being particularly significant in individuals aged 70 and younger.

These findings suggest that addressing anxiety promptly could be an effective strategy for lowering the risk of dementia. 

Dementia is defined as a
problem that interferes with daily life. It is a general term that is used to
define the loss of memory, language, thinking abilities, and problem–solving
abilities. It is caused by abnormal brain changes. Alzheimer’s is the most
common cause of dementia. Dementia was the seventh-leading cause of death
globally and the second-leading cause of death in high-income countries in
2020. Considering this Kay Khaing MMed, from the University of Newcastle, New
Lambton Heights, Australia, et. Al conducted a study to evaluate the
longitudinal association between the risk of dementia from all causes and the
presence of chronic, resolved, or new-onset anxiety.

To achieve this,
the research team studied 2132 residents of Newcastle, New South Wales,
Australia, who were between the ages of 55 and 85. Under permission from the
University of Newcastle Human Research Ethics Committee, they undertake research
using longitudinal data from the Hunter Community Study. The Kessler
Psychological Distress Scale (K10) was used to quantify anxiety. Recruitment
took place for the participants from December 2004 to December 2007. To
determine the risk of dementia, the Fine-Gray sub-distribution hazard model was
calculated.

The study contained participants’
health and demographic information. The Center for Epidemiologic Studies
Depression Scale was used to measure depression. Depression was classified as a
dichotomous variable and indicated by a total score of 16 or above, which was
determined by adding the 20 items (which have a range of 0 to 60). For
continuous data, the student-t test was employed, and for categorical data, the
chi-square test.

The findings revealed
that:

  • While resolved anxiety was not linked with
    all-cause dementia risk, chronic anxiety and new onset anxiety at follow-up
    were, with an average time to dementia diagnosis of 10 years (SD = 1.7).
  • Among participants under 70 years of age, both
    chronic and new anxiety were the main drivers of these outcomes in subgroup
    analyses.
  • Highly comparable outcomes were obtained using
    sensitivity analyses that addressed reverse causation and imputed missing data.

“As a potentially
modifiable risk factor for dementia, anxiety suggests that middle-aged and
“young” older persons may benefit from anxiety management to lower
their lifetime chance of developing dementia. Particularly among people 70
years of age and under, persistent anxiety and fresh anxiety at follow-up were
linked to an elevated risk of dementia from all causes.”, researchers
concluded.

Reference

Khaing, K., Dolja-Gore,
X., Nair, B. R., Byles, J., & Attia, J. (2024). The effect of anxiety on
all-cause dementia: A longitudinal analysis from the Hunter Community Study. Journal
of the American Geriatrics Society. https://doi.org/10.1111/jgs.19078

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Study Compares Pain Relief Methods in Elective Hand and Wrist Surgery

Nerve block for hand and wrist surgery is a beneficial anesthetic technique that helps control postoperative pain, reduce recovery time, and facilitate early hospital discharge for patients. Recent study aimed to evaluate the effectiveness and duration of peripheral nerve block versus local surgical site anesthetic infiltration for pain relief in patients undergoing elective hand and wrist surgery. The study was conducted at the Orthopedic Department of the Duhok Emergency Teaching Hospital in Iraq, including 300 patients aged 18-75 years who underwent various elective hand and wrist procedures.

The patients were randomly divided into three groups, each receiving a different pain relief method. The degree and duration of pain relief were assessed using standardized pain assessment tools.

The authors conclude that ultrasound-guided nerve block is superior for achieving longer duration of pain relief compared to the other methods. However, local surgical site infiltration was more effective at reducing the severity of postoperative pain.

The study is limited by the use of only one type of local anesthetic and the relatively small sample size. The authors recommend further research with larger sample sizes and longer follow-up periods to better understand the most appropriate pain management approach for elective hand and wrist surgeries.

Overall, this study provides valuable insights into the comparative effectiveness of different regional anesthesia techniques for pain control following hand and wrist procedures, highlighting the trade-offs between duration and intensity of pain relief.

Key Points –

Based on the provided research paper summary, the 3 key points are:

1. The study aimed to evaluate the effectiveness and duration of peripheral nerve block versus local surgical site anesthetic infiltration for pain relief in patients undergoing elective hand and wrist surgery.

2. The key findings of the study were:

– Ultrasound-guided nerve block was superior for achieving longer duration of pain relief compared to the other methods.

