International Men’s Health Week - June 9th to 15th
Eminent Author, Medical Biochemist and Scientist, Technical Education consultant.
AGD Biomedicals (Pvt) LTD. Andheri East, Mumbai.
Indian males play a significant role in the Indian economy, contributing to both labour force participation (LFPR about 74% in 2024) and overall economic growth(1,2). A healthier male workforce translates to lower healthcare costs, increased productivity and greater economic output. The theme of International men’s health week is ‘Men’s Health Checks’. This theme focuses on raising awareness of preventable health issues among men and encouraging early detection and treatment of diseases. The biggest threat to men’s health is from the following most common health conditions in Men: Type 2 Diabetes mellitus, cardiovascular diseases, stroke, thyroid diseases, fatty liver, Chronic obstructive pulmonary disease (COPD), cancer, AIDS and depression(3). Early detection of these diseases by and cutting age fifth generation POCT-backed IVD laboratory tests enable prompt and effective treatment, which can reduce the long-term expenses linked to complications of various diseases(4).
Note: LFPR means labour force participation rate. It is the percentage of the working-age population that is either employed or actively seeking employment.
Q1. What is the percentage of Indian male that suffer from cancer?
ANS: In Indian males Cancer incidence rate is about 95.6 per 100,000 cases(7).
Q2. What is the percentage of Indian male that suffer from thyroid disorders?
ANS: About 22.68% of Indian men are found to have thyroid disorders(9).
Q3. What is the percentage of Indian male that suffer from AIDS?
ANS: Approximately 0.24 out of every 100 adult males in India are estimated to be living with HIV(11).
Q4. What routine IVD laboratory test panel (profile tests per year) are suggested for male?
ANS:
- Complete hemogram and ESR
- Routine urine examination
- Routine feces examination
- Fasting and post-prandial blood sugar with HbA1C (glycosylated Hb)
- Kidney profile tests with serum uric acid
- Lipid profile tests
- Liver profile tests
- Serum total proteins, albumin and globulins
- Ultra sensitivity TSH
- Serum electrolytes (Sodium, potassium and chlorides
- Serum calcium and serum inorganic phosphorus
- Seum vitamin D3
- Serum Vitamin B12
- Blood NTproBNP
- Serum High sensitivity CRP.
NOTE:
These panel tests are useful to assess general health of a person. These tests give idea about the early detection of blood related diseases such as various types of anemia, thalassemia, leukemia, white blood cell and platelet disorders, the general functions of liver, kidneys, heart, thyroid, parathyroid hormones, electrolyte status, atherosclerotic status of blood vessels, levels of good and bad cholesterol and other lipids, levels of important vitamins, detection of early stage of an infectious disease and inflammatory status of the body.
Q5. What advanced IVD laboratory tests are included in the yearly complete body check-IVD laboratory test panel?
- Serum ultra sensitivity TSH
- Seum vitamin D3
- Serum Vitamin B12
- Serum high sensitivity CRP
- Blood NTproBNP
CASE STUDY 1
A 37 year-old-obese (weight: 86 kg and height: 5’9’’) executive of an organization undergone routine health check up. His Complete body profile laboratory test reports were as follows:
Complete hemogram: All normal values.
Routine urine examination: All normal values, except the following:
| TESTS | RESULTS | NORMAL VALUES |
| Fasting urine sugar | Present + | Absent |
Routine feces examination:
| TESTS | RESULTS | NORMAL VALUES |
| Occult blood | Present:Trace | Absent |
| Microscopic examination | Amoeba cysts: Occasional. Giardia cysts: Occasional |
Absent |
Significant values of Liver profile tests, Cardiac profile tests, Lipid profile tests, Thyroid panel tests, Electrolyte profile and other tests were as follows:
| TESTS | RESULTS | NORMAL VALUES |
| Blood sugar (Fasting) | 156 mg/dl | 70-110 mg/dl |
| HbA1C | 7.6 | Below 5.8 |
| Serum cholesterol | 288 mg/dl | Less than 200 mg/dl |
| LDL cholesterol | 165 mg/dl | Less than 100 mg/dl |
| SGPT | 110 IU | 5-35 IU |
| SGOT | 130 IU | 8-40 |
| High sensitivity CRP | 5.8 mg | Less than 1.0 mg/L |
| NTProBNP | 1300 pg/ml | Age below 70 years – Less than 125 pg/ml |
Evaluation of BMI and laboratory reports:
| TESTS | REPORT | INDICATION |
| BMI (Weight/Height in meters square) | 28 | Indication of Overweight |
| Urine sugar, Blood sugar and, HbA1C | High values | Type 2 Diabetes mellitus |
| Routine stool examination | Bacteria | Protozoal infection |
| Lipid profile test values indicate | Dyslipidemia | Risk of atherosclerosis |
| SGPT and SGOT with serum bilirubin | Increased SGPT and SGOT. Normal serum bilirubin | Progression to Fatty liver |
| NTProBNP | High values | Ventricular dysfunction. This value is useful to establish prognosis of heart failure. |
NOTE:
In Case study 1, laboratory Body profile tests were useful to diagnose the following early clinical conditions: Type 2 Diabetes mellitus, fatty liver, dyslipidemia, risk of atherosclerosis, indication of ventricular dysfunction and intestinal protozoal infection.
