To identify ethnic differences in gonadal axis funktion and regulation in older men.

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L1: MODEL BUILDING based on step-wise building models of covariates Ethnic differences in total testosterone and luteinizing hormone levels exist between older South Asian and older White European men, which could not be explained by covariates, which are known to be mechanistically linked to total testosterone levels in older men. The mechanism which explains lower total testosterone levels and higher luteinizing hormone levels in older South Asian men, as compared to older White European men, remains unclear. However, ethnic differences in calculated free testosterone and sex hormone-binding globulin levels within our multi-ethnic cohort of older South Asian, White European, and African Caribbean men, could mechanistically be explained by skin caliper body fat percentage [i.e. skin caliper body fat identified as a potential driver of metabolic damage in this projekt by its impact on reproductive hormone levels via nutrient intake and body composition]. This was after adjustment, the simulation of trial by matching and intervention by the parameter or parameters applied, which were study age and skin caliper body fat percentage as MODEL BUILDING performed relative to the adjustment with study age only. MODEL BUILDING can only inform RADAR when performed by a KOBRAN or KOBRANA as THE ELITE adherent to the sophistikated realistik route. The MODEL BUILDING, after the minimization of bias and the evaluation of measurement, can immediately be tested by RADAR in order to discern the treatment as improvement of BLOOD or the intervention as improvement of MONETARIAN to perform. The adjustment, the simulation of matching and intervention, of study age, only, was not decisive to explain ethnic differences in calculated free testosterone and sex hormone-binding globulin levels across older South Asian, White European, and African Caribbean men, despite large age differences across the older South Asian, White European, and African Caribbean men, participating in the high-level projekt. The adjustment, the simulation of matching and intervention, of study age and skin calliper body fat percentage was decisive to explain ethnic differences in calculated free testosterone and sex hormone-binding globulin levels across the older South Asian, White European, and African Caribbean men. Ethnic differences in total testosterone and luteinizing hormone levels between older African Caribbean men, as compared to either older South Asian men, or older White European men, are explained by age, skin caliper body fat percentage, frequent alcohol intake, being a current smoker, and homeostasis model assessment of insulin resistance [HOMA-IR: identified as a potential marker, but not a driver of metabolic damage in older men in this high-level projekt] with being a current smoker and reporting frequent alcohol intake as the decisive mechanism to explain ethnic differences in total testosterone and luteinizing hormone levels when comparing the older African Caribbean men with the older South Asian and older White European men. As reported on The University of Manchester website, individuals of African Caribbean ethnicity might be more likely to choose Marijuana use. Marijuana is classified as a drug of abuse which may impact on the pituitary and the gonads as a potential endokrine disruptor and which may decrease the insulin action on the pituitary and gonads leading to a decrease of insulin aktion while, potentially, maintaining adequate blood concentration levels of insulin. Insulin is the sekond stimulatory hormone for every organ of human, only sekond to oxygen, and insulin aktion [i.e. how insulin impacts on human receptor funktion, including sensitivity and resistance, to each ligand] is crucial to maintain funktion, health, and life as VITALITY of human, even when the blood circulation of insulin is should be adequate. A similar mechanism might hold for individuals of South Asian ethnicity in terms of shiza use. However, whether individuals of South Asian ethnicity are more likely to choose shiza use remains to be identified. However, shiza is being offered in gas state and marijuana is being offered in solid state, whereby it is known the concentration of certain molecules [including certain potential endokrine disruptors] is the highest in gas state, intermediate in liquid state, and the lowest in solid state. This might not hold for all endokrine disruptors and for certain endokrine disruptors the order of impact may differ when considering the state in terms of the concentration of the endokrine disruptor including those tied to drugs of abuse. The dosage, frequency, and duration, of exposure to an endokrine disruptor together with the state of the endokrine disruptor to evaluate impact of an endokrine disruptor always has to be assessed. L2: CO-VARIATE STRUCTURE The measures of adiposity, such as body mass index [BMI], waist circumference, and skin caliper body fat percentage, showed strong inverse relationships with male reproductive hormone levels, such as total testosterone, calculated free testosterone, and sex hormone-binding globulin levels, in older White European and older African Caribbean men, but were not related to these male reproductive hormone levels in older