Here are some examples of how South Australian men in the Centre’s MAILES (Florey Adelaide Male Ageing Study AND males in the NorthWest Adelaide Health Study) longitudinal male ageing study have helped to advance medical knowledge in 2016. In particular, we present summaries of papers published in some of the leading medical journals in the respective fields.
Expanding our understanding of the clinical consequences of poor sleep health
Sleep, gastrointestinal problems and mental health
It has long been accepted that men with common mental health problems, such as anxiety & depression, may also be at greater risk for gastrointestinal diseases such as gastroesophageal reflux disease (GERD). However, most of the previous evidence for this has come from small samples of men attending specialised clinics. We are one of the first to demonstrate such an association in community-based men but also we have shown that having poorer sleep quality may heighten the association between depression & GERD.
Publication: On ZX, Grant J, Shi Z, Taylor AW, Wittert GA, Tully PJ, Hayley AC, Martin S. The association between gastroesophageal reflux disease (GERD) with sleep quality, depression and anxiety in a cohort study of Australian men. J Gastroenterol Hepatol. 2016 Nov.
Obstructive sleep apnoea and kidney disease
Using data from ~900 men who generously participated in at-home sleep studies, we have been able to show that men with severe obstructive sleep apnea (OSA) were more likely to have mild chronic kidney disease. This is one of few studies in non-clinical “healthy” populations. The links to kidney disease is likely to be as a result of the lower levels of oxygen in the blood (hypoxia) that result as a consequence of severe OSA.
Publication: Antic NA, Catcheside PG, Vincent AD, Wittert GA. Association of kidney disease with obstructive sleep apnea in a population study of men. Sleep. 2016 Sep.
Waking up to urinate at night
Also using data from our sleep studies, we demonstrated that men with moderate or severe OSA were at a greater risk of having to wake to urinate two or more times per night (nocturia). This effect was persistent even after accounting for other factors that can increase nocturia (such as increasing age, diabetes, heart disease). Repeated broken sleep, such as due to nocturia, has consequences for day-time function. Dr Sean Martin presented this new knowledge at the 2016 Scientific meeting of the International Continence Society in Tokyo (pictured below).
Publication: Martin SA, Appleton SL, Adams RJ, Taylor AW, Catcheside PG, Vakulin A, McEvoy RD, Antic NA, Wittert GA. Nocturia, other lower urinary tract symptoms and sleep dysfunction in a community-dwelling cohort of men. Urology. 2016 Jun 24.
SIgnificance: Most men are unaware that they have OSA and our research continues to reveal the broader consequences of poor sleep health in men. Our findings further highlight the need for better education and GP screening for OSA in men to potentially circumvent a range of significant health problems.
Testosterone for health
It is well recognised that the sex hormone testosterone is essential for healthy development and physical and mental health over the life trajectory, particularly in men. We have shown, in our previous MAILES studies that low levels of testosterone in blood is associated with chronic disease risk. We therefore examined whether, and found that, incorporating testosterone levels as a risk factor in existing diabetes risk assessment tools improves the risk prediction for subsequent diabetes. Significance: This has implications for health screening in primary care. Whether giving men who have low levels, testosterone, offers any appreciable health benefits is still being determined.
Publication: Atlantis E, Fahey P, Martin S, O’Loughlin P, Taylor AW, Adams RJ, Shi Z, Wittert G. Predictive value of serum testosterone for type 2 diabetes risk assessment in men. BMC Endocrine Disorders. 2016 May
Depression in men and health service use
One of the core aims of MAILES is to better understand how men engage with the health system in order to better accommodate their particular needs, and by extension their health outcomes. Dr Brett Scholz talked to a group of MAILES men about their experiences with depression and how this may or may not be brought up with their doctor. He examined, in particular, men’s discourse around the links between depression and comorbid illness, and the social contexts in which depression is experienced. Significance: Greater awareness and training on cues offered by men in their discourse of depression and treatment that focusses on depression as similar to a physical health concern and as a condition experienced in social conditions will improve detection and treatment.
Publication: Scholz B, Crabb S, Wittert GA. “Males don’t wanna bring anything up to their doctor”: Men’s discourses of depression. Qual Health Res. 2016 Apr 6
Biological basis of depression in men with chronic disease
Type 2 diabetes is associated with a range of health conditions, in addition to the complications associated with diabetes. One of these conditions is depression, however little is known about how this occurs. Using data from MAILES men, Dr Phillip Tully and the research team have shown that a certain marker of endothelial (the interior lining of blood vessels) damage, called e-Selectin, was persistently higher in men with Type 2 diabetes who went on to develop depression. Significance: This finding is part of an emerging body of research demonstrating the biological basis of depression and how we may better screen for depression and risk.
Publication: Tully PJ, Baumeister H, Martin S, Atlantis E, Jenkins A, Januszewski A, OʼLoughlin P, Taylor A, Wittert GA; Florey Adelaide Male Ageing Study. Elucidating the biological mechanisms linking depressive symptoms With Type 2 Diabetes in men: The longitudinal effects of inflammation, microvascular dysfunction, and testosterone. Psychosom Med. 2016;78:221-32.
The above projects were supported by funding from the National Health and Medical Research Council of Australia, the Freemasons Foundation Centre for Men’s Health, and the ResMed Foundation.