Q6. What is the percentage of Indian male that suffer from Type 2 diabetes mellitus?
ANS: Approximately 16.8% of Indian males aged 15 years and older have diabetes(5).
Q7. What is the percentage of Indian male that suffer from fatty liver?
ANS: Among adults, the estimated pooled prevalence of fatty liver is 38.6%(12).
CASE STUDY 2
A 67-year-old man with normal body mass index (BMI); experienced severe pain, in the right hypochondrium, shortness of breath, dizziness, irregular pulse rate and sweating during early morning yoga exercises. However, these symptoms disappeared after five minutes. Similar symptoms appeared and disappeared following lunch and dinner. Antiacids were used thinking history and episodes of hyperacidity, since pain was not retrosternal (as typically seen in heart disease). At 11.30 PM he was found unconscious lying on floor. He was brought to consciousness by CPR and upon admission to emergency ward; it was found out that his pulse rate was irregular and S-T elevation in ECG. 2D Echocardiogram, angiography and angioplasty were performed subsequently and his blood (Random) was sent for the following cardiac function tests:
| TESTS | RESULTS | NORMAL VALUES ( REFERENCE RANGE) |
| Serum CK (Total) | 415 IU | 38 – 174 IU |
| Serum CK-MB | 57 IU | 5 – 13 IU |
| SGOT | 310 IU | 5 – 40 IU |
| LDH | 280 IU | 70 – 240 IU |
| SHBD | 178 IU | 65 – 165 IU |
| Cardiac Total Troponin (cTnT) | Present | Absent |
| Blood glucose (Random) | 106 mg/dl | 70 – 170 mg/dl |
| Serum total cholesterol | 175 mg/dl | < 200 mg/dl |
Evaluation of the laboratory report
From the blood report of the patient, it appears that, high CK, CK-MB, SGOT, LDH and SHBD, with presence of serum cTnT, the patient suffered from severe myocardial Infarction on the day of blood collection. During the day also he suffered from two mild MI attacks (refer to case history).
NOTE:
(A) Early intervention with a cardiologist after the first mild heart attack could have prevented significant damage to the myocardium by severe MI.
(B) The nerves that transmit pain signals from the heart also innervate the upper chest and surrounding areas, including the right hypochondrium. When the heart experiences lack of oxygen during an MI, the pain can be felt in this areas as well, as the pain signals of the body could be misdirected. That was the reason, why pain in the right hypochondrium mislead the patient.
Clinical significance of Cardiac profile tests
The cardiac enzymes remain elevated, following MI as follows: (CK total and CK-MB: About 2hrs to 3 days), SGOT: About 4 hrs to 7 days), LHD (about 8 hrs to 15 days), SHBD (About 10 hrs to 21 days) and cTnT (Within 1 hr to 15 days). In the case of the patient in Case study 2, all the Cardiac profile enzymes were significantly elevated, indicating severe MI on the day patient was admitted in the emergency ward.
Q8. What is the percentage of Indian male that suffer from cardiovascular disorders (CVDs)?
ANS: CVDs increases with age, from 22% in the 45–54 age group to 38% in those aged 70 or above( 10).
Q9. What is the percentage of Indian male that suffer from stroke?