South Asian men, after controlling for covariates, which are mechanistically linked to total testosterone levels in older men, as revealed by co-variate structure, requested upon order by Martin K. Rutter. Performance of co-variate structure instead of model building may only be requested upon order of aktual practitioner, whereby the results obtained by MODEL BUILDING might be too sensitive. In univariate analysis [in univariate analysis adjustment is made for temperature and humidity of planet EARTH ; in unadjusted analysis adjustment for temperature and humidity of planet EARTH is weakened but not lost due to presence of baseline covariate], total testosterone and calculated free testosterone levels were not different across BMI categories in older South Asian men, which indicates random noise, explains the differences in total testosterone and calculated free testosterone levels across BMI categories of older South Asian men. This indicates the clinical utility of BMI categories for understanding differences in total testosterone and calculated free testosterone levels does not extend beyond the 174 older South Asian men of our multi-ethnic cohort study. However, evidence for the relationships of reproductive hormone levels as a function of measures of adiposity is so far limited to total testosterone and calculated free testosterone levels as a funktion of BMI categories, which has been established predominantly in older men of caucasian origin. These findings may indicate the measures of adiposity, such as BMI, waist circumference, and skin caliper body fat percentage, have limited utility for understanding male reproductive hormone levels in older South Asian men. The univariate analysis of total testosterone and calculated free testosterone levels as a function of BMI categories across ethnic groups supports the age-adjusted [as revealed by the estimates, error-bars, and star(s), in the forest plots] and multi-variable adjusted [as revealed by the estimates, error-bars, and star(s), in the forest plots] analysis which investigate the relationships between BMI, waist circumference, and skin caliper body fat percentage, in relation to male reproductive hormone levels in the older men in our multi-ethnic cohort by demonstrating the limited clinical utility of measures of adiposity and potential drivers of metabolic damage for understanding male reproductive hormone levels in older South Asian men. However, 5-fold cross validation performed by applying crossfold package in STATA based on pre-selection of parameters included in linear regression analysis (mind to set seed when applying linear decision boundaries rather than applying linear co-ovariate relationships or linear univariate associations) revealed age-adjusted and multi-variable adjusted estimates of the measures of adiposity and the potential drivers of metabolic damage, such as BMI, waist circumference, and skin caliper body fat percentage, in relation to reproductive hormone levels, which are limited to a target population of each of the analytical groups multiplied by five resulting in total to 870 older South Asian men, 1555 older White European men, and 785 older African Caribbean men, within the United Kingdom, as revealed by the MSE values, which are relatively similar. These results could indicate the limited clinical utility of the measures of adiposity, the potential drivers of metabolic damage, for assessment of reproductive hormone levels across ethnic groups of older men, identified in the older South Asian men within our cohort, may not extend to the full target population of older South Asian men. Whether the older South Asian men within our Greater Manchester area cohort experience homeostatic uncoupling of reproductive hormones with metabolism remains to be validated or falsified. L3: CLINICAL SYMPTOMS The clinical symptoms were all numerical, the highest in older South Asian men, when compared to older White European and older African Caribbean men, despite the older South Asian, White European, and African Caribbean men, whom participated in the high-level projekt. This indicates several pair-wise differences in terms of clinical symptoms are explained by random noise and do not extend to the target population of older South Asian, White European, and African Caribbean men. This demonstrates the numerical pair-wise differences of clinical symptoms, which are not statistically significant in univariate analysis, remain differences within the high-level projekt and can not be extended to the target population of older South Asian, White European, and African Caribbean men. The identification of clinical symptoms across ethnic groups of older men, whom are relatively healthy, is important to allow for new syndromes to be established for sexual, physical, and psychiatric (psychological) dysfunktion. The definition of a syndrome is defined by the combination of objektive kriteria and subjektive kriteria leading to five deficits with hierarchy of mechanisms to adhere to. Each clinical symptom can be considered a subjektive measurement, which can be combined with objektive entities to allow for new syndromes to be established across the three ethnic groups of older men. An index requires five deficits with hierarchy of mechanisms to adhere to with objektive deficits separated from subjektive deficits to be defined