BACKGROUND: Penile size is a topic of significant interest among men and healthcare professionals. However, data on adult male penile dimensions in China are scarce, hindering clinical counseling and research. This study aimed to establish normative data for Chinese penile size and compare it with a global reference population.
METHODS: We conducted a meta-analysis of published studies on penile size, focusing on Chinese and international data. Studies from East and Southeast Asia were excluded to minimize regional confounding factors. The analysis included 23 Chinese studies encompassing 34,060 men aged 16-57 years, and 19 international studies encompassing 15,216 men aged 16-91 years. Penile length and circumference were assessed in both flaccid and erect states.
RESULTS: This study established the first nomogram and percentile distribution chart for adult male penile size in China. The mean flaccid length was 7.42 cm (standard deviation [SD] ± 0.95 cm), and the mean flaccid circumference was 8.54 cm (SD ± 0.62 cm). The mean erect length was 12.42 cm (SD ± 1.63 cm), and the mean erect circumference was 10.75 cm (SD ± 1.34 cm). Compared with the global reference population (flaccid length: 9.09 cm ± 1.51 cm, flaccid circumference: 9.12 cm ± 0.93 cm; p < 0.05 for both), Chinese men exhibited statistically significant shorter flaccid lengths and circumferences. No significant differences were observed in erect length or circumference between Chinese men and the global reference population (p > 0.05 for both). Notably, the growth coefficient during erection (defined as the percentage increase from flaccid length to erect length) was significantly higher in Chinese men (67.39%) compared with the global average (43.45%; p < 0.05), supporting the hypothesis of a proportionally greater increase in shorter penises.
CONCLUSIONS: This study provides novel and comprehensive data on penile size in Chinese men. Compared with a global reference population, Chinese men exhibited shorter flaccid penises but a higher proportional increase upon erection. These findings may be of value for clinical counseling and future research on penile size variations. The newly developed nomogram and percentile chart can serve as a valuable tool for both patients and healthcare professionals.

UNASSIGNED: Benign prostatic hyperplasia (BPH) is a frequent illness in aged men that impacts their quality of life; early childhood exposure to famines may have long-term effects on the chance of developing BPH. The aim of this study is to investigate the relationship between early-life famine exposure and benign prostatic hyperplasia (BPH) risk in Chinese men born during 1959-1961.
UNASSIGNED: We used medical records from a large, comprehensive hospital to screen people born in China during the years of famine (1959-1961). Birthplaces were identified as indicators of famine exposure status. In the time window between 2017 and 2022, people born during the famine years who had prostatic ultrasonic examinations were selected, and their medical records were retrieved from the database. Univariate and multivariate logistic regression analyses investigated the relationship between famine exposure and BPH risk.
UNASSIGNED: A total of 3,009 subjects were included in this study. Patients with heavy famine exposure had older age, shorter height, lighter weight, lower cholesterol, lower uric acid (UA), lower aspartate aminotransferase (ALT), and a higher incidence of BPH than those with light famine exposure (all p < 0.05). Univariate logistic regression showed that BPH was positively related to famine exposure, age, height, weight, and body mass index (BMI) but negatively related to UA (all p < 0.05). Multivariate logistic regression showed that age and famine exposure were still independent risk factors (p < 0.05), while UA was an independent protective factor for BPH (p < 0.05). Heavy famine exposure increased the risk of BPH (adjusted OR = 1.214, 95% CI = 1.05-1.467, p = 0.045).
UNASSIGNED: Famine and malnutrition exposure during early life may be independent risk factors for BPH in Chinese adults. This relationship provides additional evidence to support the fetal origins of adult diseases and offers clues for the pathological mechanisms of BPH.