ANS: Stroke prevalence in Indian males is about 2.3%(6)
CASE STUDY 3
A 64-year-old man, a known chain-smoker, suffered from pain in the chest, recurrent episodes of cough, wheezing, and shortness of breath. Upon admission to an emergency ward, he was examined by the following tests: ECG, 2D Echocardiogram and angiography. The following laboratory tests were also advised:
| TESTS | RESULTS | NORMAL VALUES (REFERENCE RANGE) |
| Serum CK (Total) | 46 IU | 38 – 174 IU |
| Serum CK-MB | 5 IU | 5 – 13 IU |
| SGOT | 28 IU | 5 – 40 IU |
| LDH | 70 IU | 70 – 240 IU |
| SHBD | 75 IU | 65 – 165 IU |
| Cardiac Total Troponin (cTnT) | Absent | Absent |
| Blood glucose (Random) | 136 mg/dl | 70 – 170 mg/dl |
| Serum total cholesterol | 195 mg/dl | < 200 mg/dl |
Note: All the cardiac panel tests were normal. Similarly, ECG was normal and angiography did not reveal any significant coronary arterial blockages. Additionally, the following lung function tests were advised:
(A) Spirometry: This test is useful to measure the degree of narrowing of bronchial tubes.
(B) Methacholine challenge test: Methacholine is responsible to trigger asthma.
(C) A chest X-ray: To identify any structural abnormalities or diseases (such as infection) that could be a cause to aggravate breathing problems.
Interpretation:
Results of tests A, B, and C, indicated that the person was suffering from Chronic Obstructive Pulmonary Disease (COPD).
Note: Smoking exacerbates COPD. Hence, patient suffered from shortness of breath, chest pain, recurrent episodes of cough, and wheezing.
Q10. What is the percentage of Indian male that suffer from COPD?
ANS: The prevalence of COPD in Indian males is generally estimated to be between 3% and 8%(8) .
References
(1) Global action on Men’s health. Men’s Health Forum. https://www.menshealthforum.org.uk
(2) The Global Gender Gap Report 2013, World Economic Forum, Switzerland. Dijkstra; Hanmer (2000). “Measuring socio-economic gender inequality: Toward an alternative to the UNDP gender-related development index”. Feminist Economics. 6 (2): 41–75. doi:10.1080/13545700050076106. S2CID 154578195.
(3) Brunilda Nazario, MD. Six top health threats to men (September 09, 2008). Written by Matthew Hoffman, MD. From the WebMD Archives.
(4) Godkar PB, Godkar DP. Text book of Medical laboratory technology (4th edition, 2024), Bhlani Publishers, Mumbai. India.
(5) Sujata, Ramna Thakur. Unequal burden of equal risk factors of diabetes between different gender in India: a cross-sectional analysis. Sci Rep. 2021 Nov 22;11:22653. doi: 10.1038/s41598-021-02012-9.
(6) Jumi Kalita, Mrinmoy Pratim Bharadwaz & Aditi Aditi. Prevalence, contributing factors, and economic implications of strokes among older adults: a study of North-East India. Scientific Reports volume 13, Article number: 16880 (2023).
(7) Krishnan Sathishkumar 1, Meesha Chaturvedi 1, Priyanka Das 1, S Stephen 1, Prashant Mathur. Cancer incidence estimates for 2022 & projection for 2025: Result from National Cancer Registry Programme, India. Indian J Med Res. 2023 Mar 11;156(4-5):598–607. doi: 10.4103/ijmr.ijmr_1821_22
(8) Arvind B. Bhome. COPD in India: Iceberg or volcano? Pulmonary Critical Care Sleep Medicine, B.V. Medical College, Pune 411043, India
(9) Bisma Jan, Mohammad Imran Dar, Bharti Choudhary, Parakh Basist, Rahmuddin Khan, Abdulsalam Alhalmi. Cardiovascular Diseases Among Indian Older Adults: A Comprehensive Review. First published: 25 June 2024 https://doi.org/10.1155/2024/6894693
(10) Global HIV & AIDS statistics—Fact sheet UNAIDS. Accessed 4 December 2021.
(11) Shalimar, Anshuman Elhence, Bhavik Bansal, Hardik Gupta, Abhinav Anand, Thakur P Singh, Amit Goel. Prevalence of Non-alcoholic Fatty Liver Disease in India: A Systematic Review and Meta-analysis. J Clin Exp Hepatol. 2021 Nov 25;12(3):818–829. doi: 10.1016/j.jceh.2021.11.010
(12) Kalra Sanjay, Unnikrishnan Ambika Gopalakrishnan, Sahay Rakesh. The global burden of thyroid disease. Thyroid Research and Practice 10(3):p 89-90, Sep–Dec 2013. | DOI: 10.4103/0973-0354.116129.
