👤 Daniel S Ory

Individuals with chronic conditions have persistent, co-occurring symptoms affecting quality of life. Understanding symptom severity susceptibilities is critical for early risk identification, but gaps remain among racial and ethnic minority men with chronic conditions. As such, this study identifies symptom severity profiles in non-Hispanic Black and Hispanic men based on five common symptoms (fatigue, pain, shortness of breath, sleep disturbance, depression) and its associated demographic, clinical, and modifiable sociobehavioral risk factors. Online survey data from 1,982 men aged 40 and older with chronic conditions was analyzed using latent profile analysis (LPA) to identify symptom severity profiles. LPA revealed three symptom severity profiles: lowest (63.4%); moderate (13.9%); and highest (22.7%). Multinomial and binary logistic regressions were used to analyze demographic, clinical, social, and behavioral factors associated with symptom severity profiles. Compared to men in the lowest symptom severity profile, men in the highest symptom severity profile were younger (OR = 0.98, p < 0.001), had lower incomes (OR = 0.95, p = 0.028), had more comorbidities (OR = 1.92, P = 0.001), had more medications (OR = 1.09, P = 0.012), reported current tobacco (OR = 1.55, P < 0.001) or cannabis (OR = 1.45, P = 0.011) use, experienced more social disconnectedness (OR = 1.34, P < 0.001), and had poorer self-management efficacy (OR = 0.93, P < 0.001). Compared to men in the moderate profile, men in the highest profile had lower education (OR = 0.53, P = 0.002), more comorbidities (OR = 1.77, P = 0.018), higher medication use (OR = 1.11 P = 0.009), and increased cannabis use (OR = 1.56, P = 0.017). Findings highlight diverse symptom experiences and key factors that can be targeted in prevention and treatment strategies to reduce symptom severity within these subpopulations. Show less

Pathogenic biallelic variants in HSD17B3 result in 17β-hydroxysteroid dehydrogenase 3 (17β-HSD3) deficiency, variable disruption of testosterone production, and phenotypic diversity among 46, XY individuals with differences of sexual development (DSDs). We performed quad whole exome sequencing (WES) on two male siblings with microphallus, perineal hypospadias, and bifid scrotum and their unaffected parents. Both male siblings were compound heterozygous for a rare pathogenic HSD17B3 variant (c.239 G > A, p.R80Q) previously identified among individuals with 17β-HSD3 deficiency and a HSD17B3 variant (c.641A > G, p.E214 G) of uncertain significance. Following WES, the siblings underwent hCG stimulation testing with measurement of testosterone, androstenedione, and dihydrotestosterone which was non-diagnostic. To confirm pathogenicity of the HSD17B3 variants, we performed transient transfection of HEK-293 cells and measured conversion of radiolabeled androstenedione to testosterone. Both HSD17B3 variants decreased conversion of radiolabeled androstenedione to testosterone. As pathogenic HSD17B3 variants are rare causes of 46, XY DSD and hCG stimulation testing may not be diagnostic for 17β-HSD3 deficiency, WES in 46, XY individuals with DSDs can increase diagnostic yield and identify genomic variants for functional characterization of disruption of testosterone production. Show less