For older Caucasian women and men, the QCT (quantitative CT) lumbar spine (LS) bone mineral density (BMD) threshold for classifying osteoporosis is 80 mg/ml. It was recently proposed that, for older East Asian women, the QCT LS BMD value equivalent to the Caucasian women\'s threshold of 80 mg/mL is about 45∼50 mg/ml. For a data of 328 cases of Chinese men (age: 73.6 ± 4.4 years) who had QCT LS BMD and DXA LS BMD at the same time and with the DXA BMD value of ≤ 0.613 g/cm2 to classify osteoporosis, the corresponding QCT LS BMD threshold is 53 mg/ml. Osteoporotic-like vertebral fracture sum score (OLVFss) ≤ -2.5 has been proposed to diagnose osteoporosis. For 316 cases of Chinese men (age:73.7±4.5 years), OLVFss ≤ -2.5 defines an osteoporosis prevalence of 4.4%; to achieve this osteoporosis prevalence, the corresponding QCT LS BMD value is < 47.5 mg/ml. In the China Action on Spine and Hip Status study, a Genant grades 2/3 radiographic \'osteoporotic vertebral fracture\' prevalence was 2.84% for Chinese men (total n = 1267, age: 62.77 ± 9.20 years); to achieve this osteoporosis prevalence, the corresponding BMD value was < 42.5 mg/ml. In a study of 357 Beijing older men, according to the clinical fragility fracture prevalence and femoral neck DXA T-score, the QCT LS BMD value to classify osteoporosis was between 39.45 mg/ml and 51.38 mg/ml. For older Chinese men (≥ 50 years), we recommend the cutpoint for the QCT LS BMD definition of osteoporosis to be 45∼50 mg/ml which is the same as the value for Chinese women.

Exposure to ambient fine particulate matter (PM2.5) was associated with decreased semen quality, but the relationship between PM2.5 constituents and semen quality was unclear. We recruited 27,824 adult men attending an infertility clinic in Wuhan, China, between 2014 and 2020. We used a four-dimensional spatiotemporal deep forest model to estimate concentrations of PM2.5 mass and its chemical constituents, including organic matter (OM), black carbon (BC), sulfate (SO42-), nitrate (NO3-), ammonium (NH4+), and chloride (Cl-). We employed linear regression models to estimate the association between PM2.5 mass and its constituents with various sperm parameters. Exposure to PM2.5 was associated with a reduction in sperm quality, with a percent change of - 5.69% (95% confidence interval [CI]: -8.53%, -2.85%) for sperm density, - 15.09% (95% CI: -22.24%, -7.94%) for sperm total count, - 1.63% (95% CI: -2.36%, -0.91%) for sperm progressive motility, and - 2.30% (95% CI: -3.04%, -1.55%) for sperm total motility. Among specific constituents, exposure to OM, BC, Cl-, or NO3- was associated with a reduction in these four semen quality parameters. The association was more pronounced among older men or individuals with lower levels of education. Our findings suggest that PM2.5 mass and each constituent were associated with decreased semen quality in adult men.

Despite increasing research on weight teasing and other forms of appearance teasing, muscularity teasing, which occurs when an individual is victimized due to low muscularity, has not yet received research attention. Given the solid evidence of positive relations between weight teasing and thinness-oriented body dissatisfaction and disordered eating, we aimed to tap into muscularity teasing and examine its relations with muscularity-oriented body dissatisfaction and muscularity-oriented disordered eating (e.g., rigid dietary rules for enhancing muscularity). A sample of 500 Chinese men, aged 18 - 62 years, were recruited online, and they competed questionnaires assessing muscularity teasing, muscularity bias internalization, muscularity-oriented body dissatisfaction, and muscularity-oriented disordered eating. Correlation analyses showed that muscularity teasing was significantly related to muscularity bias internalization (r = 0.55, p < .001), muscularity-oriented body dissatisfaction (r = 0.50, p < .001), and muscularity-oriented disordered eating (r = 0.38, p < .001). Structural equation modelling indicated that muscularity bias internalization and muscularity-oriented body dissatisfaction, as concurrent mediators, fully mediated the relationships between muscularity teasing and muscularity-oriented disordered eating. Findings extend existing knowledge in appearance teasing research to encompass muscularity teasing in order to better understand the etiology of muscularity-oriented body dissatisfaction and muscularity-oriented disordered eating.

