ECE2022 Oral Communications Oral Communications 9: Environmental Endocrinology (6 abstracts)
Morphostructural characterization of the testis in a large cohort of men living in highly polluted areas of Campania Region in south Italy: a focus on cadmium exposure
Francesco Garifalos 1 , Cristina De Angelis 1 , Aldo Di Nunzio 2 , Davide Menafra 1 , Michele Castoro 1 , Nunzia Verde 1 , Giacomo Galdiero 1 , Mariangela Piscopo 1 , Claudia Pivonello 1 , Renata Simona Auriemma 1 , Paolo Chiodini 3 , Marco Trifuoggi 2 , Annamaria Colao 1,4 & Rosario Pivonello 1,4
1Università Federico II di Napoli, Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Unità di Andrologia e Medicina della Riproduzione e della Sessualità Maschile e Femminile (FERTISEXCARES), Naples, Italy; 2Università degli Studi di Napoli Federico II, Dipartimento di Scienze Chimiche, Naples, Italy; 3University of Campania “Luigi Vanvitelli”, Medical Statistics Unit, Naples, Italy; 4Università Federico II di Napoli, Unesco Chair for Health Education and Sustainable Development, Naples, Italy
Campania Region has been facing waste management crisis since 1980, characterized by urban, toxic and industrial waste illegal disposal, burying and incineration. Cadmium (Cd) is consistently shown to affect male reproductive function by multiple mechanisms, mostly elucidated in experimental models. The aim of the current single-center, observational, cross-sectional cohort study was to evaluate the prevalence of testis morphostructural alterations in a large cohort of men living in 3 municipalities of Campania Region (Acerra, Afragola, Giugliano) belonging to the high-environmental impact area “Land of Fires”, by addressing the potential association with seminal Cd (sCd) levels. Study cohort included 465 males (age range: 14-50 yrs mean: 29.5±7.23 yrs). Morphostructural testis characteristics were assessed by ultrasound and sCd determination was performed in 385 samples by inductively coupled plasma-mass spectrometry. Prevalences of testis morphostructural alterations, unilateral or bilateral, included varicocele (35.4%), hydrocele (34.8%), parenchymal structure inhomogeneity (19%), hypotrophy (14.6%), microlithiasis (2.5%), solid lesions >5 mm (0.2%). Participants with detectable sCd levels (n=128) displayed significantly reduced mean testicular volume (16.56 ± 4.68 vs 17.66 ± 4.34; P=0.0153) and higher prevalence of hypotrophy (21% vs 10%; P=0.0059) and varicocele I-V° grade (47.5% vs 29.5%; P=0.0008), but not clinically relevant varicocele III-V grade (18% vs 11%, P=0.09), together with a slightly higher parenchymal structure prevalence of inhomogeneity (25.8% vs 16.7%; P=0.059) compared to participants with undetectable sCd levels (n=257). Furthermore, a significant difference in mean testicular volume was detected when comparing participants with sCd levels above (n=49) and below median value (n=79) and undetectable sCd levels, respectively (14.88 ± 3.79 vs 17.22 ± 5.03 vs 17.66 ± 4.34; P< 0.001). sCd level was persistently correlated with mean testicular volume after correction for the presence of clinically relevant varicocele (r=-0.185; P=0.001). sCd levels was identified as the best predictor of mean testicular volume in linear regression analysis performed by setting sCd, smoking habit, age and BMI as independent variables. ROC curve analysis highlighted that a sCd level >0.76 μg/l correctly identified testicular hypotrophy with a 60% sensibility and 70% specificity. In conclusion, the current study demonstrated for the first time, in a large cohort of adult males living in high-environmental impact areas of Campania Region, an inverse relationship between sCd levels and mean testicular volume and prevalence of varicocele, independently from age, BMI and smoking habit, therefore further strengthening the concept of gonadal toxicity exerted by Cd, potentially explained by Cd-induced damage to testicular vascular endothelium.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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