– Local surgical site infiltration was more effective at reducing the severity of postoperative pain.

3. The study was limited by the use of only one type of local anesthetic and the relatively small sample size, and the authors recommended further research with larger sample sizes and longer follow-up periods to better understand the most appropriate pain management approach for elective hand and wrist surgeries.

Reference –

Hassan W M, Mahmoud H (July 01, 2024) Effectiveness of Regional Nerve Blocks Versus Local Anesthetic Infiltration for Elective Hand and Wrist Surgery. Cureus 16(7): e63569. DOI 10.7759/cureus.63569.

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Weekly Efanesoctocog Alfa effective option for Preventing Bleeding among kids with Severe Hemophilia A: NEJM

Milan: An article published in The New England Journal of Medicine revealed that in children with severe hemophilia A, once-weekly prophylaxis with efanesoctocog alfa maintained high levels of factor VIII activity, typically above 40 IU per deciliter for at least 3 days and above 10 IU per deciliter for nearly 7 days after administration. This resulted in effective bleeding prevention. Efanesoctocog alfa was linked to primarily non-serious adverse events.

Weekly administration of efanesoctocog alfa maintains high, sustained factor VIII activity. It offers superior bleeding prevention compared to previous factor VIII prophylaxis in patients aged 12 and older with severe hemophilia A. However, there is limited data on the effectiveness of efanesoctocog alfa in children under 12 with severe hemophilia A.

Dr. Lynn Malec, M.D., Versiti Blood Research Institute, and the Division of Hematology and Oncology, Departments of Medicine and Pediatrics, Medical College of Wisconsin et. al. conducted a study on using efanesoctocog alfa prophylaxis for children with severe hemophilia A.

For this study, a phase 3, open-label trial was conducted involving previously treated patients under 12 years of age with severe hemophilia A. These patients received weekly prophylaxis with efanesoctocog alfa (50 IU per kilogram of body weight) over 52 weeks. The primary endpoint was the development of factor VIII inhibitors (neutralizing antibodies against factor VIII). Secondary endpoints included the annualized rates of treated bleeding episodes, effectiveness of bleeding treatment, safety, and pharmacokinetics.

The key findings of the research are as follows:

  • A total of 74 male patients were enrolled, with 38 under the age of 6 and 36 between the ages of 6 and 12.
  • No factor VIII inhibitors developed during the study.
  • Most adverse events were nonserious, and no serious adverse events related to efanesoctocog alfa were reported by investigators.
  • Among the 73 patients treated according to the protocol, the median annualized bleeding rate was 0.00 (IQR, 0.00 to 1.02), and the model-based mean annualized bleeding rate was 0.61 (95% CI, 0.42 to 0.90).
  • 64% of patients had no treated bleeding episodes, 88% had no spontaneous bleeding episodes, and 82% had no joint bleeding episodes.
  • 95% of bleeding episodes (41 out of 43) were resolved with a single injection of efanesoctocog alfa.
  • Mean factor VIII activity at steady state was over 40 IU per deciliter for 3 days and over 10 IU per deciliter for nearly 7 days after dose administration.
  • The geometric mean terminal half-life of efanesoctocog alfa was 40.0 hours.

Researchers have concluded that weekly administration of efanesoctocog alfa leads to high and sustained factor VIII activity, providing superior bleeding prevention compared to previous factor VIII prophylaxis in patients aged 12 and older with severe hemophilia A. However, there is limited data on the outcomes of efanesoctocog alfa treatment in children under 12 with severe hemophilia A.

Reference:

Malec L, Peyvandi F, Chan AKC, Königs C, Zulfikar B, Yuan H, Simpson M, Álvarez Román MT, Carcao M, Staber JM, Dunn AL, Chou SC, d’Oiron R, Albisetti M, Demissie M, Santagostino E, Yarramaneni A, Wong N, Abad-Franch L, Gunawardena S, Fijnvandraat K; XTEND-Kids Trial Group. Efanesoctocog Alfa Prophylaxis for Children with Severe Hemophilia A. N Engl J Med. 2024 Jul 18;391(3):235-246. doi: 10.1056/NEJMoa2312611. PMID: 39018533.

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Elevated Binge Eating and Bulimia Rates in Women With PCOS: Study

USA: A study featured in The Journal of Clinical Endocrinology & Metabolism has informed the 2023 PCOS Guidelines, highlighting the need to consider the risk of disordered eating and eating disorders in women with PCOS, irrespective of their weight, especially when offering lifestyle counseling.