Exposure to ambient fine and respirable particulate matter is associated with poor sperm quality, but evidence for particulate matter with an aerodynamic diameter ≤ 1 μm (PM1) is scarce. We aimed to estimate the association between PM1 exposure and sperm concentration, sperm count, sperm total motility, and sperm progressive motility in Chinese men.
We conducted a cross-sectional study of 33,221 men attending an infertility clinic in Hubei, China, between 2014 and 2020. Daily concentrations of PM1 data were estimated from a validated spatiotemporal artificial intelligence model. We used multivariate linear regression to estimate the association between PM1 exposure and sperm parameters during the spermatogenesis period after adjusting for age, body mass index (BMI), education, ever having fathered a child, and season of semen collection. In addition, we performed stratified analysis to assess whether the association was varied by age, BMI, and educational attainment.
A total of 27,854 participants were included in the final analysis. An interquartile range (17.2 μg/m3) increase in PM1 during the entire period of semen development was associated with declined semen concentration [-4.39% (95% CI: -7.67%, -1.12%)] and sperm count [-23.56% (95% CI: -28.95%, -18.18%)], reduced total motility [-0.86% (95% CI: -1.66%, -0.06%)] and progressive motility [-2.22% (95% CI: -3.00%, -1.43%)]. The associations were homogeneous across subgroups defined by age and education, but were more pronounced among men with underweight for sperm concentration and sperm count. We identified a critical exposure window of 0-9 lag days, 10-14 lag days, and 70-90 lag days before semen collection for sperm count and progressive motility.
Among men attending an infertility clinic in China, exposure to PM1 was associated with poor semen quality, especially during the 70-90 days before ejaculation. These results suggest that exposure to PM1 might be a novel risk factor for impaired semen quality.

OBJECTIVE: To determine the respective weights of certain facial signs on the assessment of perceived age, tired-look and healthy glow on Chinese men of different ages.
METHODS: Photographs were taken of the faces of 420 Chinese men of different ages, under standardized conditions. These photographs allowed to focus and define 15 facial signs, which were then graded by 15 experts and dermatologists, using standardized scales provided by a reference Skin Aging Atlas. The facial signs were dispatched into 5 clusters, namely wrinkles/texture, ptosis/sagging, pigmentation disorders, vascular disorders and cheek skin pores. A naïve panel, composed of 80 Chinese women, of similar age range were asked, when viewing full-face photographs, to: (i) attribute on a 0-10 scale their perception of both the tired-look and healthy glow aspects and (ii) estimate the age of the subject.
RESULTS: With the exception of vascular disorders, the severity of all 4 clusters increased with age, although at different rates. The ptosis/sagging or pigmentation disorders showed a rather regular progression. Although perceived ages and real ages were found to be closely correlated, the vast majority of subjects were judged older by 2-10 years. The changes in facial signs (and their related clusters) were significantly correlated with perceived age, with the exceptions of skin spot density and cheek skin pores. Although the aspects of tired-look and healthy glow were logically found to be anti-correlated, tired-look was more statistically associated with perceived age for the five clusters. Signs of eye contour appear to be closely correlated with the perception of a tired-look.
CONCLUSIONS: Within facial clinical clusters, wrinkles/texture and ptosis/sagging are major factors in the assessment of perceived age in Chinese men. Tired-look appears to be strongly associated with perceived age.
UNASSIGNED: De déterminer, pour des hommes chinois d’âges différents, les poids respectifs de certains signes faciaux entrant dans l’estimation de la perception des visages pour l’âge, l’air fatigué ou l’éclat. MATÉRIEL ET MÉTHODES: Les visages de 420 hommes chinois d’âges différents ont été photographiés dans des conditions standardisées. Ces clichés ont permis à 15 experts et dermatologistes d’évaluer 15 signes cliniques selon des échelles éditées dans les références Atlas Cliniques du Vieillissement. Ces signes faciaux sont regroupés dans 5 groupes (rides/texture, ptose/relâchement, désordres pigmentaires, désordres vasculaires, pores de la joue). Un panel de 80 consommatrices chinoises, d’un âge comparable, a été recruté pour donner leurs perceptions sur chaque visage complet photographié: d’abord en attribuant sur une échelle de 0 à 10 un score pour leurs perceptions de l’air fatigué et de l’aspect éclatant de santé, puis en estimant l’âge apparent du volontaire. RÉSULTATS: A l’exception des Désordres vasculaires, la sévérité des 4 groupes cliniques s’accroit avec l’âge selon des cinétiques différentes, parmi lesquelles la ptose/relâchement ou les désordres pigmentaires montrent la progression la plus constante et linéaire. Malgré une très importante et significative corrélation entre âge apparent et âge réel, une majorité des volontaires ont été jugés plus vieux que leurs âges réels, entre 2 et 10 ans. Les variations des signes faciaux (ou des groupes cliniques associés) ont été montrés significativement corrélées à l’âge apparent, à l’exception de la densité des taches pigmentaires et des pores de la joue. Bien que l’air fatigué et l’éclat sont logiquement observés comme anti-corrélés, c’est l’air fatigué qui se trouve le plus relié à l’âge apparent sur les 5 groupes cliniques. Les signes du contour des yeux apparaissent comme les plus corrélés à la perception de l’air fatigué.
CONCLUSIONS: Parmi les groupes cliniques, les rides/texture et la ptose/relâchement sont les facteurs majeurs dans l’attribution d’un âge perçu pour les hommes chinois. L’air fatigué apparaît comme très fortement relié à l’âge apparent.

