TY - JOUR
T1 - The Leydig cell biomarker INSL3 as a predictor of age-related morbidity
T2 - Findings from the EMAS cohort
AU - Ivell, Richard
AU - Heng, Kee
AU - Severn, Katie
AU - Antonio, Leen
AU - Bartfai, Gyorgy
AU - Casanueva, Felipe F
AU - Huhtaniemi, Ilpo T
AU - Giwercman, Aleksander
AU - Maggi, Mario
AU - O'Connor, Daryl B
AU - O'Neill, Terence W
AU - Punab, Margus
AU - Rastrelli, Giulia
AU - Slowikowska-Hilczer, Jolanta
AU - Tournoy, Jos
AU - Vanderschueren, Dirk
AU - Wu, Frederick C W
AU - Anand-Ivell, Ravinder
N1 - Copyright © 2022 Ivell, Heng, Severn, Antonio, Bartfai, Casanueva, Huhtaniemi, Giwercman, Maggi, O’Connor, O’Neill, Punab, Rastrelli, Slowikowska-Hilczer, Tournoy, Vanderschueren, Wu and Anand-Ivell.
PY - 2022
Y1 - 2022
N2 - BACKGROUND: Insulin-like peptide 3 (INSL3) is a constitutive hormone secreted in men by the mature Leydig cells of the testes. It is an accurate biomarker for Leydig cell functional capacity, reflecting their total cell number and differentiation status.OBJECTIVES: To determine the ability of INSL3 to predict hypogonadism and age-related morbidity using the EMAS cohort of older community-dwelling men.MATERIALS & METHODS: Circulating INSL3 was assessed in the EMAS cohort and its cross-sectional and longitudinal relationships to hypogonadism, here defined by testosterone (T) <10.5nmol/l, and a range of age-related morbidities determined by correlation and regression analysis.RESULTS & DISCUSSION: While INSL3 is an accurate measure of primary hypogonadism, secondary and compensated hypogonadism also indicate reduced levels of INSL3, implying that testicular hypogonadism does not improve even when LH levels are increased, and that ageing-related hypogonadism may combine both primary and secondary features. Unadjusted, serum INSL3, like calculated free testosterone (cFT), LH, or the T/LH ratio reflects hypogonadal status and is associated with reduced sexual function, bone mineral density, and physical activity, as well as increased occurrence of hypertension, cardiovascular disease, cancer, and diabetes. Using multiple regression analysis to adjust for a range of hormonal, anthropometric, and lifestyle factors, this relationship is lost for all morbidities, except for reduced bone mineral density, implying that INSL3 and/or its specific receptor, RXFP2, may be causally involved in promoting healthy bone metabolism. Elevated INSL3 also associates with hypertension and cardiovascular disease. When unadjusted, INSL3 in phase 1 of the EMAS study was assessed for its association with morbidity in phase 2 (mean 4.3 years later); INSL3 significantly predicts 7 out of 9 morbidity categories, behaving as well as cFT in this regard. In contrast, total T was predictive in only 3 of the 9 categories.CONCLUSION: Together with its low within-individual variance, these findings suggest that assessing INSL3 in men could offer important insight into the later development of disease in the elderly.
AB - BACKGROUND: Insulin-like peptide 3 (INSL3) is a constitutive hormone secreted in men by the mature Leydig cells of the testes. It is an accurate biomarker for Leydig cell functional capacity, reflecting their total cell number and differentiation status.OBJECTIVES: To determine the ability of INSL3 to predict hypogonadism and age-related morbidity using the EMAS cohort of older community-dwelling men.MATERIALS & METHODS: Circulating INSL3 was assessed in the EMAS cohort and its cross-sectional and longitudinal relationships to hypogonadism, here defined by testosterone (T) <10.5nmol/l, and a range of age-related morbidities determined by correlation and regression analysis.RESULTS & DISCUSSION: While INSL3 is an accurate measure of primary hypogonadism, secondary and compensated hypogonadism also indicate reduced levels of INSL3, implying that testicular hypogonadism does not improve even when LH levels are increased, and that ageing-related hypogonadism may combine both primary and secondary features. Unadjusted, serum INSL3, like calculated free testosterone (cFT), LH, or the T/LH ratio reflects hypogonadal status and is associated with reduced sexual function, bone mineral density, and physical activity, as well as increased occurrence of hypertension, cardiovascular disease, cancer, and diabetes. Using multiple regression analysis to adjust for a range of hormonal, anthropometric, and lifestyle factors, this relationship is lost for all morbidities, except for reduced bone mineral density, implying that INSL3 and/or its specific receptor, RXFP2, may be causally involved in promoting healthy bone metabolism. Elevated INSL3 also associates with hypertension and cardiovascular disease. When unadjusted, INSL3 in phase 1 of the EMAS study was assessed for its association with morbidity in phase 2 (mean 4.3 years later); INSL3 significantly predicts 7 out of 9 morbidity categories, behaving as well as cFT in this regard. In contrast, total T was predictive in only 3 of the 9 categories.CONCLUSION: Together with its low within-individual variance, these findings suggest that assessing INSL3 in men could offer important insight into the later development of disease in the elderly.
KW - Male
KW - Humans
KW - Aged
KW - Leydig Cells
KW - Cross-Sectional Studies
KW - Cardiovascular Diseases/metabolism
KW - Insulin/metabolism
KW - Proteins/metabolism
KW - Hypogonadism
KW - Testosterone
KW - Biomarkers
KW - Morbidity
KW - Hypertension
U2 - 10.3389/fendo.2022.1016107
DO - 10.3389/fendo.2022.1016107
M3 - Article
C2 - 36425465
SN - 1664-2392
VL - 13
SP - 1016107
JO - Frontiers in Endocrinology
JF - Frontiers in Endocrinology
ER -
