MetS is a rising epidemic in the United States, and importantly, approximately one in four LEOs who worked at the WTC site after 9/11 are affected. Am. J. Ind. Med. 59:752-760, 2016. © 2016 Wiley Periodicals, Inc.

In this pilot study, we hypothesize that dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) has the potential to evaluate differences in atherosclerosis profiles in patients subjected to high (initial dust cloud) and low (after 13 September 2001) particulate matter (PM) exposure. Exposure to PM may be associated with adverse health effects leading to increased morbidity. Law enforcement workers were exposed to high levels of particulate pollution after working at “Ground Zero” and may exhibit accelerated atherosclerosis. 31 subjects (28 male) with high (n = 19) or low (n = 12) exposure to PM underwent DCE-MRI. Demographics (age, gender, family history, hypertension, diabetes, BMI, and smoking status), biomarkers (lipid profiles, hs-CRP, BP) and ankle-brachial index (ABI) measures (left and right) were obtained from all subjects. Differences between the high and low exposures were compared using independent samples t test. Using linear forward stepwise regression with information criteria model, independent predictors of increased area under curve (AUC) from DCE-MRI were determined using all variables as input. Confidence interval of 95 % was used and variables with p > 0.1 were eliminated. p < 0.05 was considered significant. Subjects with high exposure (HE) had significantly higher DCE-MRI AUC uptake (increased neovascularization) compared to subjects with lower exposure (LE). (AUC: 2.65 ± 0.63 HE vs. 1.88 ± 0.69 LE, p = 0.016). Except for right leg ABI, none of the other parameters were significantly different between the two groups. Regression model indicated that only HE to PM, CRP > 3.0 and total cholesterol were independently associated with increased neovascularization (in decreasing order of importance, all p < 0.026). HE to PM may increase plaque neovascularization, and thereby potentially indicate worsening atherogenic profile of “Ground Zero” workers.

INTRODUCTION AND OBJECTIVES: It has been well established that Vitamin D plays in an important role in bone metabolism, but within the last decade Vitamin D has been shown be associated with the inflammatory cascade as well as immune-modulating properties. Numerous studies have implicated low Vitamin D levels in increased overall mortality, cardiovascular (CV) and cancer mortality. In fact, Siadat et al showed that low serum 25-hydroxyvitamin D (VitD-25) is associated with prevalent coronary artery disease independent of CV risk factors. Studies have shown a complex relationship between vitamin D and androgen metabolism. To date, there is conflicting information regarding the association of vitamin D and androgen levels in men. In this abstract, we aim to show relationship between total testosterone (TT) and serum VitD-25 independent of CV risk among asymptomatic middle-aged men.METHODS: We evaluated 824 male participants in the World Trade Center (WTC)-CHEST program from January 2011 to June 2014. Blood samples were analyzed for various laboratory parameters including VitD-25 and total testosterone. Hypovitaminosis D is defined as VitD-25 less than 30.0 ng/L. We used the Framingham 10-year CV disease risk as a proxy for general CV risk.RESULTS: Insufficient VitD-25 was noted in 68.3% (563) of the participants. Only 11.4% (64) of those with insufficient VitD-25 took Vitamin D supplementation. Subjects with insufficient VitD-25 were significantly younger, and have higher BMI than those with normal VitD-25 (table). In subjects with hypovitaminosis D, TT was 319.66, b108.85 ng/L which was significantly lower than those with normal VitD-25 whose TT was 341.77, b132.36 (p ¼ 0.013). When adjusted for Framingham 10-year CV Disease risk, subjects with hypovitaminosis D still had significantly lower TT than those with normal TT (p ¼ 0.019) CONCLUSIONS: There is a significant association between hypovitaminosis D and total testosterone among this population of asymptomatic middle-aged men independent of cardiac risk. It is important to evaluate vitamin D levels in men having low total testosterone. INTRODUCTION AND OBJECTIVES: Polycythemia (PCT) iswell-recognized adverse effect of testosterone supplementation. However, widely disparate rates exist in the literature (2-24%) based on varied definitions of PCT and modality of T supplementation. We attempted to determine the rate of PCT in patients in our intramuscular testosterone (IMT) program.METHODS: Symptomatic men with two low total T (TT) levels (<350 ng/dl), using IMT for at least 6 months comprised the study cohort. Men used 200mg IM every 2 weeks and had peak (day 1-2) and trough T (day 13-14) levels checked after two cycles, and every 6 months. PCT was defined as hematocrit (HCT) !52%. Patients were excluded from IMT if they had baseline HCT >48%. A multivariate model was constructed to define predictors of PCT development. Factors assessed included: patient age, mean BMI, cigarette smoking history, baseline HCT, mean per patient peak TT level, mean per patient trou...

IMT fails to demonstrate such a correlation. Moreover, a novel doppler parameter, cavernous IMT seems promising as an additional tool in evaluation of cavernosal function by PDU. Table 1. Patient characteristics and ultrasound data. Values were expressed as mean Ϯ standard deviation (min-max). Organic ED (nϭ29) Psychogenic ED (nϭ21) p value BMI (kg/m2) 27,4Ϯ4,2 (19,6-36,3) 27,1Ϯ2,7 (21,1-31,8) 0,768 Age (years) 52,2Ϯ11,0 (30-77) 48,7Ϯ8,3 (31-68) 0,156 IIEF score 10,6Ϯ5,3 (5-20) 17,3Ϯ2,6 (13-21) Ͻ0,001 Carotid Arteries IMT (mm) 0,83Ϯ0,20 (0,40-1,30) 0,79Ϯ0,19 (0,43-1,13) 0,601 PSV (cm/second) 75,1Ϯ19,7 (40,0-115,0) 94,0Ϯ12,4 (75,0-122,0) 0,001 EDV (cm/second) 23,8Ϯ6,8 (11,0-42,0) 34,0Ϯ7,9 (21,0-51,0) Cavernous Arteries IMT (mm) 0,21Ϯ0,09 (0,10-0,40) 0,14Ϯ0,10 (0,03-0,33) 0,012 PSV (cm/second) 21,7Ϯ6,9 (7,0-33,0) 49,8Ϯ21,3 (30,0-130,0) Ͻ0,001EDV (cm/second) 3,8Ϯ3,5 (0-10,0) 0,2Ϯ1,1 (0-5,0) Ͻ0,001

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