BACKGROUND: Dyslipidaemia and male sex are associated with gallbladder polyp (GBP) formation. However, the potential relation between the non-high-density lipoprotein-cholesterol-to-high-density lipoprotein-cholesterol (non-HDL-c/HDL-c) ratio and GBPs in men is unclear.
METHODS: A total of 1866 eligible subjects were selected for this retrospective cohort study from Wuhan Union Hospital between April 1, 2013, and November 30, 2014. Clinical and laboratory data of subjects were collected. Patients with GBPs or cholecystectomy at baseline, with missing data for baseline lipid profiles, following abdominal ultrasonography or taking lipid-lowering drugs were excluded. The patients were divided into five groups based on their non-HDL-c/HDL-c ratios, and descriptive analyses of the baseline data were performed. A Cox proportional hazards model was applied to estimate the relationship between the non-HDL-c/HDL-c ratio and GBPs.
RESULTS: After a median follow-up of 1 year, 7.34% (n = 137) of the subjects developed GBPs. Compared with subjects without GBPs, those who developed GBPs after follow-up had significantly higher triglyceride (TG) levels and non-HDL-c/HDL-c ratios. The prevalence of GBPs showed a linearity increment with age, peaked in the 30-39 years group, 40-49 years group and 50-59 years group, and then declined slightly. The results of univariate analysis showed that the non-HDL-c/HDL-c ratio (hazard ratio (HR) = 1.29, 95% confidence interval (CI), 1.05-1.60, P = 0.0159) was positively correlated with GBPs. In the fully adjusted Cox regression model, the HRs were 2.24 for quintile 2 (95% CI: 1.13-4.44, P = 0.0203), 1.50 for quintile 3 (95% CI: 0.73-3.10, P = 0.269), 2.52 for quintile 4 (95% CI: 1.26-5.01, P = 0.0087) and 2.13 for quintile 5 (95% CI: 1.04-4.37, P = 0.0397). No interaction was found among the subgroups.
CONCLUSIONS: A higher non-HDL-c/HDL-c ratio is independently related to a higher risk of GBP formation in Chinese men. Further research is needed to investigate whether this association exists in different regions and races.