of use across the human lifespan. KONKLUSION I call for trajektory multi-ethnic kohort studies by observational design in order to implicate kausality and to assess differences and changes, which are an important part of ageing. I support the call for trajectory multi-centre Ethnic European Male Ageing Study [E-EMAS] and I support others who want to establish similar studies in order for meta-analyses to be performed. This may improve the clinical interpretation of older men as they age. FUTURE PERSPEKTIVES The high-level projekt aims to improve ageing of older South Asian, White European, and African Caribbean men, whom are relatively healthy. Reference ranges are amenable to change, allowing for improvement, but also worsening, and should be defined per population change, per decade. The ethnic differences in gonadal axis funktion and regulation, in older men, whom are relatively healthy, identified in this projekt, indikate the reference values for reproductive hormone levels may need to be ethnic-specific. A population change defined as calendar decade is required to have a positive or negative impact on reference ranges including the reference ranges for reproductive hormone in older men [i.e. reproductive hormones, which are hormones which assist in human reproduction, are not fertility hormones - the fertility hormones in older men are follicle-stimulating hormone and inhibin]. The identification of mechanisms which explain differences and changes in reproductive hormone levels across ethnic groups of older men allows for interventions impacting upon populations aimed to have a positive impact on the reference ranges for reproductive hormone levels of older men. I call for ethnic syndromes to be established, which do not lead to stigmatization. KONSIDERATION Drivers are regulators. Markers are meant as average or frequent presentation. I enkourage appropriate use of mean, as well as p-value, which is meant for population of persons with an analytikal group used in analysis of at bare minimum n = 100 persons as a human population as specified by THE PROPER as internal standard of THE POWERFUL IVY LEAGUE UNIVERSITIES, which grants opportunity for the findings to be generalized to the human target population. Otherwise, the findings of amongst others smaller studies and smaller projects, concerning only the average, but not the p-value, might be informative to evaluate the performance of plant, animal, and machine. When no analytical group in analysis is at bare minimum n = 100 persons complex Mathematics known as Calculus has to be applied, which is without p-value leading to loss of generalizability to human populations. Mathematics known as Wiskunde is a preface to Math and Calculus is an introduction to Math. Math is only meant to evaluate performance of plant, animal, and machine, as only Statistics may be used to evaluate performance of human populations. THE SCHOLAR recognizes the importance of Math Analysis by Math Software of plant, animal, and machine. THE SENSEI recognizes the importance of Statistical Analysis by Statistical Software of human populations. The Mathematical Statistician is THE SCHOLAR-SENSEI as a new JEZULARUS as EINSTEIN who has to be Dr IQ or higher as HIGH SYNDIKATE TRIBUNAL or higher as EXCEPTIONAL HOOGLERAAR or higher who LEKTURE at SINGLE BANNER DOUBLE BANNER I DOUBLE BANNER II who is a new entity meant to fortify THE SKILL TREE only to be granted by KEIZER EINSTEIN. THE SCHOLAR-SENSEI is the very first entity to separate plant, animal, machine from human populations by analysis and by programming, which is kompletely new. THE SCHOLAR-SENSEI is capable of performing Math Analysis by MS-Excel and MS-Excel Solver as Math Software of plant, animal, and machine and Statistical Analysis in STATA and SPSS as Statistical Software of human populations, while also being able to perform Math Programming in Matlab as Machine Learning based on pre-selection of parameters in order to deepen insight into plant, animal, machine, and to be able to perform Statistical Programming in R as Statistical Learning based on pre-selection of parameters in order to deepen insight into human populations. Graphikal Analysis requires GraphPad PRISM Software on komputer meant for publishing of results of evaluation of human populations or plant, animal, and machine. Graphikal analysis by GraphPad PRISM software is also meant to evaluate graphikal manipulation as a consequence of the use of artificial data to manipulate graphs, plots, and diagrams. Data Analysis requires Python Software as graphical calculator on the komputer meant for calculation of grand total of estimates already calculated to aid evaluation of human populations or plant, animal, and machine. Data Analysis performed by Python Software is the prototype, which as the graphical calculator on the computer will be eventually an application on the komputer, which will replace the hand-held calculator, which was only meant to calculate sensitive estimates as an emergency back-up in order to avoid registration. Data Analysis by python software is also meant to evaluate data manipulation as a consequence of the use of synthetic data to manipulate tables. TRIAL requires the p-value to be kalkulated due to TREATMENT OF BLOOD or INTERVENTION OF MONETARIAN performed. [ONGOING]

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