In this study, Laura G. Cooney, Department of Obstetrics and Gynecology, University of Wisconsin contributed to the 2023 International PCOS Guideline by performing a systematic review and meta-analysis to assess the prevalence of disordered eating and eating disorders in women with and without PCOS.

For this study, databases including Ovid MEDLINE, EMBASE, PsycInfo, and All EMB were searched from their inception up to February 1, 2024, to find studies that compared the prevalence of eating disorders or disordered eating in adolescent and adult women. Random effects meta-analyses were utilized to calculate the pooled odds ratios (OR) or standardized mean differences (SMD) for outcomes in women with PCOS versus controls. The methodological quality of the studies was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system, and the included studies were assessed for potential bias.

The key findings of the study were:

  • Out of 1,352 articles identified, 20 studies were included, involving 28,922 women with PCOS and 258,619 controls.
  • Women with PCOS had 1.53 times higher odds of having any eating disorder, according to eight studies.
  • The increased odds of eating disorders in women with PCOS persisted, particularly in studies where PCOS was diagnosed using the Rotterdam criteria.
  • The odds of bulimia nervosa, binge eating disorder, and disordered eating were higher in women with PCOS, but there was no increased risk for anorexia nervosa.
  • Women with PCOS also had higher mean disordered eating scores (SMD: 0.52), as shown in 13 studies, even when accounting for normal and higher weight body mass index.

The researchers stressed that their study calls for attention to the risk of disordered eating and eating disorders in women with PCOS, regardless of their weight, with a special emphasis on lifestyle counseling.

Reference

Laura G Cooney, Kaley Gyorfi, Awa Sanneh, Leeann M Bui, Aya Mousa, Chau Thien Tay, Helena Teede, Elisabet Stener-Victorin, Leah Brennan, Increased Prevalence of Binge Eating Disorder and Bulimia Nervosa in Women With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis, The Journal of Clinical Endocrinology & Metabolism, 2024;, dgae462, https://doi.org/10.1210/clinem/dgae462  

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Further proof of role testosterone plays in preventing severe Covid provided by experts in new study

A new study has revealed important information about how a patient’s testosterone level can help protect them from severe Covid-19.

Previous research involving Swansea University investigated how sex hormones are likely to be important determinants of Covid-19 severity.

Now digit ratio expert Professor John Manning, of the Applied Sports, Technology, Exercise and Medicine (A-STEM) research team, has been working with colleagues in Poland and Sweden to look more closely at the subject.

He says their findings, which have just been published by prestigious online journal Andrology, could have significant implications for public health and future treatments.

Professor Manning said: “Covid-19 varies markedly in its severity across both nations and individuals. It is most severe in elderly men. This has led to suggestions that testosterone may influence severity. However, it is unclear whether testosterone increases or decreases severity.

“In collaboration with colleagues in Poland and Sweden, we have been looking at testosterone-dependent finger patterns in hospitalized-patients compared to controls.”

He explained there are two opposing explanations – the low-androgen-driven and high-androgen-driven theories. The first theory implicates high testosterone as aiding infection by the virus, but the latter theory argues that is the low levels of testosterone found in elderly men which increases their inflammatory immune response to Covid, resulting in a poor prognosis.

For this new research the team looked at sex differences in relative digit length in hospitalized patients and controls. It is thought that sex differences in relative digit lengths arise as the result of exposure to testosterone and/or oestrogen in the womb or at puberty. Long index-fingers are thought to relate to low testosterone/high oestrogen and long little-fingers to high testosterone/low oestrogen.

The study, conducted in the Medical University of Lodz, Poland, considered two samples taken before and after vaccination was widely available. In both samples, hospitalized patients had short little fingers relative to controls.

Professor Manning said: “The patients had digit ratios that indicated low testosterone before and after birth. The pattern was present at the beginning of the pandemic and after widespread vaccination.

“This means we can conclude that testosterone is protective against severe Covid-19. The effect may arise because the hormone reduces inflammation in the lungs and other organs. The findings have public health and treatment implications.”

References: Anna Kasielska-Trojan, John T. Manning, Maciej Jabłkowski, Jolanta Białkowska-Warzecha, Oliwia Kwaśniewska, Angelica L Hirschberg, Bogusław Antoszewski First published: 29 July 2024 https://doi.org/10.1111/andr.13709

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