BACKGROUND: Obesity has become an epidemic in China with its increased prevalence, especially in the male population. Disparities in fat distribution rather than increasing body mass index (BMI) confer the risk of different diseases, including cardiac abnormalities. Therefore, early detection of cardiac abnormalities is important for treatment to reverse the progression to heart failure. Nowadays, strain analysis based on cardiac magnetic resonance (CMR) imaging has been established to assess myocardial function in diverse cardiac diseases. We aimed to assess the relationship between fat distribution and subclinical diastolic dysfunction in obese Chinese men assessed by deformation registration algorithm (DRA)-based myocardial strain rate (SR) analysis.
METHODS: A total of 115 male participants with different BMI underwent CMR scanning using a 1.5T MAGNETOM Aera (Siemens Healthcare, Erlangen, Germany) and computed tomography (CT) scan. All the participants were enrolled from September 2017 to April 2018. They were classified into 3 groups according to their BMIs with 23 and 27.5 kg/m2 being the cutoff values. A Trufi-Strain prototype software (version 2.0, Siemens Healthcare, Erlangen, Germany) was used to quantify SR in both early and late diastole from CMR cine images. Ratios of early and late SRs were calculated. Areas of epicardial and pericardial adipose tissue (EAT and PAT) were measured on a single 4-chamber-view slice of cine images. Volumes of visceral and subcutaneous adipose tissue (VAT and SAT) were acquired semi-automatically from CT images using the dedicated software Cardiac Risk2.0 (Siemens Healthcare). Waist and hip circumferences were manually measured (WC and HC). Analysis of variance or nonparametric tests, along with correlation and stepwise multivariate regression analysis models, was applied for statistical analysis.
RESULTS: Peak late diastolic SRs were higher in obese men compared with their lean counterparts [-36.25±10.46 vs. -29.46±8.17, 66.97±18.58 vs. 45.62 (42.44, 55.96), and 56.81±15.07 vs. 41.40±6.41 for radial, circumferential, and longitudinal SRs, respectively; P<0.05]. All SR ratios in the obese subgroups were lower than those of lean men (3.12±1.14 vs. 4.63±1.24, 2.12±0.58 vs. 2.96±0.62 and 1.63±0.50 vs. 2.20±0.63 for radial, circumferential, and longitudinal directions, respectively; P<0.05). EAT was a significant predictor of diastolic function assessed by radial and circumferential SR ratios (β=-0.439 and -0.337 respectively; all P<0.001), while VAT was a significant predictor of circumferential and longitudinal SR ratios (β=-0.216 and -0.355, respectively, P<0.05).
CONCLUSIONS: Decreased LV diastolic function assessed by DRA-based SR analysis in obesity is associated with fat distribution. Furthermore, EAT and VAT might be better predictors of a decrease of diastolic function in obese Chinese men than BMI.

OBJECTIVE: To investigate the optimal age for the baseline serum prostate-specific antigen (PSA) test and for repeat screening and its economic burden in a single center in China.
METHODS: 35,533 men with PSA screening were retrospectively enrolled in this study. Follow-ups were conducted in 1,586 men with PSA >4 ng/mL, and receiver-operating characteristic (ROC) curves were employed to investigate the optimal cutoffs.
RESULTS: ROC analysis indicated that the optimal age for initial PSA screening was 57.5 years (AUC = 0.84), 62.5 years (AUC = 0.902), 60.5 years (AUC = 0.909), and 61.5 years (AUC = 0.890) for individuals with PSA >4 and >10 ng/mL, a diagnosis of prostate cancer (PCa), and clinically significant PCa defined as the focus events, respectively. For Chinese men aged 50-59, 60-69, and >70 years, the initial PSA levels of 1.305 ng/mL (AUC = 0.699), 1.975 ng/mL (AUC = 0.711), and 2.740 ng/mL (AUC = 0.720) might have a PSA velocity >0.75 ng/mL per year during the follow-up. In addition, the total cost amounts to CNY 13,609,260 in these cases, but only 60 of the 35,533 (0.17%) men gained benefit from PSA screening.
CONCLUSIONS: In our opinion, the optimal starting age for initial PSA testing was 57.5 years. The necessity for repeat screening should be based on the first PSA level depending on age. A cost--benefit analysis should be included in population-based screening.